Resistance of the Esophageal Mucosa in Patients with GERD: the Dialogue Between Clinician and Pathologist

Matoshina, I.V.; Fedorin, M. M.; Ливзан, М. А.; Mozgovoy, S.I. Mozgovoy

doi:10.33978/2307-3586-2021-17-4-34-39

Cited by 5 publications

(1 citation statement)

References 22 publications

(37 reference statements)

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“…Ожирение, часто ассоциированное с метаболическим синдромом, является установленным фактором риска развития ряда хронических неинфекционных заболеваний, в том числе патологий сердечно-сосудистой системы и неалкогольной жировой болезни печени (НАЖБП) [12]. Нарушение состава кишечной микробиоты у лиц, страдающих ожирением и/или НАЖБП, способствует повышению проницаемости кишечного эпителиального барьера [13,14]. В свою очередь желчные кислоты ограничивают избыточной рост бактерий кишечника и последующие нарушения эпителиальной проницаемости толстой кишки, регулируют метаболизм глюкозы и липидов посредством передачи сигналов через фарнезоидный X-рецептор (FXR) и мембрано-ассоциированный рецептор, связанный с G-белком (TGR5).…”

Section: особенности пищевого поведения у больных срк с избыточной ма...unclassified

Features of the course of irritable bowel syndrome in overweight and obese people

Fedorin,

Livzan,

Gaus

2024

jour

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The aim of the study: to study the characteristics of the course of irritable bowel syndrome (IBS), associated with overweight and obesity, to optimize the management of this group of patients. Material and methods. An open-label cross-sectional study was performed including 175 participants aged 18 to 44 years (mean age 30.06 ± 6.15 years). Group 1 included 100 patients with IBS aged 18 to 44 years (mean age 30.63 ± 6.37 years, BMI 25.88 ± 6.28 kg/m2). In group 1, subgroup 1A included 50 people with IBS associated with overweight or obesity. Subgroup 1B included 50 IBS patients with normal weight. Group 2 included 75 people who did not suffer from IBS, aged from 19 to 43 years (mean age 29.31 ± 5.81 years, BMI 27.80 ± 6.20 kg/m2). Subgroup 2A included 50 participants who did not suffer from IBS and were overweight or obese. Subgroup 2B included 25 apparently healthy participants. The presence and severity of IBS symptoms were assessed using a 10-point scale. The severity of gastrointestinal symptoms, the presence of anxiety and depression, the level of specific anxiety, quality of life and eating habits were assessed using verified questionnaires. All participants underwent a study of the levels of leptin and adiponectin in the blood serum and zonulin in the feces. Results. The characteristic clinical stigmas in patients suffering from IBS associated with overweight and obesity are described: IBS with a predominance of constipation, severe course of the disease, high incidence of signs of depressive and anxiety disorders, special eating habits characterized by the predominance of flour, sweet, fatty and salty foods in the diet food, severe disturbances in the permeability of the intestinal epithelial barrier. High concentrations of leptin and low levels of adiponectin in the blood serum of such patients may play a significant role in the formation of IBS symptoms. Conclusion. The results obtained open up opportunities for research into the pathogenetic mechanisms of the formation of IBS in people with overweight and obesity, as well as modification of existing treatment regimens for patients with IBS.

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Section: особенности пищевого поведения у больных срк с избыточной ма...unclassified

Features of the course of irritable bowel syndrome in overweight and obese people

Fedorin,

Livzan,

Gaus

2024

jour

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Adherence to treatment of patients with irritable bowel syndrome: state of the issue

Sukhanova¹,

Timakova²,

Ливзан³

et al. 2021

Profil. med.

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Features of therapeutic correction of GERD: focus on cytoprotection (with a clinical case)

Pakhomova

2022

Medicinskij sovet

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Тo date, the possible links of the pathogenesis of this disease have been well studied and described, which predetermine certain approaches to the treatment of various variants of gastroesophageal reflux disease (GERD). Effective drug therapy for GERD includes proton pump inhibitors (PPI). However, PPI monotherapy is not always effective. One approach is to increase the PPI dose. At the same time, combination therapy with the addition of drugs that affect the protective properties of the esophageal mucosa seems to be more rational. It is known that in the development of GERD, the violation of cytoprotection of the esophageal mucosa is one of the key links in pathogenesis. Consequently, the issue of combination therapy of PPIs with drugs that increase the protective properties of the mucous barrier along with acid suppression becomes relevant. An example of such an approach is the appointment of rebamipide, the action of which is to regulate the synthesis of prostaglandins through COX-2 mediated mechanisms, influence on endothelial growth factor, increase the expression of tight intercellular contact proteins in epithelial cells of the mucous membrane, reduce the level of interleukin-8 and free oxygen radicals, directed to protect the mucous membrane of the gastrointestinal tract and restore its natural barrier properties. The effectiveness of the combination of PPI and rebamipide contributes to a greater regression of complaints in patients with GERD and a lower frequency of disease relapses than with PPI monotherapy. This article provides a review of the literature on the features of GERD therapy, primarily with an emphasis on the correction of the cytoprotective properties of the esophageal mucosa, including against the background of the use of nonsteroidal anti-inflammatory drugs (NSAID), and a clinical case analysis with a discussion of rational pharmacological correction.

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Resistance of the Esophageal Mucosa in Patients with GERD: the Dialogue Between Clinician and Pathologist

Cited by 5 publications

References 22 publications

Features of the course of irritable bowel syndrome in overweight and obese people

Features of the course of irritable bowel syndrome in overweight and obese people

Adherence to treatment of patients with irritable bowel syndrome: state of the issue

Features of therapeutic correction of GERD: focus on cytoprotection (with a clinical case)

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