scholarly journals The features of psycho-vegetative disorders and their role in the pathogenesis of gastroesophageal reflux disease with obesity

2015 ◽  
Vol 14 (2) ◽  
pp. 142-145
Author(s):  
Alex Oparin ◽  
Daria Korniienko ◽  
Anatoliy Oparin ◽  
Nataly Lavrova ◽  
Julia Dvoyashkina ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Vegetative State ◽  
Medical Science ◽  
Young Patients ◽  
Developed Countries ◽  
Esophageal Wall ◽  
Significant Difference ◽  
The Developed Countries

Background: Gastroesophageal reflux disease (GERD) is a disease of the XXI century, affecting the population in the developed countries. There is a clear tendency to increasing of gastroesophageal reflux disease among people of young age.Aim: The aim of the study is to determine the characteristics and role of psychosomatic and vegetative state disorders in the pathogenesis of GERD with concomitant obesity.Materials and methods: 50 young patients with GERD were examined during the study. Depending on the presence or absence of concomitant obesity, two groups were formed. They underwent pH-metery, ultrasonic scanning. State of psycho-somatic, vegetative statuses and quality of life we determined by the questionnaires of Beck, Spielberg, Sheehan, Wayne.Results: During the ultrasound examination we determined the esophageal opening diameter, the thickness of esophageal wall, the esophagus width in the lower one third of the esophagus differed significantly in 2 groups of patients (p<0.05). In the group of the GERD patients with concomitant obesity the sharp increase of depression level was found, comparing with both the standard and the second group (p<0.05). It wasn’t found the significant difference amount other figures of vegetative and psychosomatic statuses in 2 groups of patients (p>0.05). The patients with GERD of both groups had significantly higher level of motor-evacuation and psycho-vegetative disorders comparing with healthy people (p<0.05).Conclusion: GERD patients have pronounced motor-evacuation disorders and significantly greater manifestations of psycho-vegetative disorders which were more pronounced in gastroesophageal reflux disease patients with concomitant obesity.Bangladesh Journal of Medical Science Vol.14(2) 2015 p.142-145

scholarly journals Phenotype of obesity and gastroesophageal reflux disease in the context of comorbidity in patients with cardiovascular diseases

2019 ◽  
Vol 91 (2) ◽  
pp. 126-133 ◽  
Author(s):  
I V Maev ◽  
G L Yurenev ◽  
E M Mironova ◽  
T V Yureneva-Thorzhevskaya
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Significant Risk ◽  
Erosive Esophagitis ◽  
Epidemiological Data ◽  
Significant Risk Factor ◽  
Developed Countries ◽  
Abdominal Pressure ◽  
The Developed Countries

The relevance of studying such problems as gastroesophageal reflux disease (GERD) and obesity is caused by their high prevalence in the developed countries of the world. Epidemiological data indicate that obesity is a significant risk factor for developing GERD due to increased intra-abdominal pressure and gastroesophageal gradient, slowing of gastric evacuation and formation of hiatal hernia. Abdominal obesity increases the likelihood of complications of GERD: erosive esophagitis, Barrett's esophagus and adenocarcinoma. This fact is connected with humoral influences: increased production of pro-inflammatory cytokines and leptin, and decreased secretion of adiponectin. Treatment of comorbid patients requires higher dosages and longer courses of antisecretory medicines, and an additional prescription of ursodeoxycholic acid.

scholarly journals THE EFFICACY OF THE DIFFERENT ENDOSCOPIC TREATMENTS VERSUS SHAM, PHARMACOLOGIC OR SURGICAL METHODS FOR CHRONIC GASTROESOPHAGEAL REFLUX DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS

2018 ◽  
Vol 55 (3) ◽  
pp. 296-305 ◽  
Author(s):  
Martin Andrés CORONEL ◽  
Wanderley Marques BERNARDO ◽  
Diogo Turiani Hourneaux de MOURA ◽  
Eduardo Turiani Hourneaux de MOURA ◽  
Igor Braga RIBEIRO ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Meta Analysis ◽  
Short Term ◽  
Significant Difference ◽  
Objective Outcomes

