Аннотация:
Purpose of the review to present up-to-date data on the causes, methods of diagnosis and treatment of the refractory form of gastroesophageal reflux disease (GERD). Refractory GERD is the preservation of typical symptoms of the disease and/or incomplete healing of the esophageal mucosa against the background of taking a standard dose of proton pump inhibitors (PPI) once a day for 8 weeks. The reasons for the lack of response to the treatment are divided into related to the patient, related to therapy, and not related to GERD. Diagnostic approaches include x-ray examination of the esophagus and stomach, endoscopy with biopsy, 24-hour Impedance-pH monitoring, esophageal manometry. Depending on the reasons for the lack of response to the therapy, treatment may include lifestyle changes, doubling the dose of PPI, replacing PPI with another, adding H2-receptor antagonists, prokinetics, antacids, alginates and adsorbents. If conservative treatment is ineffective, it is possible to consider a
Ключевые слова:
Gastroesophageal reflux disease; Proton pump inhibitors; Refractory symptoms
antacid agent; histamine H2 receptor antagonist; proton pump inhibitor; combination drug therapy; complication; differential diagnosis; gastroesophageal reflux; gastroscopy; hiatus hernia; human; lifestyle; medication compliance; obesity; Antacids; Diagnosis, Differential; Drug Therapy, Combination; Gastroesophageal Reflux; Gastroscopy; Hernia, Hiatal; Histamine H2 Antagonists; Humans; Life Style; Medication Adherence; Obesity; Proton Pump Inhibitors
Ивашкин В. Т. Владимир Трофимович 1939-
Маев И. В.
Трухманов А. С. Александр Сергеевич 1963-
Румянцева Д. Е. Диана Евгеньевна 1989-
Ivashkin V. T. Vladimir Trofimovich 1939-
Maev I. V.
Trukhmanov A. S. Aleksandr Sergeevich 1963-
Rumyantseva D. E. Diana Evgenyevna 1989-
Modern achievements in the diagnosis and treatment of the refractory gastroesophageal reflux disease
Текст визуальный непосредственный
Терапевтический архив
Медицинское маркетинговое агентство "МедиаМедика"
Т. 90, Вып. 8 С. 4-12
2018
Статья
Gastroesophageal reflux disease Proton pump inhibitors Refractory symptoms
antacid agent histamine H2 receptor antagonist proton pump inhibitor combination drug therapy complication differential diagnosis gastroesophageal reflux gastroscopy hiatus hernia human lifestyle medication compliance obesity Antacids Diagnosis, Differential Drug Therapy, Combination Gastroesophageal Reflux Gastroscopy Hernia, Hiatal Histamine H2 Antagonists Humans Life Style Medication Adherence Obesity Proton Pump Inhibitors
Purpose of the review to present up-to-date data on the causes, methods of diagnosis and treatment of the refractory form of gastroesophageal reflux disease (GERD). Refractory GERD is the preservation of typical symptoms of the disease and/or incomplete healing of the esophageal mucosa against the background of taking a standard dose of proton pump inhibitors (PPI) once a day for 8 weeks. The reasons for the lack of response to the treatment are divided into related to the patient, related to therapy, and not related to GERD. Diagnostic approaches include x-ray examination of the esophagus and stomach, endoscopy with biopsy, 24-hour Impedance-pH monitoring, esophageal manometry. Depending on the reasons for the lack of response to the therapy, treatment may include lifestyle changes, doubling the dose of PPI, replacing PPI with another, adding H2-receptor antagonists, prokinetics, antacids, alginates and adsorbents. If conservative treatment is ineffective, it is possible to consider a