Clinical application of proton pump inhibitor in the treatment of gastroesophageal reflux disease, complicated with Barrett syndrome (a clinical case)

Abstract

The article presents a clinical case of patient with Barrett’s esophagus. A patient of 36 years old went to the clinic with complaints of heartburn, which did not stop while taking a standard dose of a proton pump inhibitor. After examination and esophagogastroduodenoscopy with biopsy, the diagnosis of hiatal hernia and gastroesophageal reflux disease, Barrett’s esophagus, CM4, undefined dysplasia, with typical reflux syndrome was established.The patient was administered nutritional correction and therapy with a proton pump inhibitor (Nolpaza 40 mg, 1 tablet twice a day) with a duration of 6 months. After the treatment completion, repeated examination and esophagogastroduodenoscopy with biopsy in dynamics were carried out. The diagnosis was changed to Barrett’s esophagus without dysplasia. The patient was recommended the long‑term intake of proton pump inhibitor and gastroscopy check after 3 years.This case showed that definitive therapy is not the only possible method of treatment of such precancerous condition as Barrett’s esophagus. The variants of Barrett’s esophagus exist, when drug therapy with a double dose of PPIs and periodic observation of the patient with upper endoscopy are sufficient. With account of the world standards for the management of patients with Barrett’s esophagus with undetermined dysplasia, this clinical example gives grounds to recommend the administration of pantoprazole (Nolpaza) as an effective drug at the Barrett’s esophagus diagnosis.