ABSTRACT BACKGROUND: Endoscopic antireflux treatments for gastroesophageal reflux disease (GERD) are still evolving, and most of the published studies address symptom relief in the short-term. Objective - We aimed to perform a systematic review and meta-analysis focused on evaluating the efficacy of the different endoscopic procedures. METHODS: Search was restricted to randomized controlled trials (RCTs) on MedLine, Cochrane, SciELO, and EMBASE for patients with chronic GERD (>6 months), over 18 years old and available follow up of at least 3 months. The main outcome was to evaluate the efficacy of the different endoscopic treatments compared to sham, pharmacological or surgical treatment. Efficacy was measured by different subjective and objective outcomes. RESULTS: We analyzed data from 16 RCT, totaling 1085 patients. The efficacy of endoscopic treatments compared to sham and proton pump inhibitors (PPIs) treatment showed a significant difference up to 6 months in favor of endoscopy with no heterogeneity (P<0.00001) (I2: 0%). The subgroup analysis showed a statistically significant difference up to 6 months in favor of endoscopy: endoscopy vs PPI (P<0.00001) (I2: 39%). Endoscopy vs sham (P<0.00001) (I2: 0%). Most subjective and objective outcomes were statistically significant in favor of endoscopy up to 6 and 12 months follow up. CONCLUSION: This systematic review and meta-analysis shows a good short-term efficacy in favor of endoscopic procedures when comparing them to a sham and pharmacological or surgical treatment. Data on long-term follow up is lacking and this should be explored in future studies.

The Effects of Diaphragmatic Breathing and Omeprazole on Respiratory Indices and Diaphragmatic Excursion in Patients with Gastroesophageal Reflux Disease

2020 ◽  
Vol 22 (7) ◽  
Author(s):  
Mehdi Ahmadi ◽  
Mohsen Amiri ◽  
Tahere Rezaeian ◽  
Amir Mansour Rezadoost ◽  
Enayatollah Bakhshi ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Clinical Problem ◽  
Forced Expiratory Volume ◽  
Control Group ◽  
Diaphragmatic Breathing ◽  
Positive Effects ◽  
Refractory Gerd ◽  
Significant Difference

Background: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal disorders that can disturb patients’ respiratory indices. Proton pump inhibitors (PPIs) such as omeprazole are currently the most common treatment in the patients. PPI-refractory GERD is a clinical problem constituting around 30% of patients with GERD. Objectives: The aim of this study was to investigate the effects of diaphragmatic breathing (DB) and omeprazole on respiratory indices (RI) and diaphragmatic excursion (DEX) in patients with GERD. Methods: This is a clinical trial conducted for eight weeks among 40 patients with severe GERD in Tehran in 2018. The block randomization method was designed to randomize 40 patients into two groups (DB and control) that resulted in equal sample sizes. The control group received omeprazole 20 mg once daily, and the DB group, in addition to omeprazole, performed DB. Respiratory indices, including (Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), Peak Expiratory Flow (PEF)), and DEX were evaluated before, immediately, and six weeks after the end of intervention by spirometry and ultrasonography; respectively. Results: There was no significant difference in the RI and DEX before the intervention between groups. FVC (P = 0.04) and PEF (P = 0.02) significantly changed in the control group, but FEV1 (P = 0.001), FVC (P = 0.002), PEF (P = 0.001) and DEX (0.001) significantly changed after DB. There was a significant difference in terms of RI between before and followed up in DB. Conclusions: Diaphragmatic breathing with omeprazole had more effects on RI and DEX than omeprazole alone. The positive effects of DB remain at least six weeks after the end of the intervention.

