The effect of rabeprazole on the secretory and motor function of the gastrointestinal tract

Parietal cell proton pump inhibitors (PPIs) have become firmly established in clinician practice. When discussing the features of their action, as a rule, researchers focus on their antisecretory effect. In the available literature, we found only a single report on the effect of PPIs on the motor-evacuation function of the gastrointestinal tract (GIT). We have found that the PPI rabeprazole not only has an antisecretory effect, but also normalizes the motor-evacuation function of all parts of the gastrointestinal tract. In this regard, it can be used in patients with gastric hypersecretion in functional gastrointestinal disorders (FGID) with impaired motor-evacuation function. Aim. To study the effect of the antisecretory drug rabeprazole on the state of gastrointestinal motility in patients suffering from FGID of the gastrointestinal tract and overlap syndrome (overlap syndrome) with functional dyspepsia (FD) with gastric hypersecretion and irritable bowel syndrome (IBS). Material and methods. We examined 30 patients suffering from FGID of the gastrointestinal tract and cross syndrome - FD with gastric hypersecretion and IBS. To relieve clinical symptoms of FD, the drug rabeprazole 20 mg was prescribed once a day for 14 days. Before and after the start of treatment, patients were examined with VAS and SF-36 tests, intragastric pH-metry and peripheral electrogastroenterocolography (EGECG) were performed. Results. In all 30 patients with FGID of the gastrointestinal tract with FD and overlap syndrome with IBS, gastric hypersecretion was eliminated within 3 hours after taking 20 mg of rabeprazole. 2 weeks after the start of treatment, abdominal pain and heartburn were completely eliminated in 28 (93.3%) patients. In all (100%) patients with FGID of the gastrointestinal tract with gastric hypersecretion and overlap syndrome, after two weeks of treatment, sour belching disappeared, and nausea disappeared in 23 (77%) patients. Rabeprazole therapy in the examined individuals was accompanied by a marked improvement in the quality of life in all assessed SF-36 parameters. 2 weeks after starting rabeprazole, in patients with FGID of the gastrointestinal tract and overlap syndrome of FD and IBS, the frequency of bowel movements and stool quality were normalized, and according to the results of EGECG, the relative myoelectric activity (P(i)/PS) of the gastrointestinal tract and the rhythmicity coefficient (Kritm) were normalized. Conclusion. Rabeprazole quickly neutralizes gastric secretion and helps eliminate symptoms of FD. It also has a beneficial effect on the motor-evacuation function of all parts of the gastrointestinal tract, normalizing the frequency of bowel movements, stool quality and myoelectric activity of all parts of the gastrointestinal tract according to EGECG. Rabeprazole can be used in patients with FGID with FD with gastric hypersecretion and overlap syndrome with IBS.

Functional dyspepsia, rabeprazole, gastric secretion, irritable bowel syndrome, myoelectric activity of the gastrointestinal tract

1. Pakhomova I.G. Motility disorders in functional gastrointestinal disorders. Possibilities of therapeutic correction using a clinical example. Medical Council. 2020, No. 5, pp. 18-23. (in Russ.)@@ Пахомова И.Г. Нарушение моторики при функциональных расстройствах ЖКТ. Возможности терапевтической коррекции на клиническом примере // Медицинский совет, 2020. - №5. - С.18-23.

2. Ivashkin V.T., Maev I.V., Trukhmanov A.S., Lapina T.L., Storonova O.A., Zayratiants O.V. and others. Recommendations of the Russian Gastroenterological Association for the diagnosis and treatment of gastroesophageal reflux disease.Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2020;30(4):70-97. (in Russ.)@@ Ивашкин В.Т., Маев И.В., Трухманов А.С., Лапина Т.Л., Сторонова О.А., Зайратьянц О.В. и др. Рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению гастроэзофагеальной рефлюксной болезни. Российский журнал гастроэнтерологии, гепатологии, колопроктологии, 2020. - Т.30. - №4. - С. 70-97.

3. Ushkalova E.A. Clinical pharmacology of modern antacids. Pharmateka. 2006, No. 11, pp. 1-6. (in Russ.)@@ Ушкалова Е.А. Клиническая фармакология современных антацидов. // Фарматека, 2006. - №11. - С.1-6.

4. Storonova O.A., Trukhmanov A.S.Comparison of clinical and pharmacodynamic effectiveness of proton pump inhibitors in the treatment of patients with gastroesophageal reflux disease. RZHGGK. 2015, No. 6, pp. 82-91. (in Russ.)@@ Сторонова О.А., Трухманов А.С. Сравнение клинической и фармакодинамической эффективности ингибиторов протонной помпы при лечении пациентов с гастроэзофагеальной рефлюксной болезнью // РЖГГК, 2015. - №6. - С. 82-91.

5. Marelli S., Pace F. Use of rabeprazole for the treatment of acid-related diseases. Expert Review Gastroenterology & Hepatology. 2012;6(4):423-435.

