Heterogeneity of gastroesophageal reflux disease. Myth or reality
Simanenkov V.I., Tichonov S.V., Lishchuk N.B.

North-Western State Medical University named after I.I Mechnikov, St. Petersburg

Resistance to proton pump inhibitors (PPI) is a frequent phenomenon in clinical practice. Heterogeneity of gastroesophageal reflux disease (GERD), particularly non-acidic gastroesophageal reflux (GER), is one of the reason for the lack of effectiveness of PPIs therapy. The paper addresses prevalence of non-acidic form of GERD, etiology and pathogenesis, clinical manifestation, approaches to therapy; results of our own study on the efficacy and safety of a differentiated approach to GERD treatment. Intermediate results of our own research on the effectiveness of differentiated treatment in patients with non-acidic form of GERD are presented. Patients with weakly acidic reflux (40 persons) were randomized into two groups and received PPI or combination of PPI rabeprazole and prokinetic agent itopride. Patients with weakly alkaline reflux (22 persons) were randomized into two groups and received monotherapy with ursodeoxycholic acid, or combination of ursodeoxycholic acid and itopride. According to the results differentiated approach to the treatment of non-acidic form of GERD increases treatment effectiveness.

Key words: GERD, non-acid, mixed, alkaline gastroesophageal reflux (GER), ursodeoxycholic acid, itopridum.

For citation: Simanenkov V.I., Tichonov S.V., Lishchuk N.B. Heterogeneity of gastroesophageal reflux disease. Myth or reality // RMJ. 2016. № 17. P. 1119–1124.