The role of nitric oxide in the development of gastroesophageal reflux disease against the backdrop of obesity

2021 ◽  
Vol 43 (3-4) ◽  
pp. 63-66
Author(s):  
O. M. Malіar ◽  
◽  
O .A. Oparin ◽  
Т. М. Oparinа ◽  
A. J. Novokhatnia ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Esophagitis ◽  
Reflux Disease ◽  
Sulfanilic Acid ◽  
Control Group ◽  
Leading Position ◽  
Antireflux Barrier

Today gastroesophageal reflux disease (GERD) occupies a leading position among chronic diseases of the gastrointestinal tract. The prevalence of GERD in people with normal BMI ranges from 15 to 20%, with obesity – from 50% to 100%. The basis of GERD is a violation of the motor – evacuation function of the gastroesophageal zone, which is accompanied by a steady relaxation of the antireflux barrier. Nitric oxide (NO) plays an important role in this process. The aim of this work is to study the level of nitric oxide in patients with gastroesophageal reflux disease on the background of obesity and to assess its impact on the course of the disease. Materials and methods. The study involved 80 young people. Questionnaire was conducted using the GERDQ questionnaire, BMI, serum nitric oxide level by Griss spectrophotometric method with sulfanilic acid and 1-naphthylamine, FGDS to determine the severity of reflux esophagitis. Study participants were divided into 3 groups: patients with GERD with concomitant obesity, patients with GERD without concomitant pathology, the control group, which consisted of almost healthy individuals. Analyzing the obtained results, a significant increase in the concentration of nitric oxide in the blood of patients with GERD with concomitant obesity, compared with patients with GERD without concomitant pathology and the control group. There is a direct correlation between the level of nitric oxide in the blood and the severity of reflux esophagitis in patients with GERD with concomitant obesity. Further study of the role of nitric oxide in the pathogenesis of comorbid GERD and obesity will contribute to the development of improved methods for diagnosis, treatment and prediction of disorders.

scholarly journals Combined Therapy of Gastroesophageal Reflux Disease

2021 ◽  
Vol 17 (16) ◽  
pp. 32-39
Author(s):  
O.I. Berezina ◽  
E.R. Valitova ◽  
E.V. Bystrovskaya ◽  
D.S. Bordin
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Combination Therapy ◽  
Reflux Esophagitis ◽  
Reflux Disease ◽  
Combined Therapy ◽  
Combined Treatment ◽  
Control Group ◽  
Esophageal Mucosa ◽  
Endoscopic Picture

Objective: to evaluate the benefits of co-administration of the esophagoprotector Alfazox and the proton pump inhibitor (PPI) for the relief of symptoms and epithelialization of esophageal mucosal erosions in patients with gastroesophageal reflux disease (GERD). Material and methods. 40 patients with GERD with reflux esophagitis were examined. Patients were randomized into two groups: 19 patients of the first group (8 men and 11 women, age 48,0 [39,0;60,5] years) received combination therapy: pantoprazole 40 mg per day and Alfazox 10 ml four times a day; 21 patients from the second group (13 men and 8 women, age 47,0 [33,0; 64,0] years) received pantoprazole 40 mg per day. The duration of therapy was 28 days. The dynamics of the frequency and severity of symptoms of the disease were evaluated on the Likert scale. According to the EGDS data, the effectiveness of the treatment of erosive esophagitis was evaluated. Results. The advantages in reducing the severity of symptoms in the first group were noted. On the first day of combined treatment, heartburn was stopped in 64% of patients (χ2 p < 0.05). By the fourth day of treatment in this group, heartburn persisted in 11% of patients and in 42% of patients receiving pantoprazole monotherapy (χ2 p < 0.05). Combination therapy was more effective in reducing the severity and frequency of belching and dysphagia (Wilcoxon p < 0.01, χ2 p < 0.05). Against the background of combined therapy, endoscopic remission of reflux esophagitis was achieved in all patients, and erosion of the esophageal mucosa persisted in 25% of patients in the control group (χ2 p = 0.033). Conclusions. The study showed the advantages of combination therapy (PPI + Alfazox) both in achieving the symptomatic response and in improving the endoscopic picture in patients with erosive reflux esophagitis.