scholarly journals CASPASE-DEPENDENT ACTIVATION OF CASCADE CYTOKINES IN YOUNG PATIENTS WITH AUTOIMMUNE THYROIDITIS IN COMBINATION WITH GASTROESOPHAGEAL REFLUX DISEASE

2021 ◽  
pp. 58-63
Author(s):  
Tamara Pasiieshvili ◽  
Lyudmila Pasiieshvili ◽  
Natalia Zhelezniakova ◽  
Olga Kovalyova
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Autoimmune Thyroiditis ◽  
Reflux Disease ◽  
Young Patients ◽  
Prognostic Indicator ◽  
Esophageal Mucosa ◽  
Caspase 1 ◽  
Local Methods ◽  
Commercial Kits

The aim of the study: to assess the role of caspase-1 and IL-18 in the implementation of the inflammatory response in young patients with autoimmune thyroiditis (AIT) associated with gastroesophageal reflux disease (GERD). Materials and methods. The study was conducted in two groups of patients homogeneous by gender and age. The first group included 42 patients with an isolated AIT and the second group – 120 patients with a comorbid course of AIT and GERD. The contingent of the surveyed was students. Median age was from 18 to 25 years: 23.1±1.2 years in group with isolated AIT and 21.9±2.7 years in group with combined pathology. The activity of caspase-1 was determined using “Elabscience” kits, USA (China) by immunoassay method. The content of IL-18 was investigated using commercial kits “Bender MedSystems GmbH” (Austria) according to the proposed methods by immunoassay method. Statistical data processing was carried out using the local universal software package Statistica Basic Academic 13 for Windows En Local. Methods of non-parametric statistics were used: Kruskal-Wallis test, median test, Mann-Whitney test. Results. It has been found that caspase-1 is activated in patients both in the isolated course of AIT and in its combination with GERD. At the same time, a significant increasing in the synthesis of IL-18 was established, which has pro-inflammatory and autoimmune effects. Re-examination after 2 months of caspase-1 and IL-18 in examined persons determined decreasing their levels, but control results were not achieved. Conclusion. In young patients, the combination of GERD and AIT, as well as an isolated AIT is accompanied by an increasing the levels of caspase-1 and IL-18 in blood serum related to inflammatory process in the thyroid gland and esophageal mucosa with autoimmune component. These biomarkers may reflect the severity of clinical course of diseases and serve as prognostic indicator of outcome in case of comorbidity.

scholarly journals The Safety and Efficacy of Lansoprazole plus Metoclopramide among Neonates with Gastroesophageal Reflux Disease Resistant to Conservative Therapy and Monotherapy: A Clinical Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Peymaneh Alizadeh Taheri ◽  
Elahe Validad ◽  
Kambiz Eftekhari
Keyword(s):  
Clinical Trial ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Response Rate ◽  
Clinical Manifestations ◽  
Secondary Outcome ◽  
Double Blind ◽  
Term Neonates ◽  
Significant Difference

Background. Gastroesophageal reflux disease (GERD) is one of the most common problems in neonates. The main clinical manifestations of neonatal GERD are frequent regurgitation or vomiting associated with irritability, crying, anorexia or feeding refusal, failure to thrive, arching of the back, and sleep disturbance. Aims. The efficacy and safety of ranitidine plus metoclopramide and lansoprazole plus metoclopramide in reducing clinical GERD symptoms based on I-GERQ-R scores in neonatal GERD resistant to conservative and monotherapy. Study Design. This study was a randomized clinical trial of term neonates with GERD diagnosis (according to the final version of the I-GERQ-R), resistant to conservative and monotherapy admitted to Bahrami Children Hospital during 2017-2019. Totally, 120 term neonates (mean age 10.91 ± 7.17 days; girls 54.63%) were randomly assigned to a double-blind trial with either oral ranitidine plus metoclopramide (group A) or oral lansoprazole plus metoclopramide (group B). The changes of the symptoms and signs were recorded after one week and one month. At the end, fifty-four neonates in each group completed the study and their data were analyzed. Results. There was no significant difference in demographic and baseline characteristics between the two groups. The response rate of “lansoprazole plus metoclopramide” was significantly higher than “ranitidine plus metoclopramide” ( 7.44 ± 3.86 score vs. 9.3 ± 4.57 score, p = 0.018 ) after one week and ( 2.41 ± 3.06 score vs. 4.5 ± 4.12 score, p = 0.003 ) after one month (primary outcome). There were no drug adverse effects in either group during intervention (secondary outcome). Conclusions. The response rate was significant in each group after one week and one month of treatment, but it was significantly higher in the “lansoprazole plus metoclopramide” group compared with the “ranitidine plus metoclopramide” group. The combination of each acid suppressant with metoclopramide led to a higher response rate in comparison with monotherapy used before intervention. This study has been registered at the Iranian Registry of Clinical Trails (RCT20160827029535N3).

