Saratov JOURNAL of Medical and Scientific Research

gastroesophageal reflux disease

The influence of different variants of glucose-lowering therapy on indices of inflammation in patients with diabetes type 2 on a background of gastroesophageal reflux disease and obesity

Year: 2018, volume 14 Issue: №3 Pages: 368-372
Heading: Internal Diseases Article type: Original article
Authors: Andreeva E.l.
Organization: Stavropol State Medical University
Summary:

Aim: to evaluate the effect of different types of hypoglycemic therapy on the level of leptin, interleukin-6, C-reactive protein, tumor necrosis factor-alpha, as well as body mass index. Material and Methods. The study involved 250 people. 200 case histories of patients with the main diagnosis Gastroesophageal Reflux Disease were analyzed. Group I consisted of 50 suffering from diabetes type II diabetes in combination with obesity of varying severity and GERD. Treatment of diabetes in this group was carried out with the help of Metformin. Group II consisted of 50 patients with type II diabetes mellitus combined with obesity of varying severity and gastroesophageal reflux disease. Patients in this group took exenatide. Group III consisted of 50 patients suffering from obesity of different severity and gastroesophageal reflux disease. The comparison group (IV) consisted of 50 patients with gastroesophageal reflux disease without overweight and comorbidities. For the treatment of GERD in the study subjects used — omeprazole. The control group (V) consisted of 50 healthy volunteers. Laboratory tests (General blood test, biochemical, immunological parameters) were performed on automated hematological (Ruby), immunochemical (Architect 2000) and biochemical (Architect 4000) analyzers (Abbott, USA). Results. In the course of assessing the indicators before therapy, we can note an increase in the level of leptin in the group of patients with obesity, while against the background of type 2 diabetes. Assessing the level of interleukin-6, C-reactive protein, tumor necrosis factor-alpha statistically significant increase in indicators was observed in the groups of patients with obesity (I, II, III study group). As a result of treatment, weight loss in patients of group II correlated with a decrease in the level of leptin, interleukin 6, C-reactive protein and TNF. Conclusion. As a result of treatment with exenatide, weight loss in patients of group II correlated with a decrease in the level of leptin, interleukin 6, C-reactive protein and TNF, indicating a decrease in the metabolic activity of visceral fat, which consists in the activation of lipolysis, release of free fatty acids and adipocytokines

AttachmentSize
2018_3_368-372.pdf358.27 KB

Features of the clinical course of gastroesophageal reflux disease associated with obesity

Year: 2018, volume 14 Issue: №1 Pages: 42-45
Heading: Internal Diseases Article type: Original article
Authors: Andreeva E.l.
Organization: Stavropol State Medical University
Summary:

The research goal is to reveal the features of clinical manifestations of gastroesophageal reflux disease (GERD) in obesity. Material and Methods. A survey and anthropometric study of 51 patients suffering from GERD and obesity aged 30 to 60 years were conducted. The average age of the patients was 42.3±2.11 years. Patients were divided into groups according to the BMI score. The control group consisted of patients suffering from GERD without obesity. Results. The main complaint of the patients of the control group was heartburn, while the patients of the main group had complaints of dyspeptic nature. With an increase in BMI, there was an increase in the incidence of complaints, in addition, complaints of an extra-esophageal nature associated with the direct effect of acidic gastric contents on the pharyngeal mucosa were detected. This regularity is explained in the article by pathogenetic mechanisms of GERD development. In patients suffering from GERD without obesity, the development of the disease is caused by a change in the motor activity of the esophagus due to a decrease in the tone of the lower esophageal sphincter, and in patients with co-pathology the main role is given to increased intragastric pressure, which leads to disruption of the sphincter. Conclusion. Thus, the clinical picture of combination of GERD and obesity differs atypical for GERD current, the main features of which are the predominance of dyspeptic complaints, motor-evacuation disorders, and the presence of extraesophageal complaints.

AttachmentSize
2018_1_042-045.pdf414.26 KB

Peculiarities of clinical course of gastroesophageal reflux disease in patients with type 2 diabetes and obesity

Year: 2017, volume 13 Issue: №4 Pages: 809-812
Heading: Internal Diseases Article type: Original article
Authors: Andreeva E.l.
Organization: Stavropol State Medical University
Summary:

Aim: to study the clinical course of gastroesophageal reflux disease (GERD) in patients with type 2 diabetes and evaluation of the parameters of the esophagus 24-hour pH-metry. Material and Methods. In the examination of patients with GERD, three groups of patients were selected for 50 people each. The first group includes patients with GERD with combined course of obesity and type 2 diabetes (mean age 54.6±2.73 year; 32 females and 18 males). The second group included patients with GERD against obesity (mean age 42.3±2.11 year; 30 females and 20 males). The control group consisted of patients with GERD without excess body weight and concomitant pathology (average age43.6±2.11 year; 29 females and 21 males). In addition to collecting complaints and anamnesis, the patients and the control group underwent a 24-hour pH-metric study of the esophagus according to a conventional method. Results. Patients suffering from GERD in the background of type 2 diabetes have a clinically asymptomatic or asymptomatic course; there is a significant increase in the daily pH-metry, indicating a more pronounced nature of the changes. Conclusion. Patients suffering from GERD in the background of type 2 diabetes require a comprehensive examination of the upper digestive tract to identify GERD, even if there are no complaints characteristic of the disease.

