Tactics of management of patients with refractory GERD


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Abstract

At present, it is assumed that the proportion of patients with gastroesophageal reflux disease (GERD), who does not fully respond to proton pump inhibitors (PPIs), is about 30% of all patients. The main goal of the management of these patients is a careful examination with definition of disease phenotype. In patients with evidence of pathological acid reflux, choice should be made in favor of the activation of acid-suppressive therapy (PPI, alginates). In other cases, PPIs are combined with drugs that affect the tone of the lower esophageal sphincter (baclofen), motility (prokinetics), hypersensitivity of the esophagus (antidepressants). Surgical treatment requires careful examination and represents a possible approach to the management of patients with refractory GERD.

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About the authors

V. V Tsukanov

FSBEI Federal Research Center “Krasnoyarsk Scientific Center" of Siberian Branch of the Russian Academy of Sciences; Scientific Research Institute of Medical Problems of the North

Email: gastro@impn.ru
MD, Prof, Head of the Clinical Department of Pathology of the Digestive System in Children and Adults

E. V Kasparov

FSBEI Federal Research Center “Krasnoyarsk Scientific Center" of Siberian Branch of the Russian Academy of Sciences; Scientific Research Institute of Medical Problems of the North

A. V Vasyutin

FSBEI Federal Research Center “Krasnoyarsk Scientific Center" of Siberian Branch of the Russian Academy of Sciences; Scientific Research Institute of Medical Problems of the North

Yu. L Tonkikh

FSBEI Federal Research Center “Krasnoyarsk Scientific Center" of Siberian Branch of the Russian Academy of Sciences; Scientific Research Institute of Medical Problems of the North

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