scholarly journals ACTIVITY OF MITOCHONDRIAL ANTIOXIDANT DEFENSE SYSTEM IN YOUNG PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE

2020 ◽  
Vol 7 (4) ◽  
pp. 164-167
Author(s):  
Olga Kovalyova ◽  
Tamara Pasiieshvili
Keyword(s):  
Superoxide Dismutase ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Manganese Superoxide Dismutase ◽  
Antioxidant Defense ◽  
Young Patients ◽  
Antioxidant Defense System ◽  
Defense System ◽  
Manganese Superoxide

Background. Despite numerous studies, the pathogenesis of gastroesophageal reflux disease remains unclear. Aim of research: assessment the activity of antioxidant defense system in young patients with GERD based on expression of biomarker associated with mitochondrial function. Material and methods. The study included 45 patients with gastroesophageal reflux disease. The examined contingent was presented by students age from 18 to 25 years. 20 healthy persons were included as control group. Levels of manganese superoxide dismutase were determined in blood serum of study persons with enzyme immunoassays (ELISA, Elabscience, USA). Statistical data processing by the Statistica Basic Academic 13 for Windows En local was made. Results. Gastroesophageal reflux disease in young patients is characterized by significantly increasing of manganese superoxide dismutase as compare to control group (7.1700 ng/ml vs 4.4720 ng/ml respectively, p<0.01). Presence of erosion in esophagus mucous doesn't accompanied by significant changes of evaluated parameter as compare with non-erosion form of disease in patients. Conclusion. The elevation in young patients with GERD the biomarker of mitohondrial antioxidant defense system we may speculate as adaptive response contributing to non-specific citoprotection. Taking to account the publishing facts about dual role of manganese superoxide dismutase it is necessary to monitoring antioxidant enzyme in patients with gastroesophageal reflux disease for prediction of possible complications and outcome.

scholarly journals Gastroesophageal reflux disease and autoimmune thyroiditis: features of pathomorphological manifestation in young people

2021 ◽  
pp. 4-8
Author(s):  
Tamara Pasiieshvili ◽  
Natalia Zhelezniakova ◽  
Tetiana Bocharova ◽  
Lyudmila Pasiyeshvili
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Autoimmune Thyroiditis ◽  
Reflux Disease ◽  
Intercellular Space ◽  
Basal Layer ◽  
Young Patients ◽  
Esophageal Mucosa ◽  
Leukocyte Infiltration ◽  
Morphological Form

