Расстройства пищевода у больных синдромом раздраженного кишечника
Расстройства пищевода у больных синдромом раздраженного кишечника
Морозова Ю.Н., Погромов А.П., Мнацаканян М.Г. и др. Расстройства пищевода у больных синдромом раздраженного кишечника. Терапевтический архив. 2020; 92 (2): 19–23. DOI: 10.26442/00403660.2020.02.000483
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Аннотация
Цель исследования. Изучить весь спектр пищеводных расстройств у больных синдромом раздраженного кишечника (СРК) с применением высокотехнологичных методов исследования.
Материалы и методы. В исследование включены 102 пациента (из них 47 мужчин, средний возраст 40,8±12,2 года) с диагнозом СРК и расстройствами пищевода в виде изжоги (иногда с отрыжкой), кома в горле и боли в грудной клетке некардиального генеза. Всем выполнено рентгенологическое исследование верхних отделов желудочно-кишечного тракта, эзофагогастродуоденоскопия (при наличии показаний – с биопсией), суточная рН-импедансометрия, 13С-УДТ на H. pylori. Расстройства пищевода оценивались по Римским критериям IV.
Результаты. У 21 больного СРК (20,6%) диагностирована эрозивная рефлюксная болезнь (ЭРБ), при этом у 7 пациентов в данной группе отмечен перекрест ЭРБ с функциональными расстройствами пищевода (ФРП). Неэрозивная рефлюксная болезнь (НЭРБ) диагностирована у 27 (26,5%) больных. У 54 (52,9%) пациентов патологии пищевода не выявлено, у них диагностированы ФРП. Статистически значимой разницы в распространенности пищеводных расстройств у больных СРК в зависимости от пола и возраста, а также варианта клинического течения СРК не выявлено.
Заключение. У больных СРК коморбидные расстройства пищевода имеют разноплановый характер и представлены органической патологией, функциональными расстройствами и перекрестом между ними. Оценить коморбидные расстройства пищевода у больных СРК невозможно без применения таких методов, как суточная рН-импедансометрия и манометрия пищевода.
Ключевые слова: синдром раздраженного кишечника, гастроэзофагеальная рефлюксная болезнь, неэрозивная рефлюксная болезнь, функциональные расстройства пищевода, суточная рН-импедансометрия.
Materials and methods. 102 IBS patients (47 males, mean age 40.8, diagnosis of IBS was established according to Rome III criteria) with esophageal symptoms (heartburn, belching, globus sensation and noncardiac chest pain) were examined in gastroenterology department. All patients underwent endoscopy, with biopsies if required, X-ray examination of upper gastrointestinal tract; 24-hour 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 overlap between GERD and functional esophageal disorders (FED). 27 (26.5%) individuals had nonerosive reflux disease (NERD). In 54 (52.9%) individuals endoscopy and pH-impedance monitoring data did not differ from normal, suggesting this group as group of patients with FED. There was no significant difference for age, sex and IBS subtypes in GERD, NERD and FED groups.
Conclusion. Comorbid esophageal disorders in patients with IBS are different and represented by organic diseases, FED and overlap between them. Methods such as 24-h pH-impedance measurement and esophageal manometry should be used to assess comorbid esophageal disorders in IBS patients.
Keywords: irritable bowel syndrome, gastroesophageal reflux disease, nonerosive reflux disease, functional esophageal disorders, 24-h pH-impedance measurement.
Материалы и методы. В исследование включены 102 пациента (из них 47 мужчин, средний возраст 40,8±12,2 года) с диагнозом СРК и расстройствами пищевода в виде изжоги (иногда с отрыжкой), кома в горле и боли в грудной клетке некардиального генеза. Всем выполнено рентгенологическое исследование верхних отделов желудочно-кишечного тракта, эзофагогастродуоденоскопия (при наличии показаний – с биопсией), суточная рН-импедансометрия, 13С-УДТ на H. pylori. Расстройства пищевода оценивались по Римским критериям IV.
Результаты. У 21 больного СРК (20,6%) диагностирована эрозивная рефлюксная болезнь (ЭРБ), при этом у 7 пациентов в данной группе отмечен перекрест ЭРБ с функциональными расстройствами пищевода (ФРП). Неэрозивная рефлюксная болезнь (НЭРБ) диагностирована у 27 (26,5%) больных. У 54 (52,9%) пациентов патологии пищевода не выявлено, у них диагностированы ФРП. Статистически значимой разницы в распространенности пищеводных расстройств у больных СРК в зависимости от пола и возраста, а также варианта клинического течения СРК не выявлено.
