Current management of proton pump inhibitor-refractory gastroesophageal reflux disease
Here we review current concepts in diagnosis and treatment of proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (PPIGERD) which includes an insufficient response to daily PPI 8-week therapy in combination with pathological gastroesophageal reflux. Patients with PPI-GERD frequent...
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| Format: | Article |
| Language: | Russian |
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Kemerovo State Medical University
2020-06-01
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| Series: | Фундаментальная и клиническая медицина |
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| Online Access: | https://fcm.kemsmu.ru/jour/article/view/268 |
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| author | V. V. Tsukanov A. V. Vasyutin Yu. L. Tonkikh |
| author_facet | V. V. Tsukanov A. V. Vasyutin Yu. L. Tonkikh |
| author_sort | V. V. Tsukanov |
| collection | DOAJ |
| description | Here we review current concepts in diagnosis and treatment of proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (PPIGERD) which includes an insufficient response to daily PPI 8-week therapy in combination with pathological gastroesophageal reflux. Patients with PPI-GERD frequently suffer from non-acidic and asymptomatic gastroesophageal reflux. In developed countries, PPI-GERD accounts for 30-40% of all patients receiving PPIs. Diagnosis of PPIGERD is performed by means of clinical anamnesis, esophagogastroscopy and impedance-pH monitoring. PPI-GERD needs to be differentiated with functional heartburn, reflux hypersensitivity and nonerosive reflux disease. Functional heartburn is characterised by reference time with a esophageal pH < 4 and the absence of a link between reflux episodes and GERD symptoms. Reflux hypersensitivity is diagnosed with normal esophageal acid exposure and association of reflux episodes with symptoms of GERD. Nonerosive reflux disease can be diagnosed solely by evaluating pathological acid exposure (pH < 4 for > 6% of the time). Treatment of PPI-GERD includes diet and lifestyle modification to reduce weight in obese patients, optimization of PPI use, and administration of alginate, prokinetics, baclofen and other drugs. Surgical treatment is also widely used and provide good results. |
| format | Article |
| id | doaj-art-10b207f56525413a92b0b00ac149e628 |
| institution | Kabale University |
| issn | 2500-0764 2542-0941 |
| language | Russian |
| publishDate | 2020-06-01 |
| publisher | Kemerovo State Medical University |
| record_format | Article |
| series | Фундаментальная и клиническая медицина |
| spelling | doaj-art-10b207f56525413a92b0b00ac149e6282025-08-20T03:42:38ZrusKemerovo State Medical UniversityФундаментальная и клиническая медицина2500-07642542-09412020-06-01529310010.23946/2500-0764-2020-5-1-93-100207Current management of proton pump inhibitor-refractory gastroesophageal reflux diseaseV. V. Tsukanov0A. V. Vasyutin1Yu. L. Tonkikh2Research Institute for Medical Problems in the North, Krasnoyarsk Research Center, Siberian Branch of the Russian Academy of SciencesResearch Institute for Medical Problems in the North, Krasnoyarsk Research Center, Siberian Branch of the Russian Academy of SciencesResearch Institute for Medical Problems in the North, Krasnoyarsk Research Center, Siberian Branch of the Russian Academy of SciencesHere we review current concepts in diagnosis and treatment of proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (PPIGERD) which includes an insufficient response to daily PPI 8-week therapy in combination with pathological gastroesophageal reflux. Patients with PPI-GERD frequently suffer from non-acidic and asymptomatic gastroesophageal reflux. In developed countries, PPI-GERD accounts for 30-40% of all patients receiving PPIs. Diagnosis of PPIGERD is performed by means of clinical anamnesis, esophagogastroscopy and impedance-pH monitoring. PPI-GERD needs to be differentiated with functional heartburn, reflux hypersensitivity and nonerosive reflux disease. Functional heartburn is characterised by reference time with a esophageal pH < 4 and the absence of a link between reflux episodes and GERD symptoms. Reflux hypersensitivity is diagnosed with normal esophageal acid exposure and association of reflux episodes with symptoms of GERD. Nonerosive reflux disease can be diagnosed solely by evaluating pathological acid exposure (pH < 4 for > 6% of the time). Treatment of PPI-GERD includes diet and lifestyle modification to reduce weight in obese patients, optimization of PPI use, and administration of alginate, prokinetics, baclofen and other drugs. Surgical treatment is also widely used and provide good results.https://fcm.kemsmu.ru/jour/article/view/268gastroesophageal reflux diseasediagnosistreatmentproton pump inhibitors |
| spellingShingle | V. V. Tsukanov A. V. Vasyutin Yu. L. Tonkikh Current management of proton pump inhibitor-refractory gastroesophageal reflux disease Фундаментальная и клиническая медицина gastroesophageal reflux disease diagnosis treatment proton pump inhibitors |
| title | Current management of proton pump inhibitor-refractory gastroesophageal reflux disease |
| title_full | Current management of proton pump inhibitor-refractory gastroesophageal reflux disease |
| title_fullStr | Current management of proton pump inhibitor-refractory gastroesophageal reflux disease |
| title_full_unstemmed | Current management of proton pump inhibitor-refractory gastroesophageal reflux disease |
| title_short | Current management of proton pump inhibitor-refractory gastroesophageal reflux disease |
| title_sort | current management of proton pump inhibitor refractory gastroesophageal reflux disease |
| topic | gastroesophageal reflux disease diagnosis treatment proton pump inhibitors |
| url | https://fcm.kemsmu.ru/jour/article/view/268 |
| work_keys_str_mv | AT vvtsukanov currentmanagementofprotonpumpinhibitorrefractorygastroesophagealrefluxdisease AT avvasyutin currentmanagementofprotonpumpinhibitorrefractorygastroesophagealrefluxdisease AT yultonkikh currentmanagementofprotonpumpinhibitorrefractorygastroesophagealrefluxdisease |