The aim of the work. To study the effect of concomitant autoimmune thyroiditis (AIT) on the pathomorphological features of lesions of the esophageal mucosa in young patients with gastroesophageal reflux disease (GERD). Material and research methods. The study included 165 individuals. The contingent of the surveyed was students of Kharkov higher educational institutions. The main group consisted of 120 patients with a combined course of GERD and AIT, the comparison group included 65 individuals with an isolated GERD. The morphological form of the GERD was revealed during esophagogastroduodenoscopy (“Fuginon” system). A histomorphological study of the obtained biopsy material from the mucous membrane of the esophagus was carried out. Samples were studied on an Olympus BX-41 microscope. Morphometric study of the esophageal mucosa was performed using the Olympus DP-Soft. Research results. Histological examination of biopsy specimens revealed that the main pathomorphological signs of GERD in both groups were hyperplasia of the basal zone, lengthening of epithelial papillae, leukocyte infiltration, intercellular edema, expansion of the intercellular space, dystrophic changes, submucous fibrosis, the presence of severe inflammatory infiltration in the submucosal layer. Presence of concomitant AIT was associated with a statistically higher frequency of occurrence of certain signs: hyperplasia of the basal layer of the epithelium, elongation of the papillae, epithelial edema, expansion of the intercellular space, dystrophic changes in the epithelium (p<0.05). Conclusions. The presence of concomitant AIT in young patients with GERD does not affect the incidence of erosive GERD, but is associated with a significant increase in the severity of erosive esophagitis. The comorbid course of GERD and AIT in the student population is accompanied by a significant increase in the incidence and statistically significant intensification of the severity of hyperplasia of the basal layer of the epithelium, elongation of connective tissue papillae and leukocyte infiltration compared with isolated GERD

scholarly journals Features of the course and comparative characteristics of gastroesophageal reflux disease in pediatric patients with esophageal atresia after primary repair

2020 ◽  
pp. 24-29
Author(s):  
M.G. Aksionchyk ◽  
◽  
K.Y. Marakhousk ◽  
V.I. Averin ◽  
◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Esophageal Atresia ◽  
Reflux Disease ◽  
Pediatric Patients ◽  
Impedance Measurement ◽  
Index Number ◽  
Common Symptom ◽  
Esophageal Mucosa ◽  
Significant Difference

The aim is to evaluate clinical data and data of intraesophageal 24-hour pH/impedance measurement in pediatric patients with corrected esophageal atresia. Material and methods. A retrospective analysis was carried out on the basis of inpatient records of 43 pediatric patients with corrected esophageal atresia (CEA) aged from 1 to 14 years, who were examined at the State Institution «Republican Scientific and Practical Center of Pediatric Surgery» from November 2017 to March 2020. Average age of the group: 5.09±1.2 years, of which 23 boys (53.5%), 20 girls (46.5%). All patients with CEA underwent esophagogastroduodenoscopy (EGD) and intraesophageal 24-hour pH/impedance measurement while off acid-suppressive therapy. Results. Depending on the results of pH/impedance measurement, the patients with CEA were divided into two groups: CEA with gastroesophageal reflux disease (GERD) – 20 (54.1%) and CEA without GERD – 17 (45.9%). The most common symptom in patients with CEA was cough in both groups, in 26 (70.27%) children. Only in 4 out of 37 patients with CEA no symptoms during the time of the study were registered. Upper gastrointestinal tract endoscopy showed that 16 (43.2%) children with CEA had grade A esophagitis (according to the Los Angeles classification), 1 (2.7%) had gastric metaplasia of the esophageal mucosa, and 6 (16.2%) had chronic gastritis. EGD data did not reveal any significant differences between CEA patients with GERD and CEA patients without GERD (P=0.819). When comparing pH/impedance parameters, a significant difference (P<0.005) was obtained for the following parameters: reflux index, number of reflux episodes, distal mean nocturnal baseline impedance (MNBI) and duration of the longest reflux episode. In addition, the positive association of symptoms with episodes of refluxes (>95%) in the group of CEA patients without GERD was significantly higher than in CEA patients with GERD: 3/20 (15%) versus 8/17 (47.06%). Conclusions. The prevalence of GERD in patients with CEA in this study was 54.06%. Extraesophageal symptoms (in particular, cough) are prevalent in patients with CEA (70.3%). GERD can be asymptomatic in patients with CEA. In this study, 15% of CEA patients with confirmed GERD were asymptomatic. Patients with CEA in the study groups rarely had typical GERD symptoms (heartburn, regurgitation, chest pain and belching). The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institutions indicated in the article. Informed consent of parents and children was obtained for the research. The authors declare no conflicts of interest. Key words: corrected esophageal atresia, gastroesophageal reflux disease, esophagitis, children, esophageal 24-hour pH/impedance measurement.

