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Insight into the Role of Melatonin in the Prevention of Gastritis and Gastroesophageal Reflux

As discussed in the previous article, the management of gastritis and gastro-oesophageal reflux is a common challenge in the sphere of gastrointestinal diseases. We examined the origins, symptoms, and different therapeutic approaches, also focusing on natural remedies such as bicarbonate, alginate, and chamomile.

Today, we will explore in more detail a key element we have already referred to and which deserves further investigation: melatonin.

Although melatonin is universally known for its role in sleep regulation, its beneficial properties extend far beyond the domain of night rest. Recently, research has brought to light the positive influence melatonin can have on the gastrointestinal system, offering new perspectives in the prevention and management of disorders such as gastritis and gastroesophageal reflux.

As mentioned in the previous article, several mechanisms seem to justify the protective role of melatonin in the gastric context. First, it acts as a powerful antioxidant, counteracting oxidative stress and reducing inflammation in the gastric mucosa.
Furthermore, it has the ability to modulate the release of gastric acid, prostaglandins, mucus and bicarbonate while maintaining ratios that are useful for digestion but do not damage the mucosa.

In the case of gastro-oesophageal reflux, melatonin, by inducing the release of gastrin, may help protect the oesophagus from excessive acidity, improving the function of the lower oesophageal sphincter (LES) and reducing the release of gastric acid. These combined effects make melatonin a promising candidate in preventing reflux episodes and managing associated oesophageal inflammation.

Finally, being able to modulate gastric mucosal repair and regeneration, melatonin is able to facilitate the healing process of gastric injuries and ulcers.

In the field of gastrointestinal disorders, there are numerous studies done on cellular or animal models demonstrating these different activities of melatonin but, in this context, we would like to illustrate a clinical study performed on reflux patients.

Comparison of Melatonin and Omeprazole for Reflux Patients

In this study [x], the efficacy of omeprazole, i.e. an active ingredient commonly used in drugs for the treatment of gastritis and reflux, and melatonin in the management of patients with reflux was compared.

Method of analysis: 36 patients were selected and divided into 4 groups of 9 people each:

Control group (C): consisting of healthy, non-reflux patients whose parameters were used as a comparison

Melatonin group (M): reflux patients who were treated for 8 weeks with melatonin (3 mg daily)

Omeprazole group (O): patients with reflux who were treated for 8 weeks with omeprazole (20 mg – twice daily)

Omeprazole and melatonin group (O+M): reflux patients who were treated with O + M (3 mg melatonin, 20 mg omeprazole – 2 times daily).

The control group, i.e. of healthy subjects, was used to evaluate the efficacy of melatonin, omeprazole and the combination of these two over time, specifically over 4 and 8 weeks, in the reflux patient group.

Overall, it was found that melatonin had the ability to modulate reflux and patients’ perceived symptoms, similarly if not better than omeprazole alone.

In particular, melatonin showed remarkable efficacy in regulating the activity of the lower oesophageal sphincter (LES), that fundamental structure separating the oesophagus and stomach.

In the graph in figure 1, we can observe different parameters related to SLE: SLE pressure and residual pressure indicate the contractile capacity of the SLE; pH indicates acidic conditions 5 cm above the SLE itself.

The “control” columns represent the group of healthy patients, these values are then used as a comparison for the other groups.

The ‘pre-treatment’ columns indicate the condition of patients with reflux before starting therapy with melatonin, omeprazole or the combination of the two.

The columns ‘8 weeks’ indicate the condition following the different treatments for 8 weeks.

As can be seen, the melatonin-treated group all had similar values to the control group at the end of 8 weeks. This is not the case for the omeprazole-treated group as this molecule only has the ability to act on pH, as can be seen from the graph, but has no effect on SLE and its activity.

Melatonin’s ability to positively modulate SLE activity is one of the effects seen above and is crucial to better manage reflux and its symptoms.

The group treated with melatonin and omeprazole, not shown in the figure, had a marked improvement in all parameters. This may be due to the combined effects of omeprazole and melatonin.

We can therefore say that melatonin, due to its global regulation of the gastrointestinal tract, has the ability to positively modulate various functions, reducing reflux and associated symptoms. These broad-spectrum activities make it a real solution for patients suffering from conditions that alter the functioning of the gastrointestinal tract.

This study also showed that melatonin could be used as a monotherapy, and thus as the only therapeutic solution, or as a combination together with commonly used therapies.

In conclusion, while melatonin has established its reputation in regulating sleep, it is crucial to recognise its multifunctional role, particularly in the gastrointestinal context. Present and future studies could help further delineate the efficacy of melatonin as a preventive and complementary agent in the management of gastritis and gastro-oesophageal reflux. A holistic approach, integrating melatonin with other treatment strategies, could offer a new front in the fight against these digestive disorders, improving the quality of life for those affected.

Remember that a correct diagnosis of one’s condition by a health professional remains essential, so that one can be directed towards the best therapeutic strategy.

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