Заключение. У больных СРК коморбидные расстройства пищевода имеют разноплановый характер и представлены органической патологией, функциональными расстройствами и перекрестом между ними. Оценить коморбидные расстройства пищевода у больных СРК невозможно без применения таких методов, как суточная рН-импедансометрия и манометрия пищевода.
Ключевые слова: синдром раздраженного кишечника, гастроэзофагеальная рефлюксная болезнь, неэрозивная рефлюксная болезнь, функциональные расстройства пищевода, суточная рН-импедансометрия.
________________________________________________
Materials and methods. 102 IBS patients (47 males, mean age 40.8, diagnosis of IBS was established according to Rome III criteria) with esophageal symptoms (heartburn, belching, globus sensation and noncardiac chest pain) were examined in gastroenterology department. All patients underwent endoscopy, with biopsies if required, X-ray examination of upper gastrointestinal tract; 24-hour 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 overlap between GERD and functional esophageal disorders (FED). 27 (26.5%) individuals had nonerosive reflux disease (NERD). In 54 (52.9%) individuals endoscopy and pH-impedance monitoring data did not differ from normal, suggesting this group as group of patients with FED. There was no significant difference for age, sex and IBS subtypes in GERD, NERD and FED groups.
Conclusion. Comorbid esophageal disorders in patients with IBS are different and represented by organic diseases, FED and overlap between them. Methods such as 24-h pH-impedance measurement and esophageal manometry should be used to assess comorbid esophageal disorders in IBS patients.
Keywords: irritable bowel syndrome, gastroesophageal reflux disease, nonerosive reflux disease, functional esophageal disorders, 24-h pH-impedance measurement.
Список литературы
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6. Whitehead WE, Palsson OS, Levy RR, Feld AD, Turner M, Von Korff M. Comorbidity in irritable bowel syndrome. Am J Gastroenterol. 2007 Dec;102(12):2767-76. doi: 10.1111/j.1572-0241.2007.01540.x
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10. De Bortoli N, Martinucci I, Bellini M, Savarino E, Savarino V, Blandizzi C, Marchi S. Overlap of functional heartburn and gastroesophageal reflux disease with irritable bowel syndrome. World J Gastroenterol. 2013 Sep 21;19(35):5787-97. doi: 10.3748/wjg.v19.i35.5787
11. De Bortoli N, Natali V, Melissari S, Simonetti N, Tapete G, Marchi S. Overlap of GERD and gastrointestinal functional disorders. Minerva Gastroenterol Dietol. 2017 Sep;63(3):205-20. doi: 10.23736/S1121-421X.17.02398-4
12. Sichuan Da Xue Xue Bao Yi Xue Ban. Symptom overlaps between functional heartburn, functional dyspepsia, and irritable bowel syndrome. J Sichuan Univ Med Sci Ed. 2014 May;45(3):489-92.
13. Lee SY, Lee KJ, Kim SJ, Cho SW. Prevalence and risk factors for overlaps between gastroesophageal reflux disease, dyspepsia and irritable bowel syndrome: a population-based study. Digestion. 2009;79:196-201. doi: 10.1159/000211715
14. Nojkov B, Rubenstein JH, Adlis SA, et al. The influence of co-morbid IBS and psychological distress on outcomes and quality of life following PPI therapy in patients with gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2008;27:473-82. doi: 10.1111/j.1365-2036.2008.03596
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16. Кайбышева В.О., Сторонова О.А., Трухманов А.С. и др. Возможности внутрипищеводной рН-импедансометрии в диагностике ГЭРБ. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2013;23(2):4-16 [Kaibisheva VO, Storonova OA, Trukhmanov AS, et al. Possibilities of intraluminal pH-impedance in the diagnostics of GERD. Russian journal for gastroenterology, hepatology, coloproctology. 2013;23(2):4-16 (In Russ.)].