scholarly journals The problem of concomitant diseases with a focus on the cardiovascular system condition in patients with arterial hypertension and acid-related diseases

2013 ◽  
Vol 94 (1) ◽  
pp. 80-85 ◽  
Author(s):  
O V Khlynova ◽  
A V Tuev ◽  
L N Beresneva ◽  
A V Agafonov
Keyword(s):  
Blood Pressure ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Arterial Hypertension ◽  
Reflux Disease ◽  
Medical Science ◽  
Clinical Manifestations ◽  
Pressure Profile ◽  
Arterial Blood ◽  
Blood Pressure Profile

At present, the problem of concomitant diseases still remains very important for medical science as well as for medical practice. Arterial hypertension is one of the most actual global healthcare problems, holding the leading place among cardiovascular diseases. Acid-related diseases, including gastroesophageal reflux disease and duodenal ulcer are also widely-spread with the tendency of prevalence growth, and are having the leading place among gastrointestinal diseases. The combination of arterial hypertension and acid-related diseases is a new state of an organism regulation. Their synchronism is not accidental, as both diseases share links of the general etiology and pathogenesis. The daily arterial pressure profile and heart rhythm variability has a number of distinctive features when the diseases collide. The presence and progression of esophageal and duodenal mucous membranes inflammation in these patients promotes the certain arterial blood pressure profile formation. The data concerning the prevalence, common etiology and pathogenesis, features of hemodynamics and clinical manifestations in patients with arterial hypertension associated with peptic ulcer disease and gastroesophageal reflux disease are reviewed. Data of autonomic regulation features, 24-hour blood pressure profile and central hemodynamics condition in patients the combination with the mentioned diseases are also covered.

scholarly journals TOTAL ANTIOXIDANT ACTIVITY AND INFLAMMATION MARKERS DURING PROGRESSION OF GASTROESOPHAGEAL REFLUX DISEASE IN YOUNG PATIENTS WITH AUTOIMMUNE THYROIDITIS

2021 ◽  
Vol 21 (1) ◽  
pp. 44-48
Author(s):  
T.M. Pasiieshvili
Keyword(s):  
Antioxidant Activity ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Autoimmune Thyroiditis ◽  
Reflux Disease ◽  
Young Patients ◽  
Total Antioxidant Activity ◽  
Histological Changes ◽  
Oesophageal Mucosa ◽  
Total Antioxidant

The aim of this study is to establish the content of inflammation markers (tumour necrosis factor alpha and interleukin 18) and the index of total antioxidant activity in young patients with comorbidity between gastroesophageal reflux disease and autoimmune thyroiditis and to determine their dependence on morpho-histological changes in the oesophageal mucosa. Materials and methods. The study involved 182 students aged 18 to 25 years: 120 patients with comorbidity between gastroesophageal reflux disease and autoimmune thyroiditis, 42 those having an isolated course of autoimmune thyroiditis. The methodology included complex clinical, instrumental, immunological, statistical methods. Results. Determining the activity of proinflammatory cytokines has revealed their statistically significant increase. The level of these cytokines depends on morpho-histological changes in the mucous membrane and reaches the maximum during the erosive process. At the same time, the indicator of total antioxidant activity significantly decreases. In this case, the erosive form of the disease is accompanied by more expressive changes in this indicator. Conclusions. The inflammatory process in the oesophagus is accompanied by the activation of the pro-inflammatory segment of immunity against the background of the suppression of the antioxidant system, which is dependent on morphological changes in the oesophageal mucosa. These changes will contribute to the development of pathological apoptosis and the progression of nosologies.

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