Feasibility of Transitioning Adults with Mild-to-Moderate Reflux from Proton Pump Inhibitors to a Patented Papaya–Oat Food Supplement: A Single-Arm Pilot Study

Background: Proton pump inhibitors (PPIs) serve as efficacious therapies for acid-related conditions; nonetheless, the possibility of unwarranted prolonged usage has led to heightened focus on PPI management and suitable deprescribing practices. Investigating supportive non-pharmacological approaches after the cessation of PPIs is necessary. Objective: This single-arm pilot study evaluated the feasibility and acceptability of a structured transition from proton pump inhibitor (PPI) therapy to papaya–oat food supplementation with Caricol®-Gastro in adults with mild-to-moderate reflux/heartburn. Changes in patient-reported symptoms during supplementation were assessed as exploratory clinical outcomes. Adults with mild-to-moderate reflux/heartburn underwent a protocol-defined PPI treatment phase, followed by PPI discontinuation and five weeks of Caricol®-Gastro supplementation. Symptoms reported by patients were evaluated utilizing a tailored 15-item questionnaire right prior to supplementation and at Week 5. Feasibility results encompassed research finalization, compliance, fulfillment of the protocol-specified transition, and the necessity for symptom-associated PPI reinstatement. A 14-day observation period without products following the intervention evaluated the short-term incidence of symptoms after the cessation of supplementation. Results: All 39 persons who enrolled finished the trial. The average compliance with supplementation was 93.2%, and no participant ceased using Caricol®-Gastro due to exacerbation or recurrence of reflux/heartburn symptoms, nor did any require the reinitiation of protocol-allowed PPIs during the supplementation period. The average overall symptom score diminished from 37.38 (SD 2.88) before supplementation to 24.85 (SD 4.84) by Week 5, reflecting a mean within-participant alteration of −12.54 points (95% CI: −13.54 to −11.53; p < 0.001). Throughout the 14-day observation period following the intervention without product use, 11 subjects (28.2%) exhibited no symptoms, while 28 (71.8%) experienced symptoms on at most two occasions. Conclusions: The results support the feasibility and acceptability of the protocol-defined transition from PPI therapy to papaya–oat supplementation in this selected population. The noted decreases in symptoms within participants are preliminary and, due to the lack of a controlled design, cannot be causally linked to Caricol®-Gastro. These results advocate for additional assessment of the supplementation as a possible supporting approach after the clinically suitable cessation of PPIs in a sufficiently powered randomized controlled trial employing a validated patient-reported primary outcome.

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Publication Details

Journal
Gastrointestinal Disorders
Published
2026-09-10
DOI
https://doi.org/10.3390/gidisord8030055
Primary Topic
Gastroesophageal reflux and treatments
Type
article
Field-Weighted Citation Impact
0.00
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article

Feasibility of Transitioning Adults with Mild-to-Moderate Reflux from Proton Pump Inhibitors to a Patented Papaya–Oat Food Supplement: A Single-Arm Pilot Study

Stanislav Gueorguiev, V. Koynarski, Svetoslav Stoev, Hristina Viktorova Lebanova et al.
Gastrointestinal Disorders
Gastroesophageal reflux and treatments
article

Feasibility of Transitioning Adults with Mild-to-Moderate Reflux from Proton Pump Inhibitors to a Patented Papaya–Oat Food Supplement: A Single-Arm Pilot Study

Stanislav Gueorguiev, V. Koynarski, Svetoslav Stoev, Hristina Viktorova Lebanova, Vesselina Evtimova Yanachkova, Elina Petkova-Gueorguieva
article en

Abstract

Background: Proton pump inhibitors (PPIs) serve as efficacious therapies for acid-related conditions; nonetheless, the possibility of unwarranted prolonged usage has led to heightened focus on PPI management and suitable deprescribing practices. Investigating supportive non-pharmacological approaches after the cessation of PPIs is necessary. Objective: This single-arm pilot study evaluated the feasibility and acceptability of a structured transition from proton pump inhibitor (PPI) therapy to papaya–oat food supplementation with Caricol®-Gastro in adults with mild-to-moderate reflux/heartburn. Changes in patient-reported symptoms during supplementation were assessed as exploratory clinical outcomes. Adults with mild-to-moderate reflux/heartburn underwent a protocol-defined PPI treatment phase, followed by PPI discontinuation and five weeks of Caricol®-Gastro supplementation. Symptoms reported by patients were evaluated utilizing a tailored 15-item questionnaire right prior to supplementation and at Week 5. Feasibility results encompassed research finalization, compliance, fulfillment of the protocol-specified transition, and the necessity for symptom-associated PPI reinstatement. A 14-day observation period without products following the intervention evaluated the short-term incidence of symptoms after the cessation of supplementation. Results: All 39 persons who enrolled finished the trial. The average compliance with supplementation was 93.2%, and no participant ceased using Caricol®-Gastro due to exacerbation or recurrence of reflux/heartburn symptoms, nor did any require the reinitiation of protocol-allowed PPIs during the supplementation period. The average overall symptom score diminished from 37.38 (SD 2.88) before supplementation to 24.85 (SD 4.84) by Week 5, reflecting a mean within-participant alteration of −12.54 points (95% CI: −13.54 to −11.53; p < 0.001). Throughout the 14-day observation period following the intervention without product use, 11 subjects (28.2%) exhibited no symptoms, while 28 (71.8%) experienced symptoms on at most two occasions. Conclusions: The results support the feasibility and acceptability of the protocol-defined transition from PPI therapy to papaya–oat supplementation in this selected population. The noted decreases in symptoms within participants are preliminary and, due to the lack of a controlled design, cannot be causally linked to Caricol®-Gastro. These results advocate for additional assessment of the supplementation as a possible supporting approach after the clinically suitable cessation of PPIs in a sufficiently powered randomized controlled trial employing a validated patient-reported primary outcome.

Gastrointestinal DisordersVol. 8(3)
Medical University Plovdiv (BG), Medical University of Sofia (BG), National Institute of Emergency Medicine "Pirogov" (BG), Dr. Shterev Hospital (BG), Medical University Pleven (BG)
Zero hunger
Openalex Percentile: Top 9%
Gastroesophageal reflux and treatments
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