Лечащий Врач (Nov 2024)
Gastroesophageal reflux disease in a comorbid patient, refractory to proton pump inhibitors. How can we help?
Abstract
Background. Gastroesophageal reflux disease is a multifactorial disease that is quite common in clinical practice. High prevalence, a clear trend towards increasing incidence not only in Russia, but also in all countries of the world, chronic relapsing course and significant impact on the quality of life of patients, the complexity of managing patients with gastroesophageal reflux disease, especially in comorbid patients, often distinguish it from other types of organ pathologies digestion. A significant contribution to the development of gastroesophageal reflux disease in a comorbid patient is made by obesity, hiatal hernia, duodenogastroesophageal reflux, etc.Results. First-line therapy for gastroesophageal reflux disease is proton pump inhibitors. Often, it is in a comorbid patient that an incomplete response to roton pump inhibitor monotherapy may occur, when the clinician faces the difficult problem of diagnosing the causes of nonresponse, as well as approaches to the treatment of refractory gastroesophageal reflux disease. An integrated approach to the treatment of gastroesophageal reflux disease in a comorbid patient allows for relief of the symptoms of the disease. At the same time, it is important to take into account the risks of drug-drug interactions of prescribed drugs, given the fact that comorbid patients initially receive a considerable number of medications for other diseases. In this regard, an effective approach to the treatment of gastroesophageal reflux disease may be the administration of alginic acid in combination with proton pump inhibitors. Аlginic acid, being a universal antireflux drug, has sorption properties, which is important for mixed reflux. In addition, the use of alginates is compatible with proton pump inhibitors. The alginic acid containing drug, due to its composition and mechanism of action, is effective and safe in comorbid patients.
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