Эрозивно-язвенные поражения пищеварительного тракта: оптимизация диагностики и тактики ведения - Журнал Терапевтический архив №2 Вопросы гастроэнтерологии 2022

Эрозивно-язвенные поражения пищеварительного тракта: оптимизация диагностики и тактики ведения

Осадчук М.А., Осадчук А.М. Эрозивно-язвенные поражения пищеварительного тракта: оптимизация диагностики и тактики ведения. Терапевтический архив. 2022;94(2):271–276.
DOI: 10.26442/00403660.2022.02.201376

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Osadchuk MA, Osadchuk AM. Erosive and ulcerative lesions of the digestive tract: optimization of diagnosis and management tactics. Terapevticheskii Arkhiv (Ter. Arkh.). 2022;94(2):271–276.
DOI: 10.26442/00403660.2022.02.201376

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Аннотация

Эрозивно-язвенные поражения пищеварительного тракта являются одной из актуальнейших проблем в клинической практике внутренних заболеваний из-за чрезвычайно широкой распространенности, наличия тяжелых осложнений, нередко с летальным исходом, трудностей диагностики, обусловленных большим числом бессимптомно протекающих патологий и затруднениями в рациональном выборе терапии. Особого внимания заслуживают данные о том, что в период глобальной пандемии инфекция COVID-19 способна достаточно часто вызывать развитие эрозивно-язвенных повреждений желудочно-кишечного тракта. В связи с этим представляется важным применение лекарственных средств, способных не только предупредить возникновение эрозивно-язвенных поражений и стриктур на всем протяжении желудочно-кишечного тракта, но и эффективно достигать эпителизации повреждений слизистой оболочки ротовой полости, пищевода, желудка, тонкой и толстой кишки. Одним из них является Ребамипид-CЗ (НАО «Северная звезда»), характеризующийся достаточно высоким профилем безопасности и эффективности. Представляется важным рассмотреть вопросы оптимизации профилактики и лечения эрозивно-язвенных поражений различных отделов желудочно-кишечного тракта различной этиологии с учетом возможности применения ребамипида как в составе комплексной терапии, так и изолированно.

Ключевые слова: эрозии и язвы пищеварительного тракта, клиника, диагностика, лечение, ребамипид

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Erosive and ulcerative lesions of the digestive tract are one of the most pressing problems in the clinic of internal diseases due to the extremely widespread prevalence, the presence of severe complications, often fatal, diagnostic difficulties due to the presence of a large number of asymptomatic pathologies and difficulties in the rational choice of therapy. Particularly noteworthy is the data that during the global pandemic of Covid-19 infection, it is capable, quite often, of causing the development of erosive and ulcerative lesions of the gastrointestinal tract. In this regard, it seems important to use drugs that can not only prevent the occurrence of erosive and ulcerative lesions and strictures throughout the gastrointestinal tract, but also effectively achieve epithelialization of injuries to the mucous membrane of the oral cavity, esophagus, stomach, small and large intestine. One of them is Rebamipid-CZ, which has a fairly high safety and efficacy profile. It seems important to consider the issues of optimizing the prevention and treatment of erosive and ulcerative lesions of various parts of the gastrointestinal tract of various etiologies, taking into account the possibility of using rebamipide both as part of complex therapy and in isolation.

Keywords: erosion and ulceration of the digestive tract, clinical picture, diagnosis, treatment, rebamipide

