Correction of eating behavior in patients with erosive reflux esophagitis
- Authors: Tikhonov S.V.1, Simanenkov V.I.1, Bakulina N.V.1, Lishchuk N.B.1, Topalova Y.G.1
-
Affiliations:
- North-West State Medical University named after I.I. Mechnikov
- Issue: Vol 13, No 1 (2021)
- Pages: 71-84
- Section: Original research
- URL: https://journal-vniispk.ru/vszgmu/article/view/63311
- DOI: https://doi.org/10.17816/mechnikov63311
- ID: 63311
Cite item
Abstract
AIM: To compare the efficacy of 1-month inhibitors of H+,K+-ATPase therapy and eating behavior correction over 6 months with initial 1-month and 5-month maintenance inhibitors of H+,K+-ATPase therapy in overweight and obese patients with erosive esophagitis.
MATERIALS AND METHODS: The randomized clinical study included 29 patients 54.8 ± 13.5 years with erosive esophagitis. 13 (45%) patients were overweight, 16 (55%) — obese, 26 (90%) had abdominal obesity. The patients were randomized into 2 groups: control group — 15 patients received 20 mg of omeprazole twice a day during 4 weeks and 20 mg of omeprazole once a day during 5 months; intervention group — 14 patients participated in the eating behavior correction program and received 20 mg of omeprazole once a day for 4 weeks initially. Clinical symptoms, the endoscopic and histological data , anxiety, depression and quality of life, motor disorders were under investigation.
RESULTS: At the end of the 4-week therapy, the control group had a lower frequency of heartburn (1.8 ± 0.08 vs 2.4 ± 0.6 points), intensity of heartburn (1.13 ± 0.51 vs 1.78 ± 0.89 points), healing of erosive esophagitis was more common (13 (86%) vs 5 (35%) patients), more % weakly acidic (2.5 ± 1.6 vs 0.8 ± 0.4) and % weakly alkaline time (0.44 ± 0.3 vs 0.15 ± 0.2) in the esophagus, more alkaline gastroesophageal refluxes (9.1 ± 9.8 vs 2.8 ± 3.9). By the end of the sixth month, the control group had higher frequency (3.46 ± 0,5 vs 2.28 ± 0.7 points) and the intensity of regurgitation (1.6 ± 0.5 vs 1.07 ± 0.26 points), more % weakly acidic (2.32 ± 1.86 vs 0.89 ± 0.57) and % weakly alkaline time (0.54 ± 0.72 vs 0.22 ± 0.28), lower quality of life according to GH scale and RE scale SF-36 questionnaire.
CONCLUSIONS: The superiority of an eating behavior correction strategy over inhibitors of H+,K+-ATPase therapy was demonstrated in this study. Weight loss leads to fewer symptoms of gastroesophageal reflux disease and improved gastroesophageal motility.
Full Text
##article.viewOnOriginalSite##About the authors
Sergey V. Tikhonov
North-West State Medical University named after I.I. Mechnikov
Author for correspondence.
Email: sergeyvt2702@gmail.com
ORCID iD: 0000-0001-5720-3528
SPIN-code: 6921-5511
MD, Cand. Sci. (Med.)
Russian Federation, 41 Kirochnaya str., Saint Petersburg, 191015Vladimir I. Simanenkov
North-West State Medical University named after I.I. Mechnikov
Email: visimanenkov@mail.ru
ORCID iD: 0000-0002-1956-0070
SPIN-code: 8073-2401
MD, Dr. Sci. (Med.), Professor
Russian Federation, 41 Kirochnaya str., Saint Petersburg, 191015Natalya V. Bakulina
North-West State Medical University named after I.I. Mechnikov
Email: natalya.bakulina@szgmu.ru
ORCID iD: 0000-0003-4075-4096
SPIN-code: 9503-8950
Scopus Author ID: 7201739080
ResearcherId: N-7299-2014
http://www.researcherid.com/rid/N-7299-2014
MD, Dr. Sci. (Med.), Assistant Professor
Russian Federation, 41 Kirochnaya str., Saint Petersburg, 191015Nadezhda B. Lishchuk
North-West State Medical University named after I.I. Mechnikov
Email: lishchuk.nadezhda@mail.ru
ORCID iD: 0000-0002-0703-9763
MD, Cand. Sci. (Med.)
