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Гастроэзофагеальная рефлюксная болезнь у лиц с ожирением: особенности курации и лечения пациентов
Гастроэзофагеальная рефлюксная болезнь у лиц с ожирением: особенности курации и лечения пациентов
Ливзан М.А., Кролевец Т.С., Лаптева И.В. Гастроэзофагеальная рефлюксная болезнь у лиц с ожирением: особенности курации и лечения пациентов. Consilum Medicum. Гастроэнтерология (Прил.). 2016; 2: 17–22.
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Аннотация
Отмечена высокая распространенность гастроэзофагеальной рефлюксной болезни (ГЭРБ) среди лиц с ожирением или избыточной массой тела. Имеются особенности клинического течения ГЭРБ у данной категории пациентов. Монотерапия ингибиторами протонной помпы не в полной мере купирует проявления заболевания и сопровождается менее значимым приростом показателей качества жизни в сравнении с лицами без ожирения. Алгинаты, обладая высокой скоростью купирования симптомов, благоприятным профилем безопасности, реализацией цитопротективного эффекта в отношении защиты эпителиоцитов слизистой оболочки пищевода от агрессивных молекул рефлюктата, могут быть рекомендованы в качестве препаратов при ее неэффективности или при недостаточном эффекте терапии.
Ключевые слова: гастроэзофагеальная рефлюксная болезнь, ингибиторы протонной помпы, алгинаты, вспомогательная терапия.
Key words: gastroesophageal reflux disease, proton pump inhibitors, alginate, assistive therapy.and is accompanied by a less significant increase in quality of life compared to individuals without obesity. Alginate with high speed relief of symptoms, favorable safety profile, the implementation of cytoprotective effect in relation to the protection of epithelial cells in esophageal mucosa from aggressive molecules refluctate can be recommended as drugs of accompaniment to therapy with proton pump inhibitors.
Key words: gastroesophageal reflux disease, proton pump inhibitors, alginate, assistive therapy.
Ключевые слова: гастроэзофагеальная рефлюксная болезнь, ингибиторы протонной помпы, алгинаты, вспомогательная терапия.
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Key words: gastroesophageal reflux disease, proton pump inhibitors, alginate, assistive therapy.and is accompanied by a less significant increase in quality of life compared to individuals without obesity. Alginate with high speed relief of symptoms, favorable safety profile, the implementation of cytoprotective effect in relation to the protection of epithelial cells in esophageal mucosa from aggressive molecules refluctate can be recommended as drugs of accompaniment to therapy with proton pump inhibitors.
Key words: gastroesophageal reflux disease, proton pump inhibitors, alginate, assistive therapy.
Полный текст
Список литературы
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2. Boeckxstaens G. Symptomatic reflux disease: the present, the past and the future. Gut 2014; 63 (7): 1185–93.
3. Osipenko M.F. Pishchevod Barreta – sovremennoe sostoianie problemy. Ros. zhurn. gastroenterologii, gepatologii, koloproktologii. 2007; 17 (4): 11–9. [in Russian]
4. Osipenko M.F. Vzaimosviaz' ozhireniia s zabolevaniiami verkhnikh otdelov organov pishche-vareniia. Dokazatel'naia gastroenterologiia. 2014; 2: 36–8. [in Russian]
5. Drahos J. Metabolic syndrome increases risk of Barrett esophagus in the absence of gastroesophageal reflux: an analysis of SEER-Medicare Data. J Clin Gastroenterol 2014; 49 (4): 285–8.
6. Jacobson BC, Somers SC, Fuchs CS et al. Body-mass index and symptoms of gastroesophageal reflux in women. N Engl J Med 2006; 354 (22): 2340–8.
7. Acosta A, Camilleri M. Gastrointestinal Morbidity in Obesity Ann N Y Acad Sci 2014; 1311: 42–56.
8. Chang P, Friedenberg F, Obesity & GERD. Gastroenterol Clin North Am 2014; 43 (1): 161–73.
9. Bordin D.S. Patogeneticheskie osnovy razvitiia gastroezofageal'noi refliuksnoi bolezni. Diagnostika i lechenie. Vestn. semeinoi meditsiny. 2013; 1: 36–40. [in Russian]
10. Zvenigorodskaia L.A. Metabolicheskii sindrom i organy pishchevareniia. M.: Anakharsis, 2009; s. 184. [in Russian]
11. Bray G. Drag treatment of the overweight patient. World Journal of Gastroentero-logy 2007; 132 (6): 2239–52.
12. Roshchina T.V. Gastroezofageal'naia refliuksnaia bolezn'. Rus. med. zhurn. 2000; 2: 5–7. [in Russian]
13. Suter M, Dorta G, Giusti V et al. Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients. Obes Surg 2004; 14 (7): 959–66.
