Experience in administration of an esophageal protective agent in patients with achalasia cardia and Barrett's esophagus
DOI: 10.32364/2587-6821-2026-10-5-9
Experience in administration of an esophageal protective agent in patients with achalasia cardia and Barrett's esophagus
I.V. Ufimtseva, S.V. Yakovleva, A.V. Blagikh
Lotus Medical Center LLC, Chelyabinsk, Russian Federation
Achalasia cardia (AC) and Barrett's esophagus (BE) are precancerous conditions whose relevance is associated with a significant increase in the morbidity over the past 30 years and a high risk of esophageal adenocarcinoma. Despite different mechanisms of development, these diseases have similar clinical presentations (regurgitation, swallowing disorders, cough, chest pain, heartburn) and share some tissue changes related to inflammation in the esophageal mucosa. Gastroesophageal reflux disease (GERD) plays a key role in both conditions: as a cause of BE and as an adverse clinical outcome in patients with AC. Both diseases share a common mechanism of tissue changes such as damaged mucosal barrier, impaired apical junction complex, dilated intercellular spaces, and the disease progression. In patients with AC, pneumatic dilation of the cardia and incision of the esophagogastric junction muscles lead to damage of muscle fibers and inflammation. As for BE, radiofrequency ablation of the metaplastic esophageal tissue also affects the mucosa. Clinical case reports of patients with BE and AC demonstrate efficacy of an esophageal protective agent including sodium hyaluronate, sodium chondroitin sulfate, and Poloxamer 407. Owing to reliable protection of the esophageal mucosa, inflammation reduction, and recovery of intercellular connections, it may be used to treat BE and AC along with background therapy.
Keywords: Barrett's esophagus, achalasia cardia, GERD, esophageal protective agent, case reports.
For citation: Ufimtseva I.V., Yakovleva S.V., Blagikh A.V. Experience in administration of an esophageal protective agent in patients with achalasia cardia and Barrett's esophagus. Russian Medical Inquiry. 2026;10(5):326–333 (in Russ.). DOI: 10.32364/2587-6821-2026-10-5-9
About the authors:
Irina V. Ufimtseva — C. Sc. (Med.), Gastroenterologist, Leading Specialist at Lotus Medical Center LLC; 4, Engels str., Chelyabinsk, 454080, Russian Federation; ORCID iD 0000-0002-7626-5000
Sofia V. Yakovleva — C. Sc. (Med.), Therapist, Head of the Therapeutic Department No. 1, Lotus Medical Center LLC; 4, Engels str., Chelyabinsk, 454080, Russian Federation; ORCID iD 0000-0001-6945-5060
Andrey V. Blagikh — Endoscopist, Head of the Endoscopy Department, Lotus Medical Center LLC; 4, Engels str., Chelyabinsk, 454080, Russian Federation.
Contact information: Irina V. Ufimtseva, e-mail: ufimtsevaiv77@mail.ru
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 04.05.2026.
Revised 22.05.2026.
Accepted 29.05.2026.
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2. Samo S., Carlson D.A., Gregory D.L. et al. Incidence and prevalence of achalasia in central Chicago, 2004–2014, since the widespread use of high-resolution manometry. Clin Gastroenterol Hepatol. 2017;15(3):366–73. DOI: 10.1016/j.cgh.2016.08.030
3. Savarino E., Bhatia S., Roman S. et al. Achalasia. Nat Rev Dis Primers. 2022;8(1):28. DOI: 10.1038/s41572-022-00356-8
4. Romero-Hernández F., Furuzawa-Carballeda J., Hernández-Molina G. et al. Autoimmune comorbidity in achalasia patients. J Gastroenterol Hepatol. 2018;33(1):203–208. DOI: 10.1111/jgh.13839
5. Ивашкин В.Т., Трухманов А.С., Маев И.В. и др. Диагностика и лечение ахалазии кардии (Клинические рекомендации РГА, РНМОТ, РОПИ, Ассоциации эндоскопического общества «РЭндО» (Российского . эндоскопического общества)). Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2024;34(6):120–148. DOI: 10.22416/1382-4376-2024-34-6-120-148. Ivashkin V.T., Trukhmanov A.S., Maev I.V. et al. Diagnostics and Treatment of Esophageal Achalasia (Clinical Guidelines of the Russian Gastroenterological Association, Russian Scientific Medical Society of Internal Medicine, Russian Society for the Prevention of Noncommunicable Diseases, REndO Endoscopic Society). Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2024;34(6):120–148 (in Russ.). DOI: 10.22416/1382-4376-2024-34-6-120-148
6. Tustumi F., Bernardo W.M., da Rocha J.R.M. et al. Esophageal achalasia: A risk factor for carcinoma. A systematic review and meta-analysis. Dis Esophagus. 2017;30(10):1–8. DOI: 10.1093/dote/dox072
7. De Moura E.T.H., Jukemura J., Ribeiro I.B. et al. Peroral endoscopic myotomy vs laparoscopic myotomy and partial fundoplication for esophageal achalasia: A single-center randomized controlled trial. World J Gastroenterol. 2022;28(33):4875–4889. DOI: 10.3748/wjg.v28.i33.4875
8. Mota R.C.L., De Mouro E.G.H., De Mouro D.T.H. et al. Risk factors for gastroesophageal reflux after POEM for achalasia: A systematic review and meta-analysis. Surg Endosc. 2021;35(1):383–397. DOI: 10.1007/s00464-020-07412-y
9. Schlottmann F., Neto R.M.L., Herbella F.A.M., Patti M.G. Esophageal achalasia: Pathophysiology, clinical presentation, and diagnostic evaluation. Am Surg. 2018;84(4):467–472. PMID: 29712590
10. Boeckxstaens G.E., Zaninotto G., Richter J.E. Achalasia. Lancet. 2014;383(9911):83–93. DOI: 10.1016/S0140-6736(13)60651-0
11. Ghoshal U.C., Daschakraborty S.B., Singh R. Pathogenesis of achalasia cardia. World J Gastroenterol. 2012;18(24):3050–3057. DOI: 10.3748/wjg.v18.i24.3050
12. Patel D.A., Kim H.P., Zifodya J.S., Vaezi M.F. Idiopathic (primary) achalasia: A review. Orphanet J Rare Dis. 2015;10(1):89. DOI: 10.1186/s13023-015-0302
13. Andolfi C., Fisichella P.M. Meta-analysis of clinical outcome after treatment for achalasia based on manometric subtypes. Br J Surg. 2019;106(4):332–341. DOI: 10.1002/ bjs.11049
14. Nelson M., Zhang X., Genta R.M. et al. Lower esophageal sphincter muscle of patients with achalasia exhibits profound mast cell degranulation. Neurogastroenterol Motil. 2021;33(5):e14055. DOI: 10.1111/nmo.140
15. Петровский Б.В. Кардиоспазм и его хирургическое значение. В кн.: Труды 27-го Всесоюзного съезда хирургов. М.; 1962:162–173. Petrovsky B.V. Cardiospasm and surgical significance: abstracts of the 27th All-Union congress of surgeons. M.; 1962:162–173 (in Russ.).
