scholarly journals Efficacy of combined therapy in patients with erosive gastroesophageal reflux disease

2021 ◽  
Vol 5 (6) ◽  
pp. 366-372
Author(s):  
I.V. Matoshina ◽  
◽  
M.A. Livzan ◽  
M.M. Fedorin ◽  
I.V. Lapteva ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Esophagitis ◽  
Reflux Disease ◽  
Comparison Group ◽  
Combined Therapy ◽  
Life Quality ◽  
Main Group ◽  
Esophageal Mucosa

Aim: to evaluate the efficacy and safety of combined therapy with a proton pump inhibitor (PPI) and an esophagoprotector to relieve the symptoms of reflux esophagitis, improve the life quality of patients and achieve faster and complete disease remission. Patients and Methods: a randomized study included 60 patients, including 33 men (mean age 40.96±13.44 years) and 27 women (mean age 48.29±12.69 years) with a duration of gastroesophageal reflux disease (GERD) of 21.85±15.48 months and C/D stage of reflux esophagitis. Depending on the prescribed treatment, the patients were divided into 2 groups of 30 subjects. Patients of the main group received complex therapy: PPI pantoprazole 40 mg once per day and esophagoprotector based on hyaluronic acid, chondroitin sulfate and poloxamer 407. In the comparison group, only pantoprazole was prescribed at the same dosage. The duration of the treatment course in both groups was 4 weeks. Before and after treatment, the presence and severity of complaints were assessed on the Likert scale, life quality according to the SF-36 questionnaire and endoscopic examination data. Results: after the end of the therapy course, a statistically significant decrease in the severity of epigastric burning, regurgitation, substernal pain, gaseous eructation, odynophagia and dysphagia was found both in the main group (in all cases p<0.05, Wilcoxon Matched Pairs Test) and the comparison group (in all cases p<0,05, Wilcoxon Matched Pairs Test). The use of combination therapy made it possible to achieve a more significant improvement in the life quality of patients in all indicators versus PPI monotherapy. In addition, 3 (10%) patients of the main group achieved endoscopic remission, while there were no such patients in the comparison group. The use of esophagoprotector in addition to PPI made it possible to reach the primary and secondary endpoints significantly more commonly versus during monotherapy. Conclusion: the obtained data indicate the high efficiency and safety of PPI therapy in combination with esophagoprotector for relieving the disease symptoms and improving the life quality of patients, faster and complete remission of reflux esophagitis by additional restoration of the esophageal mucosa resistance. Esophagoprotector as a component of complex therapy together with PPI allows achieving clinical and endoscopic disease remission in patients with erosive esophagitis in shorter terms. KEYWORDS: gastroesophageal reflux disease, esophageal mucosa resistance, esophagoprotection, proton pump inhibitor, quality of life. FOR CITATION: Matoshina I.V., Livzan M.A., Fedorin M.M., Lapteva I.V. Efficacy of combined therapy in patients with erosive gastroesophageal reflux disease. Russian Medical Inquiry. 2021;5(6):366–372 (in Russ.). DOI: 10.32364/2587-6821-2021-5-6-366-372.

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.

scholarly journals The Diagnostic Significance of Coapplying a Rabeprazole Test with the SF-36 for Gastroesophageal Reflux Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Ying Chen ◽  
Feng Wang ◽  
Yuanxi Jiang ◽  
Chen Wang ◽  
Liwen Yao ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Low Cost ◽  
Clinical Manifestations ◽  
Life Quality ◽  
Diagnostic Significance ◽  
Sf 36 ◽  
Before And After

Gastroesophageal reflux disease is a diversity disease that affects life quality of people in the world. Due to the complicated pathogenesis and variations in clinical manifestations, there is still no true gold standard for GERD diagnosis, and it is still difficult to diagnose this disease in some patients. The proton pump inhibitor’s diagnostic test (the PPI test) is noninvasive, of low cost, tied to treatment, and widely accepted. Our aim is to evaluate the diagnostic significance of coapplying a rabeprazole test with the SF-36 for GERD in this study. Our study shows that the SF-36 in combination with the rabeprazole test can screen GERD patients and increase the sensitivity and specificity of GERD diagnosis through reference to the change in SF-36 score before and after the treatment (65 in the trial).

scholarly journals LIFE QUALITY OF FIREFIGHTERS OF THE CHORNOBYL NUCLEAR POWER PLAND DISASTER WITH COMORBIDITY OF ESSENTIAL HYPERTENSION AND GASTROESOPHAGEAL REFLUX DISEASE