14. Koppman JS, Poggi L, Szomstein S et al. Esophageal motility disorders in the morbidly obese population. Surg Endosc 2007; 21 (5): 761–4.
15. Jaffin B, Knoepflmacher P, Greenstein R. High prevalence of asymptomatic esophageal motility disorders among morbidly obese patients. Obes Surg 1999; 9 (4): 390–5.
16. Kouklakis G, Moschos J, Kountouras J et al. Relationship between obesity and gastroesophageal reflux disease as recorded by 3-hour esophageal pH monitoring. Rom J Gastroenterol 2005; 14 (2): 117–21.
17. Geliebter A, Hashim SA. Gastric capacity in normal, obese, and bulimic women. Physiol Behav 2001; 74 (4–5): 743–6.
18. Günthera C, Neumanna H, Vieth M. Esophageal Epithelial Resistance. Dig Dis 2014; 32: 6–10.
19. Zvenigorodskaia L.A. Metabolicheskii sindrom i organy pishchevareniia. M.: Anakharsis, 2009; s. 184. [in Russian]
20. Ivashkin V.T., Drapkina O.M., Korneeva O.N. Klinicheskie varianty metabolicheskogo sindroma. M.: Med. inform. agentstvo, 2011; s. 220. [in Russian]
21. Finucane MM. Circulating inflammatory cytokines and adipokines are associated with Barrett’s esophagus: a case – control study. Clin Gastroenterol Hepatol 2014; 12 (2): 229–38.
22. Rubenstein JH. Associations of diabetes mellitus, insulin, leptin, and ghrelin with gastroesophageal reflux and Barrett's esophagus. World Journal of Gastroenterology 2013; 145 (6): 1237–44.
23. Tsuzuki T, Okada H, Kawahara Y et al. Proton pump inhibitor step-down therapy for GERD: a multi-center study in Japan. World J Gastroenterol 2011; 17 (11): 1480–7.
24. Ware JE et al. SF-36 Health Survey. Manual and interpretation guide. The Health institute, New England medical center. Boston: Mass, 1993.
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26. Goleva O.P. O primenenii nekotorykh sovremennykh metodov statisticheskogo analiza rezul'tatov nauchnykh meditsinskikh issledovanii. Omsk: Izd-vo OGMA, 2001; s. 82. [in Russian]
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28. Glants S. Mediko-biologicheskaia statistika. Per. s angl. Iu.A.Danilova. M.: Praktika, 1998; s. 459. [in Russian]
29. Zaks L. Statisticheskoe otsenivanie. M.: Statistika, 1976; s. 598. [in Russian]
30. Zaitsev V.M., Lifliandskii V.G., Marinkin V.I. Prikladnaia meditsinskaia statistika: ucheb. posob. SPb.: Foliant, 2003; s. 432. [in Russian]
31. Revicki DA. The impact of gastroesophageal reflux disease on health-related quality of life. Am J Med 1998; 104 (3): 252–8.
32. Wiklund I. Review of the quality of life and burden of illness in gastroesophageal reflux disease. Digestive Diseases 2004; 22 (2): 108–14.
33. Emerenziani S, Rescio MP, Guarino PL et al. Gastro-esophageal reflux disease and obesity, where is the link? World J Gastroenterol 2013; 19 (39): 6536–9.
34. Khan A, Kim A, Sanossian C, Francois F. Impact of obesity treatment on gastroesophageal reflux disease. World J Gastroenterol 2016; 22 (4): 1627–38.
35. Pace F, Coudsy B, DeLemos B et al. Does BMI affect the clinical efficacy of proton pump inhibitor therapy in GERD? The case for rabeprazole. Eur J Gastroenterol Hepatol 2011; 23 (10): 845–51.
36. Hongo M, Miwa H, Kusano M. Symptoms and quality of life in underweight gastroesophageal reflux disease patients and therapeutic responses to proton pump inhibitors. J Gastroenterol Hepatol 2012; 27 (5): 913–8.
