Specificity Of Gastroesophageal Reflux Disease In Patients With Irritable Bowel Syndrome

Aim of investigation. To study the features of gastroesophageal reflux disease (GERD) in patients with irritable bowel syndrome (IBS) in the light of the Rome IV criteria. Materials and methods. 102 IBS patients (55 females, mean age 40,8, diagnosis of IBS was established according to Rome III criteria) with esophageal symptoms were examined in gastroenterology department. Esophageal symptoms were presented with heartburn, belching, globus sensation and noncardiac chest pain. All patients underwent endoscopy, with biopsies if required, X-ray examination of upper gastrointestinal tract; 24-hour multichannel pH-impedance monitoring;¹³C-urea breath test. Evaluation of esophageal symptoms was carried out on the basis of Rome IV criteria. Results. 21 (20,6%) individuals had esophagitis (ERD). According to 24-hour pH-monitoring data, 7 of them had normal acid exposure time (AET) off proton pump inhibitors (PPIs) therapy. Using symptom association probability (SAP) for heartburn, overlap between GERD and reflux hypersensitivity (RH) was revealed in 3 patients with SAP+, and overlap between GERD and functional heartburn (FH) was revealed in 4 patients with SAP-. 27 (26,5%) individuals had nonerosive reflux disease (NERD) (19 with abnormal AET and 8 with normal AET, but SAP+ for globus and chest pain). Esophageal symptoms such as globus sensation and chest pain were only manifestation of NERD in 33,3% IBS patients. Conclusion. The course of GERD in IBS patients differs in a number of features. According to 24-h pH-impedance measurement data, some patients have the overlap between erosive reflux disease and functional esophageal disorders such as functional heartburn and reflux hypersensitivity. Esophageal symptoms such as globus sensation and chest pain can be only manifestation of NERD in IBS patients.

гастроэзофагеальная рефлюксная болезнь, неэрозивная рефлюксная болезнь, синдром раздраженного кишечника, суточная рН-импедансометрия, gastroesophageal reflux disease, nonerosive reflux disease, irritable bowel syndrome, 24-h pH-impedance measurement