17. Frazzoni L, Frazzoni M, de Bortoli N, et al. Critical appraisal of Rome IV criteria: hypersensitive esophagus does belong to gastroesophageal reflux disease spectrum. Ann Gastroenterol. 2018 Jan-Feb;31(1):1-7. doi: 10.20524/aog.2017.0199
18. Garros A, Mion F, Marjoux S, Damon H, Roman S. Factors associated with nonresponse to proton pump inhibitors therapy in patients referred for esophageal pH-impedance monitoring. Dis Esophagus. 2016;29(7):787-93. doi: 10.1111/dote.12374
19. Heitkemper M., Jarett M, Bond EF, Chang L. Impact of sex and gender on irritable bowel syndrome. Biol Res Nurs. 2003;5:56-65. doi: 10.1177/1099800403005001006
20. Bharadwaj S, Barber MD, Graff LA, Shen B. Symptomatology of irritable bowel syndrome and inflammatory bowel disease during the menstrual cycle. Gastroenterol Rep (Oxf). 2015 Aug;3(3):185-93. doi: 10.1093/gastro/gov010
21. Lovell RM, Ford AC. Prevalence of gastro-esophageal reflux-type symptoms in individuals with irritable bowel syndrome in the community: a meta-analysis. Am J Gastroenterol. 2012 Dec;107(12):1793-801. doi: 10.1038/ajg.2012.336
22. Буеверов А.О., Богомолов П.О. Старые и новые патогенетические концепции синдрома раздраженного кишечника: вместо или вместе? Клинические перспективы гастроэнтерологии, гепатологии. 2015;(2):27-35 [Bueverov AO, Bogomolov PO. Old and new pathogenetic concepts of irritable bowel syndrome: instead of or together? Clinical perspectives of gastroenterology, hepatology. 2015;(2):27-35 (In Russ.)].
23. Knowles CH, Aziz Q. Visceral hypersensitivity in non-erosive reflux disease. Gut. 2008;57:674-83. doi: 10.1136/gut.2007.127886
24. Galmiche JP, Clouse RE, Balint A, et al. Functional esophageal disorders. Gastroenterology. 2006;130:1459-65. doi: 10.1053/j.gastro.2005.08.060
25. Hollerbach S, Bulat R, May A, et al. Abnormal cerebral processing of oesophageal stimuli in patients with noncardiac chest pain (NCCP). Neurogastroenterol Motil. 2000;12:555-65. doi: 10.1046/j.1365-2982.2000.00230.x
26. Botha C, Farmer AD, Nilsson M, et al. Preliminary report: modulation of parasympathetic nervous system tone influences oesophageal pain hypersensitivity. Gut. 2015;64:611-7. doi: 10.1136/gutjnl-2013-306698
27. Fass R, Naliboff B, Higa L, et al. Differential effect of long-term esophageal acid exposure on mechanosensitivity and chemosensitivity in humans. Gastroenterology. 1998;115:1363-73. doi: 10.1016/s0016-5085(98)70014-9
2. Reshetnikov OV, Kurilovich SA, Bobac M, et al. Gastrointestinal symptoms in the adult population of Novosibirsk: prevalence and risk factors. Therapeutic Archive. 2009;(2):11-6 (In Russ.)
3. Samsonov AA, Andreev DN, Dicheva DT. Irritable bowel syndrome from the point of view of modern gastroenterology. Pharmateca. 2014;(18):7-14 (In Russ.)
4. Chang L. Review article: epidemiology and quality of life in functional gastrointestinal disorders. Aliment Pharmacol Ther. 2004 Nov;20 Suppl 7:31-9. doi: 10.1111/j.1365-2036.2004.02183.x
5. Mayer EA, Labus JS, Tillisch K, Cole SW, Baldi P. Towards a systems view of IBS. Nat Rev Gastroenterol Hepatol. 2015 Oct;12(10):592-605. doi: 10.1038/nrgastro.2015.121
6. Whitehead WE, Palsson OS, Levy RR, Feld AD, Turner M, Von Korff M. Comorbidity in irritable bowel syndrome. Am J Gastroenterol. 2007 Dec;102(12):2767-76. doi: 10.1111/j.1572-0241.2007.01540.x
7. Morozova YuN, Pogromov AP, Mnatsakanyan MG, Tashchyan OV. Functional esophageal disorders in patients with irritable bowel syndrome. Experimental and clinical gastroenterology. 2018;158(10):48-51 (In Russ.) doi: 10.31146/1682-8658-ecg-158-10-48-51
8. Morozova YuN, Pogromov AP, Mnatsakanyan MG, Tashchyan OV. The features of gastroesophageal reflux disease in patients with irritable bowel syndrome. Experimental and clinical gastroenterology. 2018;158(10):43-7 (In Russ.) doi: 10.31146/1682-8658-ecg-158-10-43-47.
