Clinically significant stigmas of the severity of GERD and dissociation with the degree of damage to the esophageal mucosa — the obligatory esophagoprotection?

Abstract

Study goal: Identify clinically significant stigmas of reduced esophageal mucosal resistance.Materials and methods: The study included 181 patients aged 18–70 years with gastroesophageal refl ux disease (GERD).Complaints, age, sex, history of the disease, life history, physical examination data, results of laboratory and instrumental examinations, data on medication intake at the time of enrollment of the patient for the main disease and concomitant pathology were noted in the individual registration card (IRC).Results: The study demonstrated the presence of features suggesting with a higher degree of probability a reduced esophageal mucosal resistance in a certain group of patients with GERD. Individuals with early- onset GERD, males, young adults, smokers, and individuals with a high body mass index (BMI) have a higher risk of esophageal mucosal erosions. The presence of esophageal hernia of the diaphragm (EVD), intake of acetylsalicylic acid (ASA), calcium channel blockers (CCBs), or nonsteroidal anti-inflammatory drugs (NSAIDs) are factors that reduce esophageal mucosal resistance. The formation of erosive esophagitis is not associated with the subjective perception of GERD symptoms and does not affect the patient’s complaints.Conclusion: Clinical manifestations of GERD are not associated with the degree of esophageal mucosal damage and cannot be a phenotypic sign of erosive esophagitis requiring mandatory prescription of an esophagoprotector. Clinically significant stigmas of decreased esophageal mucosal resistance were revealed. The need in research of expediency and efficacy of prescription of esophagoprotector in patients with GERD, having GVHD or regularly taking BCA, ASA and other NSAIDs, including obligatory estimation of therapy effi cacy taking into account patient gender and age, has been established.