AttachmentSize
2017_04_809-812.pdf445.56 KB

The treatment of gastroesophageal reflux disease in menopausal women suffering from diabetes mellitus type II

Year: 2016, volume 12 Issue: №4 Pages: 556-560
Heading: Internal Diseases Article type: Original article
Authors: Semikina Т.М., Kunitsyna M.A., Kashkina E.l.
Organization: Saratov State Medical University
Summary:

Purpose: to develop criteria for the selection of optimal tactics of supporting treatment of nonerosive gastroesophageal reflux disease with proton pump inhibitors in menopausal women suffering from diabetes mellitus type II. Material and Methods. 186 patients aged 45-59 who suffer from gastroesophageal reflux disease have been followed up, 46 of which suffer from diabetes mellitus type II as well. The climacteric syndrome's morbidity has been assessed in accordance with the modified menopause index; the level of glycated hemoglobin has been measured by the Abbott analyzer produced in the USA. Results. It is established that irrespective of the supporting treatment, the gastroesophageal reflux disease remittance was shorter in direct proportion with increase of the HbA1c level and the value of the modified menopause index in menopausal women suffering from diabetes mellitus type II. Conclusion. When the climacteric syndrome was mild or moderate, taking 20 mg Omeprazole once a day and "on demand" has comparable results, therefore this group of women prefer the "on demand" regimen as it lowers the risk of osteoporosis progression and further bone fracture. Taking 20 mg Omeprazole once a day, every other day, and "on demand" allows the disease remittance to prolong for a year and longer in less than 30% of women suffering from severe climacteric syndrome and having HbA1c>9.0%; however, this number may grow up to 70% of women in case they follow medical advice and reduce their carbohydrate input to 11 carbohydrate units and less.

AttachmentSize
2016_04_556-560.pdf327.25 KB

Results of repeated antireflux operations on hiatal hernias

Year: 2016, volume 12 Issue: №2 Pages: 191-195
Heading: Surgery Article type: Original article
Authors: Khubolov A.M.
Organization: Saratov State Medical University
Summary:

The research goal: to carry out the retrospective analysis of results of repeated antireflux interventions at the recurrent hernias of an esophageal opening of a diaphragm (HEOD). Material and methods. Results of surgical treatment of 38 patients with recurrence of HEOD in various terms after operation are studied. Results. At the most part of patients at repeated operations anatomic prerequisites to formation of recurrence of HEOD — migration of a fundoplication cuff, insolvency, an excessive tension of tissues when forming the gastric coupling, violation of technology of imposing of a cuff come to light. In this regard, proceeding from these references and the analysis of own research, it has been considered that plasticity of local tissues at recurrent HEOD, is insufficient for reliable elimination of a gastroesopha-geal reflux. Conclusion. The analysis of the results of antireflux surgical treatment of HEOD with a reflux-esophageal phenomenon has shown high efficiency of no tension plasticity, with use of a synthetic artificial limb. The fundoplication technique in antireflux surgery with no tension plasticity may be used as an operation of choice at recurrent hernias of an esophageal opening of a diaphragm.

AttachmentSize
2016_02_191-195.pdf258.25 KB

Experience of antireflux surgery application for the treatment of gastroesophageal reflux disease

Year: 2015, volume 11 Issue: №4 Pages: 583-586
Heading: Surgery Article type: Original article
Authors: Tolstokorov A.S., Khubolov A.M., Kovalenko Yu.V.
Organization: Saratov State Medical University
Summary:

Purpose of the study: post-hoc analysis of mid-term and late results of various types of antireflux surgery performed to treat hiatal hernia. Material and methods. We have studied results of post-surgery examination of 118 patients diagnosed with hiatal hernia, the examination being performed at various time intervals after surgeries. Results. The only benefits of using laparoscopic treatment include cosmetic effect, shorter terms of hospital stay and recovery of person's capacity to work. Conclusion. Analysis of immediate and late results of surgical treatment of gastroesophageal reflux disease as well as frequency of postsurgical relapses provided no certain evidence of significant beneficial effect for choosing laparoscopic surgical methods over traditional open surgery.

