Mirgeal® Gel as Add-on Therapy to Esomeprazole in Adults With Non-Erosive Gastroesophageal Reflux Disease

This is a prospective, multicenter, randomized, controlled clinical trial designed toevaluate the safety and clinical efficacy of Mirgeal® Gel as an add‐on to proton pumpinhibitor therapy in adult patients with non‐erosive gastroesophageal reflux disease(NERD). The study is designed to evaluate the superiority in clinical efficacy of thecombination of esomeprazole plus Mirgeal® Gel compared with esomeprazole alone.Mirgeal® Gel (manufacturer: PharmExtracta S.p.A.) is a dietary supplement in stick formcontaining sodium alginate and standardized derivatives of Glycyrrhiza glabra andVaccinium myrtillus. Participants will be randomly allocated in a 1:1 ratio to one of twotreatment groups. The intervention group will receive esomeprazole 20 mg/day plusMirgeal® Gel at a dose of 2 sticks per day, with 1 stick taken after lunch and 1 stickafter dinner. The control group will receive esomeprazole 20 mg/day alone. Treatment willcontinue for 4 continuous weeks.Treatment will begin following the baseline assessment. Clinical visits will be conductedat baseline and after 2 and 4 weeks of treatment. Participants will be monitoredthroughout the study for clinical outcomes, safety and treatment adherence. The totalduration of participation for each subject will be 4 weeks, with no post‐treatmentfollow‐up period.