16. Ивашкин В.Т., Трухманов А.С., Годжелло Э.А. и др. Рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению ахалазии кардии и кардиоспазма. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2016;26(4):36–54. DOI: 10.22416/1382-4376-2016-4-36-54. Ivashkin V.T., Trukhmanov A.S., Godzhello E.A. et al. Diagnostics and treatment of cardiac achalasia and cardiospasm: guidelines of the Russian gastroenterological association. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2016;26(4):36–54 (in Russ.). DOI: 10.22416/1382-4376-2016-4-36-54
17. Vaezi M.F., Pandolfino J.E., Yadlapati R.H. et al. ACG clinical guidelines: Diagnosis and management of achalasia. Am J Gastroenterol. 2020;115(9):1393–1411. DOI: 10.14309/ajg.0000000000000731
18. Годжелло Э.А., Хрусталева М.В., Шатверян Д.Г., Булганина Н.А. Диагностика и лечение ахалазии кардии — обзор зарубежной литературы. Экспериментальная и клиническая гастроэнтерология. 2020;177(5):21–35. DOI: 10.31146/1682-8658-ecg-177-5-21-35. Godzhello E.A., Khrustaleva M.V., Shatveryan D.G., Bulganina N.A. Diagnosis and treatment of achalasia — a review of foreign literature. Experimental and Clinical Gastroenterology. 2020;177(5):21–35 (in Russ.). DOI: 10.31146/1682-8658-ecg-177-5-21-35
19. Bortolotti M., Labò G. Clinical and manometric effects of nifedipine in patients with esophageal achalasia. Gastroenterology. 1981;80(1):39–44.
20. Ponds F.A., Fockens P., Lei A. et al. Effect of peroral endoscopic myotomy vs pneumatic dilation on symptom severity and treatment outcomes among treatment-naive patients with achalasia: A randomized clinical trial. JAMA. 2019;322(2):134–144. DOI: 10.1001/jama.2019.8859
21. Дробязгин Е.А., Чикинев Ю.В., Митько Н.И. Ближайшие и отдаленные результаты эндоскопического лечения пациентов с ахалазией пищевода. Экспериментальная и клиническая гастроэнтерология. 2023;213(5):59–65. DOI: 10.31146/1682-8658-ecg-213-5-59-65. Drobyazgin E.A., Chikinev Yu.V., Mit'Ko N.I. Nearest and ling-time outcomes of endoscopic treatment of patients with esophageal achalasia. Experimental and Clinical Gastroenterology. 2023;(5):59–65 (in Russ.). DOI: 10.31146/1682-8658-ecg-213-5-59-65
22. De Moura E.T.H., Jukemura J., Ribeiro I.B. et al. Peroral endoscopic myotomy vs laparoscopic myotomy and partial fundoplication for esophageal achalasia: A single-center randomized controlled trial. World J Gastroenterol. 2022;28(33):4875–4889. DOI: 10.3748/wjg.v28.i33.4875
23. Mota R.C.L., De Mouro E.G.H., De Mouro D.T.H. et al. Risk factors for gastroesophageal reflux after POEM for achalasia: A systematic review and meta-analysis. Surg Endosc. 2021;35(1):383–397. DOI: 10.1007/s00464-020-07412-y
24. Campos G.M., Vittinghoff E., Rabl C. et al. Endoscopic and surgical treatments for achalasia: A systematic review and meta-analysis. Ann Surg. 2009;249(1):45–57. DOI: 10.1097/ SLA.0b013e31818e43ab
25. Fitzgerald R.C. Barrett's Esophagus. N Engl J Med. 2026;394(17):1723–1735. DOI: 10.1056/NEJMcp2506887
26. Beydoun A.S., Stabenau K.A., Altman K.W., Johnston N. Cancer Risk in Barrett's Esophagus: A Clinical Review. Int J Mol Sci. 2023;24(7):6018. DOI: 10.3390/ijms24076018
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