Diagnostic predictors of effective therapy for gastroesophageal reflux disease
https://doi.org/10.31146/1682-8658-ecg-178-6-71-76
Abstract
In Chelyabinsk from January 2020 the method of 24-hour pH-impedance-monitoring of the esophagus was introduced. The analysis of diagnostic possibilities of this research even on a small initial sample of patients confirms high informativeness of the method in the section of diseases of the upper parts of the gastrointestinal tract. The combination of parameters of daily recording of pH-impedanceograms allows reliable identification of gastroesophageal refl ux disease (GERD) and functional dyspepsia. The tasks of differentiating the nosological affiliation of symptoms (heartburn, burning, chest pain, lump in the throat, voice axis, cough) arise for doctors of different specialties: gastroenterologists, otolaryngologists, pulmonologists, cardiologists. Comparing the complaints noted by the patient with episodes of the bolus hitting the esophagus, we get the opportunity to calculate the probability of association of symptoms with refl uxes, and thus correctly route the “complex” patient.
Thus, the daily pH-impedanceometry demonstrates high diagnostic capabilities and allows us to reliably distinguish the pathological gastroesophageal refl ux from functional heartburn. Conducting research at the stage of diagnosis and during treatment makes the technique an effective tool for quality control of the therapeutic solution in each clinical situation.
About the Authors
S. V. Fedorenko
Limited Liability Company “Evimed”
Russian Federation
Russian Federation
Cand. of Med. Sci., Gastroenterologist,
454048, Chelyabinsk, Blucher st., 9v
A. S. Sarsenbaeva
Federal State Budgetary Educational Institution of Higher Education “South Ural State Medical University” of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Dean of the ICPE, Department of Therapy ICPE, Professor, Doctor of Medical Sciences,
454092, Chelyabinsk, Vorovskogo st., 64
O. A. Gladkov
Limited Liability Company “Evimed”
Russian Federation
Russian Federation
Doctor of Med. Sci., director,
454048, Chelyabinsk, Blucher st., 9v
References
1. Vakil N., van Zanden S. V., Kahrilas P., et al. Th e Monreal Definition and Classification of Gastroesophageal Refl ux Disease: A Global Evidence-Based Consensus// Am. J. Gastroenterol. – 2006. – 101. – p.1900–1920.
2. Pasechnikov V. D., Pasechnikov D. V. How to maximize the effectiveness of drug therapy for gastroesophageal reflux disease. Farmateka. 2008, No. 13, pp. 68–72.
3. Artemev A. S., Ilyin I. A. The first Russian device for impedance-pHmetry of the esophagus “Gastroskan IAM” // Sat. doc. scientific and technical conf. “Medical and technical technol. on guard of health ”(“MEDTECH-2012”). 2012 Portugal. – M.: MSTU. N.E. Bauman, 2012. 116–119.
4. Trukhmanov A. S., Kaybysheva V. O., Ivashkin V. T. pH-impedance measurement, A manual for doctors. Moscow, Medpraktika-M Publ., 2013, 31P.
5. Bredenoord A., Weusten B., Smout A. Symptom association analysis in ambulatory gastro-oesophageal reflux monitoring// Gut. – 2005. – Dec; 54(12). – р. 1810–1817.
6. Roman S., Gyawali C. P., Savarino E. et al. Ambulatory reflux monitoring for diagnosis ofgastro-esophageal reflux disease: Update of the Porto consensus andrecommendations from an international consensus group// Neurogastroenterol. Motil. – 2017.
7. Frazzonia L., Frazzonib M., Bortolic N. et al. Critical appraisal of Rome IV criteria: hypersensitive esophagus does belong to gastroesophageal reflux disease spectrum// Annals of Gastroenterology. –2018. – 31. – р.1–7.
8. Aziz Q., Fass R., Gyawali C. P. et al. Esophageal Disorders // Gastroenterology. – 2016. – 150. – р.1368–1379.
9. Silny J. Intraluminal multiple electrical impedance procedure for measurement of gastrointestinal motility // J. Gastrointest. Motil. – 1991. – 3. – р. 151–162.
10. Shay S. Esophageal impedance Mmnitoring: the ups and downs of a new test. // Am. J.of Gastroenterol. – 2004. – 5. – р. 1020–1022.
11. Simren M., Silny J., Holloway R. et al. Relevance of ineffective oesophageal motility during oesophageal acid clearance// Gut. – 2003. – 52. – р. 784–790.
12. Shay S., Richter J. Direct comparison of impedance, manometry and pH probe in detecting reflux before and after a meal// Dig. Dis. Sci. – 2005. – 50 (9).–р. 1584–1590.
13. Hersh M.J., Sayuk G.S, Gyawali C. P. Long-term therapeutic outcome of patients undergoing ambulatory pH monitoring for chronic unexplained cough // J. Clin. Gastroenterol. – 2010. – 44. – р. 254–260.
14. Trimble K.C., Pryde A., Heading R. C. Lowered oesophageal sensory thresholds in patients with symptomatic but not excess gastro-oesophageal reflux: evidence for a spectrum of visceral sensitivity in GORD// Gut. – 1995. – 37. – р. 7–12. 15. Sifrim D., Dupont L., Blondeau K. Weakly acidic efflux in patients with chronic unexplained cough during 24 hour ph pressure and impedance monitoring // Gut. – 2005. – 54. – р. 449–454.
Review
For citations:
Fedorenko S.V., Sarsenbaeva A.S., Gladkov O.A. Diagnostic predictors of effective therapy for gastroesophageal reflux disease. Experimental and Clinical Gastroenterology. 2020;(6):71-76. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-178-6-71-76
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