AttachmentSize
2015_04_583-586.pdf266.64 KB

The role of epithelial cells proliferation and apoptosis disturbances in pathogenesis of inflammatory diseases of parodentium accompanied by gastroesophageal reflux disease

Year: 2013, volume 9 Issue: №3 Pages: 449-453
Heading: Stomatology Article type: Original article
Authors: Osipova J.L., Bulkina N.V., Osadchuk М.А., Kvetnoy I.M.
Organization: First Moscow State Medical University n.a. I.M. Sechenov, Saratov State Medical University, St. Petersburg Institute of Bioregulation and Gerontology
Summary:

The aim of the research was the study of the cell proliferation indices of the gum epithelial cells in patients with parodentium inflammatory diseases accompanied by gastroesophageal reflux disease (GERD). Material and methods. 160 patients were examined, 60 patients with parodentium inflammatory diseases accompanied by NEGERD, 40 patients with parodentium inflammatory diseases accompanied by GERD. The comparison groups consisted of 40 patients with diseases of parodentium without esophagus pathology and 20 healthy persons. Results. On the basis of the conducted clinical-endoscopic, immune-histological and morphological examinations it was established that gingivitis and periodontitis are successive stages of disturbance of the cellular homeostasis of gum epithelial cells. Conclusion. The enhancement of the processes of proliferation and apoptosis promotes the progression of the structural alterations in the tissues of parodentium and oesophagus and may serve as additional diagnostic and prognostic criteria of the diseases of parodentium accompanied by GERD.

AttachmentSize
2013-03_449-453.pdf268.89 KB

Comorbidity Of Periodontal And Gastrointestinal Diseases

Year: 2009, volume 5 Issue: №3 Pages: 393-398
Heading: Stomatology Article type: Review
Authors: O.V. Eremin, A.V. Lepilin, I.V. Kozlova, D.V. Kargin
Organization: Saratov State Medical University, Saratov Clinical Hospital №3
Summary:

The goal of this article is to present review of literature data concerning the problem of combined periodontal lesions and chronic diseases of digestive apparatus from clinical and laboratory-instrumental view point. Gastrointestinal diseases are frequently accompanied by pathologic changes of periodontium. The leading part of such syntropy is disturbance of a number of regulative mechanisms: immune and endocrine disbalance; microcirculatory and neurohumoral regulation; psychosomatic relations; changes in metabolism of connective tissues; mineral metabolism; vitamin deficit. Pathology of digestive system promotes oral microflora negative influence on periodontium, gingivitis and periodontitis development by means of decreasing nonspecific resistance of organism. Pathology of gastrointestinal tract is the risk factor for development and unfavorable clinical course of chronic inflammatory periodontal diseases

AttachmentSize
200903_393_398.pdf305.41 KB

Disturbance Of Sleep-Wake Regimen As Prognosis Criterion Of Gastroesophageal Reflux Disease Exacerbation

Year: 2009, volume 5 Issue: №3 Pages: 355-357
Heading: Internal Diseases Article type: Original article
Authors: E.I. Kashkina, R.V. Lyakisheva
Organization: Saratov State Medical University
Summary:

The goal of the present research is to define correlation of disease exacerbation risk within the next month and sleep-wake regimen changes in patients with gastroesophageal reflux disease. 40 patients with remission have been examined three times a week to determine qualitative and quantitative indices of sleep characteristic. During the following month the dynamic examination of the mentioned group of patients has been carried out for the purpose of timely acute condition diagnostics. It has been revealed that disturbances of sleep indices, such as late falling asleep, long-term falling asleep, frequency of awakening and unpleasant dreams become unfavorable risk factors for the development of the next recurrence of gastroesophageal reflux disease during the nearest month, but the remission of this disease is significantly connected with falling asleep duration and awakening time.

AttachmentSize
200903_355_357.pdf253.05 KB

FEATURES OF CLINICAL COURSE OF GASTROESOPHAGEAL REFLUX DISEASE IN NEWLY RECRUITED WITH CONNECTIVE TISSUE UNDIFFERENTIATED DYSPLASIA SYNDROME

Year: 2008, volume 4 Issue: №4 Pages: 46-49
Heading: Internal Diseases Article type: Original article
Authors: S.V. Semenov, E.I. Kashkina
Organization: Saratov State Medical University, Saratov Military Medical Institute
Summary:

The presence of connective tissue undifferentiated dysplasia syndrome against a background of psychological stress at newly recruited can promote the risk of gastroesophageal reflux disease occurrence. To the utmost, correlation between the gastroesophageal reflux disease and such manifestations of connective tissue undifferentiated dysplasia syndrome as asthenic constitution, chest deformation, Gothic palate and hypermobility of joints was found

AttachmentSize
2008_04_046_049.pdf183.55 KB