9. De Bortoli N, Frazzoni L, Savarino EV, Frazzoni M, Martinucci I, Jania A, et al. Functional heartburn overlaps with irritable bowel syndrome more often than GERD. Am J Gastroenterol. 2016;111:1711-7. doi: 10.1038/ajg.2016.432
10. De Bortoli N, Martinucci I, Bellini M, Savarino E, Savarino V, Blandizzi C, Marchi S. Overlap of functional heartburn and gastroesophageal reflux disease with irritable bowel syndrome. World J Gastroenterol. 2013 Sep 21;19(35):5787-97. doi: 10.3748/wjg.v19.i35.5787
11. De Bortoli N, Natali V, Melissari S, Simonetti N, Tapete G, Marchi S. Overlap of GERD and gastrointestinal functional disorders. Minerva Gastroenterol Dietol. 2017 Sep;63(3):205-20. doi: 10.23736/S1121-421X.17.02398-4
12. Sichuan Da Xue Xue Bao Yi Xue Ban. Symptom overlaps between functional heartburn, functional dyspepsia, and irritable bowel syndrome. J Sichuan Univ Med Sci Ed. 2014 May;45(3):489-92.
13. Lee SY, Lee KJ, Kim SJ, Cho SW. Prevalence and risk factors for overlaps between gastroesophageal reflux disease, dyspepsia and irritable bowel syndrome: a population-based study. Digestion. 2009;79:196-201. doi: 10.1159/000211715
14. Nojkov B, Rubenstein JH, Adlis SA, et al. The influence of co-morbid IBS and psychological distress on outcomes and quality of life following PPI therapy in patients with gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2008;27:473-82. doi: 10.1111/j.1365-2036.2008.03596
15. Bordin DS, Yanova OB, Valitova ER. Methodology and clinical significance of pH-impedance monitoring. Methodical recommendation. Moscow: PH “Medpractice-M”, 2013, 27 p. (In Russ.)
16. Kaibisheva VO, Storonova OA, Trukhmanov AS, et al. Possibilities of intraluminal pH-impedance in the diagnostics of GERD. Russian journal for gastroenterology, hepatology, coloproctology. 2013;23(2):4-16 (In Russ.)
17. Frazzoni L, Frazzoni M, de Bortoli N, et al. Critical appraisal of Rome IV criteria: hypersensitive esophagus does belong to gastroesophageal reflux disease spectrum. Ann Gastroenterol. 2018 Jan-Feb;31(1):1-7. doi: 10.20524/aog.2017.0199
18. Garros A, Mion F, Marjoux S, Damon H, Roman S. Factors associated with nonresponse to proton pump inhibitors therapy in patients referred for esophageal pH-impedance monitoring. Dis Esophagus. 2016;29(7):787-93. doi: 10.1111/dote.12374
19. Heitkemper M., Jarett M, Bond EF, Chang L. Impact of sex and gender on irritable bowel syndrome. Biol Res Nurs. 2003;5:56-65. doi: 10.1177/1099800403005001006
20. Bharadwaj S, Barber MD, Graff LA, Shen B. Symptomatology of irritable bowel syndrome and inflammatory bowel disease during the menstrual cycle. Gastroenterol Rep (Oxf). 2015 Aug;3(3):185-93. doi: 10.1093/gastro/gov010
21. Lovell RM, Ford AC. Prevalence of gastro-esophageal reflux-type symptoms in individuals with irritable bowel syndrome in the community: a meta-analysis. Am J Gastroenterol. 2012 Dec;107(12):1793-801. doi: 10.1038/ajg.2012.336
22. Bueverov AO, Bogomolov PO. Old and new pathogenetic concepts of irritable bowel syndrome: instead of or together? Clinical perspectives of gastroenterology, hepatology. 2015;(2):27-35 (In Russ.)
