Cytoprotection in gastroesophageal reflux disease and prospects for the use of cytoprotective agents

Abstract

The analysis of publications is devoted to the problem of treatment and prevention of gastroesophageal reflux disease with the use of cytoprotectors. Special attention is paid to Gastrotop, the new complex of plant origin. Gastrotop (Еrвоzета S.p.A, San Marino) is a new medication with cytoprotective action, containing Mucosave CG, a standardized complex of polysaccharides from the stems of Indian prickly pear (Opuntia ficus‑indica, 33.5%), leaves of European olive (Olea europaea, 24.0%); a mixture of sodium alginate and salts (sodium alginate — 50 mg, potassium bicarbonate — 10 mg, calcium carbonate — 10 mg), an extract of the leaves of Malva sylvestris L. 50 mg. Its action is aimed at the increasing of protection of esophageal and gastroduodenal mucosa from irritating effects of hydrochloric acid, pepsin, and the detergent effect of bile during reflux by means of formation of a strong mucoadhesive biofilm on the walls of the esophagus. The authors present the results of a randomized, double‑blind, controlled clinical trial evaluating the efficacy and safety of a preparation based on alginate/sodium bicarbonate in combination with extracts obtained from Opuntia ficus indica and Olea europaea related to polyphenols on the dynamics of GERD symptoms. It has been established that Gastrotop is well tolerated and effective in controlling symptoms associated with mild GERD manifestations. The results demonstrated the perspective of administration of a standardized complex of polysaccharides as part of Gastrotop in cases when it’s necessary to cancel antisecretory drugs (in particular, proton pump inhibitors PPIs), for example, before assessing the persistence of Helicobacter pylori infection or for the purpose of monitoring of the eradication effectiveness. The use of cytoprotectors in GERD promotes the reduction of incidence and prevention of possible complications, caused by the long‑term PPIs’ use.