Russian Federation, 41 Kirochnaya str., Saint Petersburg, 191015Yuliya G. Topalova
North-West State Medical University named after I.I. Mechnikov
Email: juliaklukvina11@rambler.ru
ORCID iD: 0000-0003-3999-6848
SPIN-code: 1301-6443
MD
Russian Federation, 41 Kirochnaya str., Saint Petersburg, 191015References
- Chang P, Friedenberg F. Obesity and GERD. Gastroenterol Clin North Am. 2014;43(1):161–173. doi: 10.1016/j.gtc.2013.11.009
- Lagergren J. Influence of obesity on the risk of esophageal disorders. Nat Rev Gastroenterol Hepatol. 2011;8(6):340–370. doi: 10.1038/nrgastro.2011.73
- Simanenkov VI, Tikhonov SV, Lishchuk NB. Gastroesophageal reflux disease and obesity: who is to blame and what to do? Medical alphabet. 2017;3(27(324)):5–10. (In Russ.)
- NCD Risk Factor Collaboration (NCD-RisC). Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19–7; 2 million participants. Lancet. 2016;387(10026):1377–1396. doi: 10.1016/S0140-6736(16)30054-X
- Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307(5):491–497. doi: 10.1001/jama.2012.39
- El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014;63(6):871–880. doi: 10.1136/gutjnl-2012-304269
- Lazebnik LB, Masharova AA, Bordin DS, et al. Results of a multicenter trial “epidemiology of gastroesophageal reflux disease in Russia” (MEGRE). Therapeutic Archive. 2011;83(1):45–50. (In Russ.)
- El-Serag HB. The association between obesity and GERD: a review of the epidemiological evidence. Dig Dis Sci. 2008;53(9):2307–2312. doi: 10.1007/s10620-008-0413-9
- El-Serag HB, Hashmi A, Garcia J, et al. Visceral abdominal obesity measured by CT scan is associated with an increased risk of Barrett’s oesophagus: a case-control study. Gut. 2013;63(2):220–229. doi: 10.1136/gutjnl-2012-304189
- Lazebnik LB, Zvenigorodskaya LA. Metabolicheskiy sindrom i organi pishcevareniya. Moscow: Anaharsis; 2009. P. 146–170. (In Russ.)
- Suter M, Dorta G, Giusti V, Calmes JM. Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients. Obes Surg. 2004;14(7):959–966. doi: 10.1381/0960892041719581
- Koppman JS, Poggi L, Szomstein S, et al. Esophageal motility disorders in the morbidly obese population. Surg Endosc. 2007;21(5):761–764. doi: 10.1007/s00464-006-9102-y
- Ayazi S, Hagen JA, Chan LS, et al. Obesity and gastroesophageal reflux: quantifying the association between body mass index, esophageal acid exposure, and lower esophageal sphincter status in a large series of patients with reflux symptoms. J Gastrointest Surg. 2009;13(8):1440–1447. doi: 10.1007/s11605-009-0930-7
- Kelesidis I, Kelesidis T, Mantzoros CS. Adiponectin and cancer: a systematic review. Br J Cancer. 2006;94(9):1221–1225. doi: 10.1038/sj.bjc.660305
- Rubenstein JH, Dahlkemper A, Kao JY, et al. A pilot study of the association of low plasma adiponectin and Barrett’s esophagus. Am J Gastroenterol. 2008;103(6):1358–1364. doi: 10.1111/j.1572-0241.2008.01823.x
- Kendall BJ, Macdonald GA, Hayward NK, et al. Leptin and the risk of Barrett’s oesophagus. Gut. 2008;57(4):448–454. doi: 10.1136/gut.2007.131243
- Ness-Jensen E, Lindam A, Lagergren J, Hveem K. Weight loss and reduction in gastroesophageal reflux. A prospective population-based cohort study: the HUNT study. Am J Gastroenterol. 2013;108(3):376–382. doi: 10.1038/ajg.2012.466
- Singh M, Lee J, Gupta N, et al. Weight loss can lead to resolution of gastroesophageal reflux disease symptoms: a prospective intervention trial. Obesity (Silver Spring). 2013;21(2):284–290. doi: 10.1002/oby.20279
- Fraser-Moodie CA, Norton B, Gornall C, et al. Weight loss has an independent beneficial effect on symptoms of gastro-oesophageal reflux in patients who are overweight. Scand J Gastroenterol. 1999;34(4):337–340. doi: 10.1080/003655299750026326
- Bortoli N, Tolone S, Savarino EV. Weight loss is truly effective in reducing symptoms and proton pump inhibitor use in patients with gastroesophageal reflux disease. Clin Gastroenterol Hepatol. 2015;13(11):2023. doi: 10.1016/j.cgh.2015.05.034
- Kjellin A, Ramel S, Rossner S, Thor K. Gastroesophageal reflux in obese patients is not reduced by weight reduction. Scand J Gastroenterol. 1996;31(11):1047–1051. doi: 10.3109/00365529609036885
- Frederiksen SG, Johansson J, Johnsson F, Hedenbro J. Neither low-calorie diet nor vertical banded gastroplasty influence gastro-oesophageal reflux in morbidly obese patients. Eur J Surg. 2000;166(4):296–300. doi: 10.1080/110241500750009122
- Lundell LR, Dent J, Bennett JR, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut. 1999;45(2):172–180. doi: 10.1136/gut.45.2.172
- Ware JE, Snow KK, Kosinski MA, Gandek B. SF-36 Health Survey. Manual and interpretation guide. The Health Institute, New England Medical Center. Boston: Mass;1993.