23. Knowles CH, Aziz Q. Visceral hypersensitivity in non-erosive reflux disease. Gut. 2008;57:674-83. doi: 10.1136/gut.2007.127886
24. Galmiche JP, Clouse RE, Balint A, et al. Functional esophageal disorders. Gastroenterology. 2006;130:1459-65. doi: 10.1053/j.gastro.2005.08.060
25. Hollerbach S, Bulat R, May A, et al. Abnormal cerebral processing of oesophageal stimuli in patients with noncardiac chest pain (NCCP). Neurogastroenterol Motil. 2000;12:555-65. doi: 10.1046/j.1365-2982.2000.00230.x
26. Botha C, Farmer AD, Nilsson M, et al. Preliminary report: modulation of parasympathetic nervous system tone influences oesophageal pain hypersensitivity. Gut. 2015;64:611-7. doi: 10.1136/gutjnl-2013-306698
27. Fass R, Naliboff B, Higa L, et al. Differential effect of long-term esophageal acid exposure on mechanosensitivity and chemosensitivity in humans. Gastroenterology. 1998;115:1363-73. doi: 10.1016/s0016-5085(98)70014-9
2. Решетников О.В., Курилович С.А., Bobac M. и др. Желудочно-кишечные симптомы у взрослого населения Новосибирска: распространенность и факторы риска. Терапевтический архив. 2009;(2):11-6 [Reshetnikov OV, Kurilovich SA, Bobac M, et al. Gastrointestinal symptoms in the adult population of Novosibirsk: prevalence and risk factors. Therapeutic Archive. 2009;(2):11-6 (In Russ.)].
3. Самсонов А.А., Андреев Д.Н., Дичева Д.Т. Синдром раздраженного кишечника с позиций современной гастроэнтерологии. Фарматека. 2014;(18):7-14 [Samsonov AA, Andreev DN, Dicheva DT. Irritable bowel syndrome from the point of view of modern gastroenterology. Pharmateca. 2014;(18):7-14 (In Russ.)].
4. Chang L. Review article: epidemiology and quality of life in functional gastrointestinal disorders. Aliment Pharmacol Ther. 2004 Nov;20 Suppl 7:31-9. doi: 10.1111/j.1365-2036.2004.02183.x
5. Mayer EA, Labus JS, Tillisch K, Cole SW, Baldi P. Towards a systems view of IBS. Nat Rev Gastroenterol Hepatol. 2015 Oct;12(10):592-605. doi: 10.1038/nrgastro.2015.121
6. Whitehead WE, Palsson OS, Levy RR, Feld AD, Turner M, Von Korff M. Comorbidity in irritable bowel syndrome. Am J Gastroenterol. 2007 Dec;102(12):2767-76. doi: 10.1111/j.1572-0241.2007.01540.x
7. Морозова Ю.Н., Погромов А.П., Мнацаканян М.Г., Тащян О.В. Функциональные расстройства пищевода у больных с синдромом раздраженного кишечника. Экспериментальная и клиническая гастроэнтерология. 2018;158(10):48-51 [Morozova YuN, Pogromov AP, Mnatsakanyan MG, Tashchyan OV. Functional esophageal disorders in patients with irritable bowel syndrome. Experimental and clinical gastroenterology. 2018;158(10):48-51 (In Russ.)]. doi: 10.31146/1682-8658-ecg-158-10-48-51
8. Морозова Ю.Н., Погромов А.П., Мнацаканян М.Г., Тащян О.В. Особенности течения гастроэзофагеальной рефлюксной болезни у больных с синдромом раздраженного кишечника. Экспериментальная и клиническая гастроэнтерология. 2018;158(10):43-7 [Morozova YuN, Pogromov AP, Mnatsakanyan MG, Tashchyan OV. The features of gastroesophageal reflux disease in patients with irritable bowel syndrome. Experimental and clinical gastroenterology. 2018;158(10):43-7 (In Russ.)]. doi: 10.31146/1682-8658-ecg-158-10-43-47.
9. De Bortoli N, Frazzoni L, Savarino EV, Frazzoni M, Martinucci I, Jania A, et al. Functional heartburn overlaps with irritable bowel syndrome more often than GERD. Am J Gastroenterol. 2016;111:1711-7. doi: 10.1038/ajg.2016.432
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10. De Bortoli N, Martinucci I, Bellini M, Savarino E, Savarino V, Blandizzi C, Marchi S. Overlap of functional heartburn and gastroesophageal reflux disease with irritable bowel syndrome. World J Gastroenterol. 2013 Sep 21;19(35):5787-97. doi: 10.3748/wjg.v19.i35.5787
11. De Bortoli N, Natali V, Melissari S, Simonetti N, Tapete G, Marchi S. Overlap of GERD and gastrointestinal functional disorders. Minerva Gastroenterol Dietol. 2017 Sep;63(3):205-20. doi: 10.23736/S1121-421X.17.02398-4
12. Sichuan Da Xue Xue Bao Yi Xue Ban. Symptom overlaps between functional heartburn, functional dyspepsia, and irritable bowel syndrome. J Sichuan Univ Med Sci Ed. 2014 May;45(3):489-92.