6. Tsukanov V.V., Cherepnin M.A., Vasyutin A.V., Tonkikh Yu.L., Kasparov E.V., Maslennikova N.A., Pavlova N.V. Efficacy of rabeprazole (Razo®) for the treatment of various clinical variants of GERD: results of the GERBERA trial. Medical advice. 2022;16(7):28-35. (in Russ.)@@ Цуканов В.В., Черепнин М.А., Васютин А.В., Тонких Ю.Л., Каспаров Э.В., Масленникова Н.А., Павлова Н.В. Эффективность рабепразола (Разо®) для лечения различных клинических вариантов ГЭРБ: результаты исследования GERBERA. //Медицинский совет. - 2022. - Т. 16. - №7. С. 28-35.

7. Ivanyuk A.S., Shavkunova A.A., Antipin S.A., Novikov V.N., The importance of daily pH-metry of the esophagus and stomach in the complex diagnosis of gastroesophageal reflux disease. Perm Medical Journal. 2009;26(4):57-60. (in Russ.)@@ Иванюк А.С., Шавкунова А.А., Антипин С.А., Новиков В.Н., Значение суточной рН-метрии пищевода и желудка в комплексной диагностике гастроэзофагеальной рефлюксной болезни // Пермский медицинский журнал. - 2009. - Т.26. - №4. - С. 57-60.

8. Kolesnikova I.Yu., Volkov V.S. Diagnosis and treatment of acid-related diseases of the digestive tract: A guide for doctors. Publishing House «Medical Information Agency» LLC. 2014. 432 p. (in Russ.)@@ Колесникова И.Ю., Волков В.С. Диагностика и лечение кислотозависимых заболеваний пищеварительного тракта: Руководство для врачей. - 2014: ООО «Издательство «Медицинское информационное агентство» - 432 с.

9. Kucheryavyi Yu.A. Chronic pancreatitis as an acid-dependent disease. Experimental and clinical gastroenterology. 2010, No. 9, pp. 107-115. (in Russ.)@@ Кучерявый Ю.А. Хронический панкреатит как кислотозависимое заболевание. Экпериментальная и клиническая гастроэнтерология. - 2010. - №9. - С. 107-115.

10. Balukova E.V. Pathogenesis of NSAID-induced gastric damage: the significance of inhibition of cyclooxygenase and gastric hypermotility.Russian medical journal. 2017, No. 10, pp. 697-702. (in Russ.)@@ Балукова Е.В. Патогенез НПВП-индуцированного повреждения желудка: значение ингибирования циклооксигеназы и гипермоторики желудка. Русский медицинский журнал. - 2017. - №10. - С. 697-702.

11. Mikheeva O.M. The use of proton pump inhibitors for the treatment of acid-related diseases. Therapy. 2016;2(6):43-46. (in Russ.)@@ Михеева О.М. Применение ингибиторов протонной помпы для лечения кислотозависимых заболеваний // Терапия. - 2016. - №2(6). - С. 43-46.

12. Fedrov S.P., Serebrova S.Yu. The influence of pariet on the biopotential activity of the gastrointestinal tract. Biomedicine. 2006, No. 5, pp. 46-48. (in Russ.)@@ Федров С.П., Сереброва С.Ю. Влияние париета на биопотенциальную активность желудочно-кишечного тракта. Биомедицина, 2006. - №5. - С. 46-48.

13. Novik A.A. Study of quality of life in medicine. Moscow. GEOTAR-MED, 2004. 304 p. (in Russ.)@@ Новик А.А. Исследование качества жизни в медицине: Учеб. пос. / А.А. Новик, Т.И. Ионова; под ред. акад. РАМН Ю.Л. Шевченко. - М.: - ГЭОТАР-МЕД, 2004. - 304 с.

14. Kogonija L.M., Novikov G.A., Orlova R.V., Sidorov A.V., Koroleva I.A., Sakaeva D.D. Prakticheskie rekomendacii po lecheniju hronicheskogo bolevogo sindroma u vzroslyh onkologicheskih bol’nyh. Malignant Tumors. 2021;11(3s2-2):186. (In Russ.)

15. Trukhmanov A.S., Storonova O.A., Ivashkin V.T. Clinical significance of 24-hour pH-metry in the diagnosis and assessment of the effectiveness of drugs in patients with diseases of the esophagus and stomach.Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2016;26(6):55-68. (in Russ.)@@ Трухманов А.С., Сторонова О.А., Ивашкин В.Т. Клиническое значение 24-часовой рН-метрии в диагностике и оценке эффективности лекарственных препаратов у больных с заболеваниями пищевода и желудка. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. - 2016, - Т. 26, - №6. - С. 55-68.

16. Butov M.A. Electrogastroenterocolography: a methodological manual for practical healthcare specialists. Moscow. Publishing House “MEDPRACTIKA-M”, 2018. 20 P. (in Russ.)@@ Бутов М.А. Электрогастроэнтероколография: методическое пособие для специалистов практического здравоохранения / М.А. Бутов, П.С. Кузнецов, О.А. Маслова, С.В. Папков. - М.: ИД «МЕДПРАКТИКА-М», 2018.- 20 с.

17. Gusev E.I. Neurology and neurosurgery. Vol.1. Neurology: textbook in 2 volumes. 5th ed., add. Moscow. GEOTAR-Media, 2022, 672 p. (in Russ.)@@ Гусев Е.И. Неврология и нейрохирургия. Т.1. Неврология: учебник в 2 т. / Е.И. Гусев, А.Н. Коновалов, В.И. Скворцова. - 5-е изд., доп. - М.: ГЭОТАР-Медиа, 2022. - 672 с.