- Shlyahto EV, Nedogoda SV, Konradi AO. Diagnostica, lechenie, profilactica ogireniya i associirovannih s nim zabolevaniy (nacionalnye clinicheskie recomendacii). Saint Petersburg, 2017. Available from: https://scardio.ru/content/Guidelines/project/Ozhirenie_klin_rek_proekt.pdf. Accessed: Apr 24, 2021. (In Russ.)
- Gyawali CP, Kahrilas PJ, Savarino E, et al. Modern diagnosis of GERD: the Lyon Consensus. Gut. 2018;67(7):1351–1362. doi: 10.1136/gutjnl-2017-314722
- Maev IV, Bakulin IG, Bordin DS, et al. Clinical and endoscopic characteristics of GERD in obese patients. Effectivnaya pharmakoterapiya. 2021;17(4):12–20. (In Russ.). doi: 10.33978/2307-3586-2021-17-4-12-20
- Storonova OA, Dghahaya NL, Truhmanov AS, Ivashkin VT. Correlyaciya pokazateley dvigatelnoy funkcii pischevoda i indexa massi tela. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2010;20(5):152. (In Russ.)
- Ivashkin VT, Trukhmanov AS. Evolution of concept of esophageal motor disturbances in pathogenesis of gastroesophageal reflux disease. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2010;20(2):13–19. (In Russ.)
- Kahrilas PJ, Shaheen NJ, Vaezi MF, et al. American Gastroenterological Association medical position statement on the management of gastroesophageal reflux disease. Gastroenterology. 2008;135(4):1383–1391. doi: 10.1053/j.gastro.2008.08.045
- Simanenkov VI, Tikhonov SV, Lischuk NB. Treatment compliance at initial and maintenance therapy at gastroesophageal reflux disease. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2017;27(1):29–34. (In Russ.). doi: 10.22416/1382-4376-2017-27-1-29-34
- Naik RD, Meyers MH, Vaezi MF. Treatment of refractory gastroesophageal reflux disease. Gastroenterology Hepatology. 2020;16(4):196–205.
- Lishchuk NB, Simanenkov VI, Tikhonov SV. Differentiation therapy for non-acidic gastroesophageal reflux disease. Therapeutic Archive. 2017;89(4):57–63. (In Russ.). doi: 10.17116/terarkh201789457-63
- Evsjutina JuV, Truhmanov AS. Vedenie pacientov s refrakternoj formoj GJeRB. Russian Medical Journal. 2015;(28):1684–1688. (In Russ.)
- Truhmanov AS, Evsjutina JuV. Izhoga pri gastroesophagealnoy refluxnoy bolezni – mehanizm razvitiya i podhody k terapii. Russian Medical Journal. 2017;10:707–710. (In Russ.)
- Lapteva IV, Livzan MA. Therapy optimization gastroesophageal reflux disease in obese and overweight. Modern problems of science and education. 2016;(2). (In Russ.)
- Mermelstein J, Chait Mermelstein A, Chait MM. Proton pump inhibitor-refractory gastroesophageal reflux disease: challenges and solutions. Clin Exp Gastroenterol. 2018;11:119–134. doi: 10.2147/ceg.s121056
- Yurenev GL, Mironova EM, Andreev DN, Yureneva-Tkhorzhevskaya TV. Clinical and pathogenetic parallels gastroesophageal reflux disease and obesity. Pharmateka. 2017;(13(346)):30–39. (In Russ.)
- Bakulina NV, Tikhonov SV, Lishuk NB. Alfazox is an innovative medical product with proven esophagoprotective potential. Gastroenterology. Surgery. Intensive Care. Consilium Medicum. 2019;2:17–23. (In Russ.). doi: 10.26442/26583739.2019.2.190404
Supplementary files