The Role of Laparoscopic Anti-Reflux Surgery in Obese Patients with Gastroesophageal Reflux Disease

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Flores Edgar Vargas ◽  
Cortez Juan Carlos Quintana ◽  
Contreras Jose Luis Ledesma ◽  
Medina Yazmin Berrones ◽  
Zhou Lucero Chao
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Obese Patients

Role of the c825t polymorphic locus of G-protein beta subunit (GNBβ3) in patients with gastroesophageal reflux disease

Therapy ◽  
2021 ◽  
Vol 9_2021 ◽  
pp. 46-50
Author(s):  
Zhilina A.A. Zhilina ◽  
Lareva N.V. Lareva ◽  
Luzina E.V. Luzina ◽  
Zhigula Z.M. Zhigula Z ◽  
Tomina E.A. Tomina ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
G Protein ◽  
Reflux Disease ◽  
Polymorphic Locus ◽  
Beta Subunit

scholarly journals Food patterns in Russian patients with gastroesophageal reflux disease: the results of pilot comparative study

2020 ◽  
Vol 92 (8) ◽  
pp. 66-72
Author(s):  
V. S. Kropochev ◽  
S. V. Morozov ◽  
M. A. Lantseva ◽  
A. N. Sasunova ◽  
V. I. Pilipenko ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Healthy Eating ◽  
Reflux Disease ◽  
Final Analysis ◽  
Control Group ◽  
Esophageal Ph ◽  
Symptom Evaluation ◽  
Source Data ◽  
Acid Exposure Time

Aim. To evaluate nutritional patterns in patients with gastroesophageal reflux disease (GERD) compared to the control group without GERD. Materials and methods. The data of complex examination of patients referred to perform esophageal pH-impedance recording and who gave written informed consent to participate in the study served as a source data. All the participants underwent complex examination, including clinical data (presence of heartburn and acid regurgitation), symptom evaluation (GERD-Q questionnaire), esophagogastroscopy, esophageal pH-impedance recordings and food frequency questionnaire. Diagnosis of GERD was based on GERD-Q score 8, acid exposure time 6%, number of gastroesophageal refluxes 80/day by 24-hrs esophageal pH-impedance recordings. Nutritional patterns were assessed with the use of healthy eating pyramid principles. Results. Overall 165 patients were enrolled and the data of 150 of them (34 with confirmed GERD and 116 of the control group) were available for the final analysis. The patients of the both groups consumed lower compared to the recommended amounts of dairy and higher amounts of meat. Those with GERD consumed larger amounts of fruits (0.910.68 compared to the values of healthy eating pyramid vs 0.520.57 in the control group, p=0.001), and fats (0.690.55 vs 0.490.55, p=0.001). Compared to the controls, patients with GERD consumed lower amounts of vegetables (0.860.46 of the healthy eating pyramid vs 0.940.63 in the control group, р=0.004) and sugars confectionaries (0.380.39 vs 1.930.98, p=0.0001). Conclusion. Nutritional patterns of patients with gastroesophageal reflux disease significantly differ compared to the control group. The obtained data may be used for diet modification in patients with arterial hypertension.

scholarly journals Disorders of social functioning and quality of life in patients with gastroesophageal reflux disease while combined with undifferentiated connective tissue dysplasia

2020 ◽  
Vol 3 (1) ◽  
pp. 11-16
Author(s):  
Iryna Romash
Keyword(s):  
Quality Of Life ◽  
Gastroesophageal Reflux Disease ◽  
Connective Tissue ◽  
Gastroesophageal Reflux ◽  
Social Functioning ◽  
Reflux Disease ◽  
Control Group ◽  
Group I ◽  
Group Ii