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1. Beck KE, Blansfield JA, Tran KQ, et al. Enterocolitis in patients with cancer after antibody blockade of cytotoxic T-lymphocyte-associated antigen 4. J Clin Oncol. 2006;24(15):2283-9. DOI:10.1200/JCO.2005.04.5716
2. O’Reilly M, Mellotte G, Ryan B, O’Connor A. Gastrointestinal side effects of cancer treatments. Ther Adv Chronic Dis. 2020;11:2040622320970354. DOI:10.1177/2040622320970354
3. Wang D, Mann JR, DuBois RN. The role of prostaglandins and other eicosanoids in the gastrointestinal tract. Gastroenterology. 2005;128(5):1445-61. DOI:10.1053/j.gastro.2004.09.080
4. De Petris G, Caldero SG, Chen L, et al. Histopathological changes in the gastrointestinal tract due to medications: an update for the surgical pathologist (part II of II). Int J Surg Pathol. 2014;22(3):202-11. DOI:10.1177/1066896913502230
5. Hreinsson JP, Kalaitzakis E, Gudmundsson S, Björnsson ES. Upper gastrointestinal bleeding: incidence, etiology and outcomes in a population-based setting. Scand J Gastroenterol. 2013;48(4):439-47. DOI:10.3109/00365521.2012.763174
6. Lin L, Jiang X, Zhang Z, et al. Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection. Gut. 2020;69(6):997-1001. DOI:10.1136/gutjnl-2020-321013
7. Drozdov VN, Meshcheryakov YV, Serebrova SY, Shikh EV. NSAID-induced damage to the gastrointestinal tract: new opportunities for the prevention of gastro- and enteropathies. Medical Counsil. 2020;12(21):166-74 (in Russian). DOI:10.21518/2079-701X-2019-21-166-174
8. Yasuda T, Chiba H, Satomi T, et al. Preventive effect of rebamipide gargle on chemoradiotherpy-induced oral mucositis in patients with oral cancer: a pilot study. J Oral Maxillofac Res. 2012;2(4):e3. DOI:10.5037/jomr.2011.2403
9. Peterson DE. New strategies for management of oral mucositis in cancer patients. J Support Oncol. 2006;4(2 Suppl 1):9-13.
10. Peterson DE, Bensadoun R-J, Roila F, ESMO Guidelines Working Group. Management of oral and gastrointestinal mucositis: ESMO Clinical Practice Guidelines. Ann Oncol. 2011;22 Suppl. 6:vi78-84. DOI:10.1093/annonc/mdr391
11. Akagi S, Fujiwara T, Nishida M, et al. The effectiveness of rebamipide mouthwash therapy for radiotherapy and chemoradiotherapy-induced oral mucositis in patients with head and neck cancer: a systematic review and meta-analysis. J Pharm Health Care Sci. 2019;5:16. DOI:10.1186/s40780-019-0146-2
12. Yokota T, Ogawa T, Takahashi S, et al. Efficacy and safety of rebamipide liquid for chemoradiotherapy-induced oral mucositis in patients with head and neck cancer: a multicenter, randomized, double-blind, placebo-controlled, parallel-group phase II study. BMC Cancer. 2017;17(1):314. DOI:10.1186/s12885-017-3295-4
13. Chaitanya B, Pai KM, Yathiraj PH, et al. Rebamipide gargle in preventive management of chemo-radiotherapy induced oral mucositis. Oral Oncol. 2017;72:179-82. DOI:10.1016/j.oraloncology.2017.07.024
14. Kim SH, Jeong JB, Kim JW, et al. Clinical and endoscopic characteristics of drug-induced esophagitis. World J Gastroenterol. 2014;20(31):10994-9. DOI:10.3748/wjg.v20.i31.10994
15. Ruigómez A, García Rodríguez LA, Wallander M-A, et al. Natural history of gastro-oesophageal reflux disease diagnosed in general practice. Aliment Pharmacol Ther. 2004;20(7):751-60. DOI:10.1111/j.1365-2036.2004.02169.x
16. Osadchuk AM, Davydkin IL, Gricenko TA, Osadchuk MA. Gastroesophageal reflux disease and esophagitis associated with the use of drugs: the modern state of the problem. Terapevticheskii Arkhiv (Ter. Arkh.). 2019;91(8):135-40 (in Russian). DOI:10.26442/00403660.2019.08.000228
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Авторы

М.А. Осадчук*1, А.М. Осадчук2

1 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия;
2 ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия
*osadchuk.mikhail@yandex.ru

________________________________________________

Mikhail A. Osadchuk*1, Alexey M. Osadchuk2

1 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
2 Russian Medical Academy of Continuous Professional Education, Moscow, Russia
*osadchuk.mikhail@yandex.ru

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