2019 ◽  
Vol 19 (3) ◽  
pp. 79-82
Author(s):  
V. P. Synelnik ◽  
N. A. Tkachenko ◽  
A. S. Suprun
Keyword(s):  
Quality Of Life ◽  
Essential Hypertension ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Standard Therapy ◽  
Nuclear Power ◽  
Life Quality ◽  
Role Functioning

This study was aimed at assessing the quality of life of 52 former fire-fighters of the Chornobyl nuclear power plant disaster with comorbidity of essential hypertension and gastroesophageal reflux disease. The subjects were divided into two groups similar by the sex and age (I group included 26 individuals with essential hypertension and II group included 26 individuals with comorbidity of essential hypertension and gastroesophageal reflux disease), their average age was 58,5±0,8 years. All patients received standard therapy (in accordance with the nosological form) added by the preparation Actovegin "Takeda Austria GmbH" in a dose of 200 mg once a day. The model, which underlies the designing of scales and total measurements of the SF-36 questionnaire, has three levels: 36 questions, 8 scales, formed by 2-10 questions; 2 total measurements, which are combined into scales. After calculating each indicator for separate scale, it was necessary to calculate the value of general indicators for the physical component and the psychological component of health taking into account the Z-value. In addition, when assessing the quality of life, three levels of assessment were conditionally identified: the minimum level ranged from 0 to 40 scores, satisfactory level – from 41 to 70 scores and the optimal ranged from 61 to 100 scores. The patients of the first group when having completed the therapy demonstrated statistically significantly improved indicators from 61.1 (0-100) scores to 71, 3 (0-100) (p ≤ 0.05) that consequently means the restrictions in role functioning due to physical condition (PF) decreased, overall health (OH) improved (scores increased from 42.7 (35-47) to 52.1 (47-60)) as well as the role functioning due to emotional state (ER) from 67.9 (0-100) to 76.5 (0-100) points. The second group when having completed the standard therapy added with Actovegin demonstrated statistically significantly improved indicators for most of the scales, and as a result, the subjective assessment of their quality of life was improved (p ≤ 0.05). Thus, the study has shown including Actovegin into standard therapy significantly improves most of the life quality parameters in both groups of the former fire-fighters of the Chornobyl nuclear power plant disaster. But, it should be noted that the indicators of pain scales and the state of overall health as parameters of life quality for the patients with comorbidy of hypertension and gastroesophageal reflux disease were fount at a minimum level compared with the patients having essential hypertension that indicates more significant restrictions in some fields of daily life activity for patients with comorbid pathology.

scholarly journals Correlation Between Symptom Severity and Health-Related Life Quality of a Population With Gastroesophageal Reflux Disease

2017 ◽  
Vol 10 (2) ◽  
pp. 78-83 ◽  
Author(s):  
Shou-Wu Lee ◽  
Teng-Yu Lee ◽  
Han-Chung Lien ◽  
Yen-Chun Peng ◽  
Hong-Jeh Yeh ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Symptom Severity ◽  
Life Quality ◽  
Health Related

Mucosal Protective Compounds in the Treatment of Gastroesophageal Reflux Disease. A Position Paper Based on Evidence of the Romanian Society of Neurogastroenterology

2016 ◽  
Vol 25 (4) ◽  
pp. 537-546 ◽  
Author(s):  
Teodora Surdea-Blaga ◽  
Ion Băncilă ◽  
Daniela Dobru ◽  
Vasile Drug ◽  
Ovidiu Frățilă ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Reflux Disease ◽  
Position Paper ◽  
Esophageal Mucosa ◽  
Reflux Symptoms