Introduction. It has been scientifically confirmed that the risk of developing gastroesophageal reflux disease (GERD) increases especially with generalized or regional disruption of connective tissue structure, which is widespread among the population. Patients with such comorbid pathology may have a wide range of symptoms that may go beyond the general symptoms of heartburn and regurgitation. The symptoms and complications of GERD affect general health, daily and social functioning, physical and emotional activity. It also affects the quality of life (QoL) associated with health through frequent breaks during sleep, work and social activities. Purpose. study the dynamics of the level of quality of life and social functioning in patients with gastroesophageal reflux disease in combination with the syndrome of undifferentiated connective tissue dysplasia. Methodology. A total of 120 patients were included in the study: 65 men and 55 women: in 75 of them (Group II) GERD occurred on the background of UCTD, in 45 (Group I) as an independent disease. The control group consisted of 12 healthy individuals. The study was comprehensive. The Medical Outcomes Study 36-Item Short-Form Health Status (SF-36),the Gastrointestinal Symptom Rating Scale (GSRS) and the scale of "Personal and social performance" (PSP) -  were used to study patients in detail. Results and Discussion. Analyzing the results obtained on the basis of the GSRS questionnaire (Table 1), in patients with GERD on the background of UCTD, compared with patients of group I and the control group, there is a significant increase in three and four from the five scales. QoL in patients of Group II on the scale "Abdominal pain" were 14.3 ± 0.4 points, in Group I - 5.6 ± 1.3 points, in the Control Group - 2.4 ± 0.8 points, on the scale "Reflux syndrome": 13.7 ± 0.9, 10.5 ± 1.3 and 3.1 ± 0.9, respectively. "Dyspeptic syndrome" - 15.3 ± 0.4 points in Group II, 12.2 ± 0.6- in Group I and 6.1 ± 0.3- in the control group. "Constipation syndrome" 9.5 ± 0.8, 5.6 ± 1.03 and 5.7 ± 0.4, respectively (p <0,05). Conclusions: In this research we investigated the effect of comorbid pathology on QoL in patients with GERD, which developed against the background of UCTD. The results confirm that patients with such combined pathology have a lower level of quality of life and social functioning, and the tactics of treatment of such patients should take into account these changes

scholarly journals Gastroesophageal reflux disease: new approaches to optimizing pharmacotherapy

2021 ◽  
pp. 30-37
Author(s):  
D. N. Andreev ◽  
A. V. Zaborovsky ◽  
E. G. Lobanova
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Barrier Properties ◽  
Nerve Fibers ◽  
Esophageal Mucosa ◽  
Mucosal Permeability ◽  
Other Substances ◽  
Maintenance Of Remission

Proton pump inhibitors (PPIs) are baseline drugs for induction and maintenance of remission in gastroesophageal reflux disease (GERD). PPIs have proven to be highly effective in healing esophageal mucosal lesions and relieving the symptoms of the disease in most cases. However, according to the literature data, the incidence rate of clinical ineffectiveness of PPIs in the form of partial or complete persistence of current symptoms during administration of standard doses of PPIs ranges from 10 to 40%. Optimization of GERD therapy in PPI refractory patients is a significant challenge. In most cases, experts advise to increase a dose / dosage frequency of PPIs, switch to CYP2C19-independent PPIs (rabeprazole, esomeprazole, dexlansoprazole), add an esophagoprotective or promotility agents to therapy. At the same time, these recommendations have a limited effect in some patients, which opens up opportunities for looking for new solutions related to the optimization of GERD therapy. Today there is growing evidence of the relevance of the role of disruption of the cytoprotective and barrier properties of the esophageal mucosa in the genesis of GERD and the formation of refractoriness. Intercellular contacts ensure the integrity of the barrier function of the esophageal mucosa to protect it from various exogenous intraluminal substances with detergent properties. Acid-peptic attack in patients with GERD leads to alteration of the expression of some tight junction proteins in epithelial cells of the esophageal mucosa. The latter leads to increased mucosal permeability, which facilitates the penetration of hydrogen ions and other substances into the submucosal layer, where they stimulate the terminals of nerve fibers playing a role in the induction and persistence of the symptoms of the disease. The above evidence brought up to date the effectiveness study of the cytoprotective drugs with tropism to the gastrointestinal tract, as part of the combination therapy of GERD.

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