GASTROESOPHAGEAL REFLUX DISEASE IN OVERWEIGHT VARIOUS DEGREES

Objective: To study for gastroesophageal reflux disease (GERD) in patients with overweight and obesity, and to choose treatment approaches in this group of individuals. Materials and Methods: Group of 131 patients suffering from GERD was formed. Patients completed questionnaires. We had performed a physical examination, laboratory and instrumental examination, measuring the level of leptin and its receptor. Cohort was divided into two groups: primary (n = 104) - persons with obesity and excess weight, and the comparison group (n = 27) - people with normal body weight. All patients had been appointed drug Pantoprazole. Additionally we were recruited 20 patients followed by randomization to monotherapy with proton pump inhibitors (PPIs), or a combination with ursodeoxycholic acid (UDCA). Results: Individuals both group often complained of regurgitation «bitter» (2I = 8,03; p < 0,001), the nature of biliary pain (2I = 17,17; p < 0,05). In this group non-erosive form of GERD, as well as Step C of reflux esophagitis most significantly were observed (φ = 2,28; p < 0,05). It was found that among the indicators of the main group of persons higher pH and cardia gastric body were identified. In the group of obese higher levels of leptin had identified (U = 67,0; Z = 4,35; p = 0,000), having a significant negative relationship with its receptor levels (rs = -0,452; p = 0,0004). Leptin was independent of BMI due to the pH-meter. In monotherapy PPIs in the study group the persistence of clinical symptoms was noted by the 28th day of therapy (82 (62,6 ± 4,2) of the patient), as well as the less significant increase in quality of life. In combination therapy (PPI + UDCA) symptoms (heartburn, bitter regurgitation) could more fully to stop and this data were statistically significant: (φ = 2,07; p < 0,05) and (φ = 3,51; p < 0,001), respectively. Conclusion: The features of the clinical course of GERD in patients with obesity and overweight were found, UDCA in the treatment of GERD in this category of persons can improve treatment outcomes.

obesity, overweight, gastroesophageal reflux disease, features, ursodeoxycholic acid

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