P1230 - Lifestyle Medicine Interventions Successfully Reduce Typical Symptoms of GERD in a World Trade Center First Responder Cohort

Michael S.. Smith, MD, MBA¹, Emily Senay, MD, MPH¹, John Meyer, MD, MPH², Elizabeth Garland, MD, MS¹, Maya Korin, PhD³, Ari Grinspan, MD^1
1Icahn School of Medicine at Mount Sinai, New York, NY; ²Mount Sinai Hospital, New York, NY; ³Icahn School of Medicine at Mount Sinai, New York, CT

Introduction: Gastroesophageal Reflux Disease (GERD) is the second most commonly diagnosed medical condition in responders to the World Trade Center (WTC) attack on 9/11/2001. While dietary and lifestyle modifications are recommended as first line GERD therapy, few clinicians have the time or training necessary to utilize them. Lifestyle Medicine (LM) combines health coaching, behavioral change, and motivational interviewing to apply evidence-based prescriptive lifestyle change to treat chronic health conditions. The aim of this study was to assess the efficacy of LM interventions for GERD in a WTC patient cohort.

Methods: In 2023, participation in a prospective interventional study was offered to all WTC cohort patients previously diagnosed with GERD who expressed interest in LM to manage their disease. Upon enrollment, patients completed surveys including the GERD Health-Related Quality of Life (HRQL). Patients then have a total of 7 visits with an LM-certified physician over 6 months, with training in GERD-specific interventions and LM techniques patients identified as confident they could achieve. At each subsequent monthly visit, GERD-HRQL was repeated and further LM coaching was provided.

Results: To date, a total of 24 patients have enrolled in the LM program; 67% are male, with a mean age of 59.6 years (Table 1). Eleven patients have attended at least 5 LM visits. Initial GERD-HRQL total scores at the first visit for these patients averaged 24.5, with a higher score for women (28.8 v 22.0, Figure 1). By the fifth visit, total scores demonstrated a significant decrease to a mean GERD-HRQL score of 12.4 (p=0.025). The gender gap closed by this visit, with a mean score of 11.9 for men and 13.3 for women. Individual symptom scores also demonstrated nearly statistically significant improvement during this time, with mean heartburn score decreasing from 11.2 at visit 1 to 6.5 at visit 5 (p=0.056), and mean regurgitation score decreasing from 10.1 to 5.0 (p=0.050).

Discussion: These initial study results demonstrate that LM interventions can significantly decrease typical GERD symptoms in less than 6 months. Our pilot cohort suggests a gender gap in GERD-HRQL scores which widens as men appear to respond earlier to these interventions, then narrows with time. As the study proceeds and the cohort grows, attention will be focused on this gap, as well as sustainability of symptom improvement and the ability to wean acid reduction therapy without sacrificing symptom control.




Disclosures:


Michael S.. Smith, MD, MBA¹, Emily Senay, MD, MPH¹, John Meyer, MD, MPH², Elizabeth Garland, MD, MS¹, Maya Korin, PhD³, Ari Grinspan, MD¹. P1230 - Lifestyle Medicine Interventions Successfully Reduce Typical Symptoms of GERD in a World Trade Center First Responder Cohort, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.