37. Kahrilas PJ. The Acid Pocket: A Target for Treatment in Reflux Disease? Am J Gastroenterol 2013; 108: 1058–64.
38. Woodland P, Batista-Lima F, Lee C-Y, Sifrim D. 687 Topical Alginate Protecton of Human Esophageal Epithelium for Gastro-Esophageal Reflux Disease. A Study Using Human Cell Culture and Biopsy Models. DOI: http://dx.doi.org/10.1016/S0016-5085(15)30462-5.
39. Reimer C, Lødrup AB, Smith G et al. Randomised clinical trial: alginate (Gaviscon Advance) vs. placebo as add-on therapy in reflux patients with inadequate response to a once daily proton pump inhibitor. Aliment Pharmacol Ther 2016. DOI: 10.1111/apt.13567. [Epub ahead of print].
2. Boeckxstaens G. Symptomatic reflux disease: the present, the past and the future. Gut 2014; 63 (7): 1185–93.
3. Осипенко М.Ф. Пищевод Баррета – современное состояние проблемы. Рос. журн. гастроэнтерологии, гепатологии, колопроктологии. 2007; 17 (4): 11–9. / Osipenko M.F. Pishchevod Barreta – sovremennoe sostoianie problemy. Ros. zhurn. gastroenterologii, gepatologii, koloproktologii. 2007; 17 (4): 11–9. [in Russian]
4. Осипенко М.Ф. Взаимосвязь ожирения с заболеваниями верхних отделов органов пищеварения. Доказательная гастроэнтерология. 2014; 2: 36–8. / Osipenko M.F. Vzaimosviaz' ozhireniia s zabolevaniiami verkhnikh otdelov organov pishche-vareniia. Dokazatel'naia gastroenterologiia. 2014; 2: 36–8. [in Russian]
5. Drahos J. Metabolic syndrome increases risk of Barrett esophagus in the absence of gastroesophageal reflux: an analysis of SEER-Medicare Data. J Clin Gastroenterol 2014; 49 (4): 285–8.
6. Jacobson BC, Somers SC, Fuchs CS et al. Body-mass index and symptoms of gastroesophageal reflux in women. N Engl J Med 2006; 354 (22): 2340–8.
7. Acosta A, Camilleri M. Gastrointestinal Morbidity in Obesity Ann N Y Acad Sci 2014; 1311: 42–56.
8. Chang P, Friedenberg F, Obesity & GERD. Gastroenterol Clin North Am 2014; 43 (1): 161–73.
9. Бордин Д.С. Патогенетические основы развития гастроэзофагеальной рефлюксной болезни. Диагностика и лечение. Вестн. семейной медицины. 2013; 1: 36–40. / Bordin D.S. Patogeneticheskie osnovy razvitiia gastroezofageal'noi refliuksnoi bolezni. Diagnostika i lechenie. Vestn. semeinoi meditsiny. 2013; 1: 36–40. [in Russian]
10. Звенигородская Л.А. Метаболический синдром и органы пищеварения. М.: Анахарсис, 2009; с. 184. / Zvenigorodskaia L.A. Metabolicheskii sindrom i organy pishchevareniia. M.: Anakharsis, 2009; s. 184. [in Russian]
11. Bray G. Drag treatment of the overweight patient. World Journal of Gastroentero-logy 2007; 132 (6): 2239–52.
12. Рощина Т.В. Гастроэзофагеальная рефлюксная болезнь. Рус. мед. журн. 2000; 2: 5–7. / Roshchina T.V. Gastroezofageal'naia refliuksnaia bolezn'. Rus. med. zhurn. 2000; 2: 5–7. [in Russian]
13. Suter M, Dorta G, Giusti V et al. Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients. Obes Surg 2004; 14 (7): 959–66.
14. Koppman JS, Poggi L, Szomstein S et al. Esophageal motility disorders in the morbidly obese population. Surg Endosc 2007; 21 (5): 761–4.
15. Jaffin B, Knoepflmacher P, Greenstein R. High prevalence of asymptomatic esophageal motility disorders among morbidly obese patients. Obes Surg 1999; 9 (4): 390–5.
16. Kouklakis G, Moschos J, Kountouras J et al. Relationship between obesity and gastroesophageal reflux disease as recorded by 3-hour esophageal pH monitoring. Rom J Gastroenterol 2005; 14 (2): 117–21.