Background & Aims: Gastroesophageal reflux disease (GERD) therapy is challenging and suppression of acid secretion or prokinetics do not cure all cases. Some drugs with protective action on the esophageal mucosa have been used alternatively or in association with proton pump inhibitors (PPIs) and/or prokinetics. The Romanian Society of Neurogastroenterology undertook an Evidence-Based analysis, from which this position paper evolved. Methods: We performed a systematic literature search in PubMed until October 2015, using the terms: sucralfate, guaiazulene, gaiazulene, dimethicone, alginate, antacids and gastroesophageal reflux. Forty-seven papers were included and analyzed. Several statements were elaborated regarding the use of these drugs in GERD. The evidence and recommendations were discussed between the authors. Results: There is evidence in the medical literature suggesting the benefit of these drugs in GERD. In patients with persistent or mild reflux symptoms antacids rapidly relieve heartburn. Alginate-antacid combination is superior both over placebo and antacids to treat mild reflux symptoms, and can be used to treat persistent reflux symptoms despite acid suppressant therapy. Sucralfate is superior over placebo in alleviating GERD symptoms and can be used as maintenance therapy. Guaiazulene-dimethicone improves the quality of life in patients with GERD. Conclusions: Drugs used to protect the esophageal mucosa against acid are useful in alleviating chronic heartburn, especially in patients with mild reflux symptoms. Abbreviations: CS: Chondroitin sulfate; DA: Double Action; EE : Erosive esophagitis ; GERD: Gastroesophageal reflux disease; HA: Hyaluronic acid; H2RA: Histamine 2 receptor antagonist; ITT: Intention to treat; IM: Irsogladine maleate; NERD: Non-erosive reflux disease; PPIs: Proton pump inhibitors; RCT: Randomized controlled trial; RDQ: Reflux disease questionnaire; QoL: Quality of life.

Gastroesophageal Reflux Disease: A Gastroenterologist's Perspective

2011 ◽  
Vol 21 (3) ◽  
pp. 89-99
Author(s):  
Michael F. Vaezi
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Best Practice ◽  
Clinical Care ◽  
Diagnostic Testing ◽  
Diagnostic Tools ◽  
Swallowing Function ◽  
Atypical Symptoms

Gastroesophageal reflux disease (GERD) is a commonly diagnosed condition often associated with the typical symptoms of heartburn and regurgitation, although it may present with atypical symptoms such as chest pain, hoarseness, chronic cough, and asthma. In most cases, the patient's reduced quality of life drives clinical care and diagnostic testing. Because of its widespread impact on voice and swallowing function as well as its social implications, it is important that speech-language pathologists (SLPs) understand the nature of GERD and its consequences. The purpose of this article is to summarize the nature of GERD and GERD-related complications such as GERD-related peptic stricture, Barrett's esophagus and adenocarcinoma, and laryngeal manifestations of GERD from a gastroenterologist's perspective. It is critical that SLPs who work with a multidisciplinary team understand terminology, diagnostic tools, and treatment to ensure best practice.

scholarly journals POSTOPERATIVE DYSPHAGIA AFTER LAPAROSCOPIC FUNDOPLICATION AS A TREATMENT FOR GASTROESOPHAGEAL REFLUX DISEASE

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
B Carrasco Aguilera ◽  
S Amoza Pais ◽  
T Diaz Vico ◽  
E O Turienzo Santos ◽  
M Moreno Gijon ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Surgical Technique ◽  
Gastroesophageal Reflux ◽  
Hiatal Hernia ◽  
Reflux Disease ◽  
Laparoscopic Fundoplication ◽  
Descriptive Study ◽  
Postoperative Dysphagia

Abstract INTRODUCTION Laparoscopic Fundoplication (LF) as a treatment for gastroesophageal reflux disease (GERD) has positive clinical outcomes. However, postoperative dysphagia (PD) may appear as a side effect. Our objective is to analyze PD in patients operated on for LF in our center. MATERIAL AND METHODS Retrospective and descriptive study of patients operated on for GERD from September 1997 to February 2019. RESULTS 248 patients (60.5% men), with a mean age of 49.7 (21-82), were operated. 66.1% of the patients presented associated comorbidities, highlighting obesity (19.8%). 75% manifested typical symptoms, 19% presenting with Barrett’s esophagus. Sliding hiatal, paraesophageal, mixed and complex hernia were diagnosed in 151 (60.9%), 23 (9.3%), 12 (4.8%), and 4 (1.6%) patients, respectively. The LF Nissen was the most frequent technique (91.5%), using a caliper in 46% of the cases. PD was the most frequent symptom, present in 57 (23%) patients. It was resolved with dilation in 9 patients, requiring 6 patients surgical reintervention. In those PD cases, a caliper was used in 28 (49.1%) patients, without finding significant differences between them (P = .586). Nor were there significant differences between PD and obesity (P = .510), type of hiatal hernia (P = .326), or surgical technique (P = .428). After a median follow-up of 50.5 months, quality of life was classified as Visick I-II, III, and IV in 76.6%, 6.9% and 1.2% of the cases, respectively. CONCLUSION No association between PD and the use of calipers, surgical technique or type of hiatal hernia was found in our series.

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