Внепищеводные маски гастроэзофагеальной рефлюксной болезни: частота, особенности диагностики и подготовки пациентов к офтальмохирургическим операциям

Abstract

Purpose. Evaluation of the frequency of gastroesophageal reflux disease (GERD) in the structure of somatic diseases of patients admitted to ophthalmic surgery, features of the manifestation and difficulties in diagnosing. Material and methods. The analysis of the preoperative state of 1213 patients with pathology of the gastrointestinal tract (GIT) was carried out. The frequency of GERD with typical and extraesophageal manifestations was studied. The assessment of the adequacy and effectiveness of drug therapy is given. Results. Pathology of the gastrointestinal tract in the structure of nosological forms of somatic diseases of patients entering ophthalmic surgery is 5–6%. GERD accounts for 30% of their number. Typical clinical manifestations of GERD occurred in 287 patients (79.1%). Of these, 203 people. (70.7%) were able to compensate for the disease, received adequate therapy with proton pump inhibitors. In 84 patients (29.3%), heartburn and epigastric discomfort persisted. In 76 patients (20.9%) with GERD, its extraesophageal manifestations were revealed. Have 29 people. (38%) they manifested themselves in the form of retrosternal pain. A paroxysmal dry cough, asthma attacks arising after eating, the appearance and aggravation of nocturnal symptoms of bronchial asthma disturbed 35 people (46%). Complaints of burning tongue, hoarseness, soreness when swallowing, sore throat, periodic laryngospasm were observed in 12 patients (16%). Conclusion. GERD takes the leading place among diseases of the upper gastrointestinal tract (more than 30%). About 21% are atypical manifestations of GERD. The most clinically significant among them, limiting the possibility of conducting planned surgical treatment, are cardiological and pulmonary masks. Modern etiopathogenetic treatment of GERD makes it possible to effectively stop the symptoms of the disease, avoid polypharmacy and unreasonable refusal in planned surgical treatment for patients with ophthalmic diseases. Key words: gastroesophageal reflux disease, extraesophageal manifestations, ophthalmic surgery.