17. Geliebter A, Hashim SA. Gastric capacity in normal, obese, and bulimic women. Physiol Behav 2001; 74 (4–5): 743–6.
18. Günthera C, Neumanna H, Vieth M. Esophageal Epithelial Resistance. Dig Dis 2014; 32: 6–10.
19. Звенигородская Л.А. Метаболический синдром и органы пищеварения. М.: Анахарсис, 2009; с. 184. / Zvenigorodskaia L.A. Metabolicheskii sindrom i organy pishchevareniia. M.: Anakharsis, 2009; s. 184. [in Russian]
20. Ивашкин В.Т., Драпкина О.М., Корнеева О.Н. Клинические варианты метаболического синдрома. М.: Мед. информ. агентство, 2011; с. 220. / Ivashkin V.T., Drapkina O.M., Korneeva O.N. Klinicheskie varianty metabolicheskogo sindroma. M.: Med. inform. agentstvo, 2011; s. 220. [in Russian]
21. Finucane MM. Circulating inflammatory cytokines and adipokines are associated with Barrett’s esophagus: a case – control study. Clin Gastroenterol Hepatol 2014; 12 (2): 229–38.
22. Rubenstein JH. Associations of diabetes mellitus, insulin, leptin, and ghrelin with gastroesophageal reflux and Barrett's esophagus. World Journal of Gastroenterology 2013; 145 (6): 1237–44.
23. Tsuzuki T, Okada H, Kawahara Y et al. Proton pump inhibitor step-down therapy for GERD: a multi-center study in Japan. World J Gastroenterol 2011; 17 (11): 1480–7.
24. Ware JE et al. SF-36 Health Survey. Manual and interpretation guide. The Health institute, New England medical center. Boston: Mass, 1993.
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32. Wiklund I. Review of the quality of life and burden of illness in gastroesophageal reflux disease. Digestive Diseases 2004; 22 (2): 108–14.
33. Emerenziani S, Rescio MP, Guarino PL et al. Gastro-esophageal reflux disease and obesity, where is the link? World J Gastroenterol 2013; 19 (39): 6536–9.
34. Khan A, Kim A, Sanossian C, Francois F. Impact of obesity treatment on gastroesophageal reflux disease. World J Gastroenterol 2016; 22 (4): 1627–38.
35. Pace F, Coudsy B, DeLemos B et al. Does BMI affect the clinical efficacy of proton pump inhibitor therapy in GERD? The case for rabeprazole. Eur J Gastroenterol Hepatol 2011; 23 (10): 845–51.
36. Hongo M, Miwa H, Kusano M. Symptoms and quality of life in underweight gastroesophageal reflux disease patients and therapeutic responses to proton pump inhibitors. J Gastroenterol Hepatol 2012; 27 (5): 913–8.
37. Kahrilas PJ. The Acid Pocket: A Target for Treatment in Reflux Disease? Am J Gastroenterol 2013; 108: 1058–64.
38. Woodland P, Batista-Lima F, Lee C-Y, Sifrim D. 687 Topical Alginate Protecton of Human Esophageal Epithelium for Gastro-Esophageal Reflux Disease. A Study Using Human Cell Culture and Biopsy Models. DOI: http://dx.doi.org/10.1016/S0016-5085(15)30462-5.
39. Reimer C, Lødrup AB, Smith G et al. Randomised clinical trial: alginate (Gaviscon Advance) vs. placebo as add-on therapy in reflux patients with inadequate response to a once daily proton pump inhibitor. Aliment Pharmacol Ther 2016. DOI: 10.1111/apt.13567. [Epub ahead of print].
Авторы
М.А.Ливзан*, Т.С.Кролевец, И.В.Лаптева
ФГБОУ ВО Омский государственный медицинский университет Минздрава России. 644099, Россия, Омск, ул. Ленина, д. 12
*mlivzan@yandex.ru
Omsk State Medical University of the Ministry of Health of the Russian Federation. 644099, Russian Federation, Omsk, ul. Lenina, d. 12
*mlivzan@yandex.ru
ФГБОУ ВО Омский государственный медицинский университет Минздрава России. 644099, Россия, Омск, ул. Ленина, д. 12
*mlivzan@yandex.ru
________________________________________________
Omsk State Medical University of the Ministry of Health of the Russian Federation. 644099, Russian Federation, Omsk, ul. Lenina, d. 12
*mlivzan@yandex.ru
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