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Mucus barrier correction as a target in complex treatment of gastroesophageal reflux disease


Gastroenterology & Hepatology: Open Access
Dorofeyev AE,1 Dyadyk OO,2 Zvyagintseva TD,3 Yu V Chychula,4 N.N.Rudenko,4 Stukalo AA5

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Abstract

The aim of our study was to evaluate the clinical efficacy of esophageal mucus barrier correction by complex treatment with sodium hyaluronate and sodium alginate (Hyalera/Gastropiù Bustine) application in patients with gastroesophagic reflux disease (GERD). We conducted a multicenter, randomized, open, comparative study with parallel monitoring to evaluate the effectiveness and safety of combination therapy for patients with GERD using the sodium hyaluronate and sodium alginate (Hyalera/Gastropiù Bustine). Under our supervision, there were 72 patients with GERD aged 18 to 65years. Women were 30 (41.7%), men 42 (58.3%). The criterion for inclusion in the study was the presence of GERD symptoms (primarily heartburn) with endoscopic and morphological confirmation. Omeprazole at a dose of 20mg 2 times a day and domperidone at a dose of 10mg 3 times a day were used as basic therapy in both groups. In the first group, an additional sodium hyaluronate and sodium alginate (Hyalera/Gastropiù Bustine) emulsion of 15ml sticks (Alpiflor, Italy) was prescribed. The emulsion was administered 1 stick after a meal 3 times a day.
 
The frequency of heartburn in the first group after treatment was almost three times lower than in the comparison group (p =0.035) and they did not have nightly heartburn. Also, dysphagia was absent in the first group (almost 7% of patients remained in the second), at the same time, the incidence of belching after treatment was identical in both groups (20 and 17%). Endoscopically, in the second group, 4.5 times more often than in the first, esophagitis was detected, and in 1 patient it was erosive. Morphologically, in patients of the first group, significant positive dynamics was noted.
The aim of our study was to evaluate the clinical efficacy of esophageal mucus barrier correction by complex treatment with sodium hyaluronate and sodium alginate (Hyalera/Gastropiù Bustine) application in patients with gastroesophagic reflux disease (GERD). We conducted a multicenter, randomized, open, comparative study with parallel monitoring to evaluate the effectiveness and safety of combination therapy for patients with GERD using the sodium hyaluronate and sodium alginate (Hyalera/Gastropiù Bustine). Under our supervision, there were 72 patients with GERD aged 18 to 65years. Women were 30 (41.7%), men 42 (58.3%). The criterion for inclusion in the study was the presence of GERD symptoms (primarily heartburn) with endoscopic and morphological confirmation. Omeprazole at a dose of 20mg 2 times a day and domperidone at a dose of 10mg 3 times a day were used as basic therapy in both groups. In the first group, an additional sodium hyaluronate and sodium alginate (Hyalera/Gastropiù Bustine) emulsion of 15ml sticks (Alpiflor, Italy) was prescribed. The emulsion was administered 1 stick after a meal 3 times a day.
 
The frequency of heartburn in the first group after treatment was almost three times lower than in the comparison group (p =0.035) and they did not have nightly heartburn. Also, dysphagia was absent in the first group (almost 7% of patients remained in the second), at the same time, the incidence of belching after treatment was identical in both groups (20 and 17%). Endoscopically, in the second group, 4.5 times more often than in the first, esophagitis was detected, and in 1 patient it was erosive. Morphologically, in patients of the first group, significant positive dynamics was noted.
 

Keywords

GERD, gastroesophagic reflux disease, TJ, tight junctions, PPIs, proton pump inhibitors, NMAPE, national medical academy of postgraduate education, IHA, immunohistochemical assay, esophagoscopy, anti-inflammatory drugs, claudins, occludins, antisecretory therapy, ECG, alcoholism, drug addiction, varying degrees, papillomatosis cells, manifestations

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