13. Lee SY, Lee KJ, Kim SJ, Cho SW. Prevalence and risk factors for overlaps between gastroesophageal reflux disease, dyspepsia and irritable bowel syndrome: a population-based study. Digestion. 2009;79:196-201. doi: 10.1159/000211715
14. Nojkov B, Rubenstein JH, Adlis SA, et al. The influence of co-morbid IBS and psychological distress on outcomes and quality of life following PPI therapy in patients with gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2008;27:473-82. doi: 10.1111/j.1365-2036.2008.03596
15. Bordin DS, Yanova OB, Valitova ER. Methodology and clinical significance of pH-impedance monitoring. Methodical recommendation. Moscow: PH “Medpractice-M”, 2013, 27 p. (In Russ.)
16. Kaibisheva VO, Storonova OA, Trukhmanov AS, et al. Possibilities of intraluminal pH-impedance in the diagnostics of GERD. Russian journal for gastroenterology, hepatology, coloproctology. 2013;23(2):4-16 (In Russ.)
17. Frazzoni L, Frazzoni M, de Bortoli N, et al. Critical appraisal of Rome IV criteria: hypersensitive esophagus does belong to gastroesophageal reflux disease spectrum. Ann Gastroenterol. 2018 Jan-Feb;31(1):1-7. doi: 10.20524/aog.2017.0199
18. Garros A, Mion F, Marjoux S, Damon H, Roman S. Factors associated with nonresponse to proton pump inhibitors therapy in patients referred for esophageal pH-impedance monitoring. Dis Esophagus. 2016;29(7):787-93. doi: 10.1111/dote.12374
19. Heitkemper M., Jarett M, Bond EF, Chang L. Impact of sex and gender on irritable bowel syndrome. Biol Res Nurs. 2003;5:56-65. doi: 10.1177/1099800403005001006
20. Bharadwaj S, Barber MD, Graff LA, Shen B. Symptomatology of irritable bowel syndrome and inflammatory bowel disease during the menstrual cycle. Gastroenterol Rep (Oxf). 2015 Aug;3(3):185-93. doi: 10.1093/gastro/gov010
21. Lovell RM, Ford AC. Prevalence of gastro-esophageal reflux-type symptoms in individuals with irritable bowel syndrome in the community: a meta-analysis. Am J Gastroenterol. 2012 Dec;107(12):1793-801. doi: 10.1038/ajg.2012.336
22. Bueverov AO, Bogomolov PO. Old and new pathogenetic concepts of irritable bowel syndrome: instead of or together? Clinical perspectives of gastroenterology, hepatology. 2015;(2):27-35 (In Russ.)
23. Knowles CH, Aziz Q. Visceral hypersensitivity in non-erosive reflux disease. Gut. 2008;57:674-83. doi: 10.1136/gut.2007.127886
24. Galmiche JP, Clouse RE, Balint A, et al. Functional esophageal disorders. Gastroenterology. 2006;130:1459-65. doi: 10.1053/j.gastro.2005.08.060
25. Hollerbach S, Bulat R, May A, et al. Abnormal cerebral processing of oesophageal stimuli in patients with noncardiac chest pain (NCCP). Neurogastroenterol Motil. 2000;12:555-65. doi: 10.1046/j.1365-2982.2000.00230.x
26. Botha C, Farmer AD, Nilsson M, et al. Preliminary report: modulation of parasympathetic nervous system tone influences oesophageal pain hypersensitivity. Gut. 2015;64:611-7. doi: 10.1136/gutjnl-2013-306698
27. Fass R, Naliboff B, Higa L, et al. Differential effect of long-term esophageal acid exposure on mechanosensitivity and chemosensitivity in humans. Gastroenterology. 1998;115:1363-73. doi: 10.1016/s0016-5085(98)70014-9
Авторы
Ю.Н. Морозова, А.П. Погромов, М.Г. Мнацаканян, О.В. Тащян, К.Ю. Колосова
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
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Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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