Effects of Benesco™ on Esophageal Sensitivity, Mucosal Barrier Function, and Reflux Symptoms: A Mechanistic Study

Introduction: Gastroesophageal reflux disease (GERD) is one of the most prevalent gastrointestinal diseases in the western world. Proton pump inhibitors (PPIs) are the cornerstone of GERD management however a subset of patients seeks for (natural) alternative therapies. Benesco™ is an over-the-counter supplement, of which the active ingredient is quercetin and has a presumed positive effect on esophageal barrier function. The aim of this study was therefore to evaluate the effect of benesco™ on esophageal sensitivity, mucosal barrier function, and reflux symptoms. Methods: Patients with GERD were evaluated using acid perfusion tests, an upper endoscopy with electrical tissue impedance spectroscopy, and esophageal biopsies. Results: 8 patients (3 men, median age 45 (34–64)) were included. The perfusion sensitivity score (PSS) did not change significantly after treatment with benesco™ (90.5 (21.4–129.7) to 62.5 (16.4–96.9) p = 0.123). Esophageal sensitivity based on the maximum reported VAS score during the esophageal acid perfusion test did not change significantly after treatment with benesco™ (7.4 (5.3–9.8) to 7.7 (5.3–8.7) p = 0.482). Furthermore, no effects were seen on measures of mucosal barrier function such as extracellular in vivo impedance (ETIS) (6807 (5153–8883) Ω·m vs 6702 (5106–7847) Ω·m, p = 0.575), in vitro transepithelial electrical resistance (TEER) (183 (153–204) Ω.cm2 vs 201 (128–250) Ω.cm2, p = 1.000), or fluorescein flux (896 (73–1922) nmol/cm2/h vs 811 (187–2693) nmol/cm2/h, p = 0.237). Conclusion: We did not observe an improvement of acid perception, mucosal barrier function, or reflux symptoms by benesco™ in this study. Trial registration: Dutch Trial Register number: NL9324