Lifestyle modification in the treatment of refractory gastroesophageal reflux disease and non-alcoholic fatty liver disease. A clinical case

Abstract

The article presents a clinical case of refractory gastroesophageal reflux disease (GERD) in a female patient with non-alcoholic fatty liver disease and morbid obesity. A 38-year-old woman came to the clinic with complaints of heartburn up to 5–6 times a day, other manifestations of pain and dyspeptic syndromes. Morbid obesity, refractory GERD with erosive esopha­gitis, and hepatic steatosis were diagnosed during follow-up exa­mination. A set of treatment measures was developed, which included lifestyle modification, proton pump inhibitors and ursodeoxycholic acid preparations. During the observation period of 16 months, a gradual decrease in body weight was accompanied by a decrease in the frequency of heartburn. As a result, the patient lost 49 kg. During the control instrumental examination, a positive trend was observed in terms of sonographic and endoscopic indicators, as well as a decrease in liver stiffness according to elastography data. A review of the literature on the correlation between obesity, steato­sis and reflux disease is given. Conclusion. Obesity and related fatty liver disease can be additional factors for the development of refractory GERD, and a significant reduction in body weight leads to both resolution of reflux disease and improvement of parameters cha­racterizing the structural state of the liver.

Keywords

• refractory gastroesophageal reflux disease
• obesity
• steato­sis of the liver
• elastometry
• steatometry