Correction of eating behavior in patients with erosive reflux esophagitis

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Abstract

AIM: To compare the efficacy of 1-month inhibitors of H+,K+-ATPase therapy and eating behavior correction over 6 months with initial 1-month and 5-month maintenance inhibitors of H+,K+-ATPase therapy in overweight and obese patients with erosive esophagitis.

MATERIALS AND METHODS: The randomized clinical study included 29 patients 54.8 ± 13.5 years with erosive esophagitis. 13 (45%) patients were overweight, 16 (55%) — obese, 26 (90%) had abdominal obesity. The patients were randomized into 2 groups: control group — 15 patients received 20 mg of omeprazole twice a day during 4 weeks and 20 mg of omeprazole once a day during 5 months; intervention group — 14 patients participated in the eating behavior correction program and received 20 mg of omeprazole once a day for 4 weeks initially. Clinical symptoms, the endoscopic and histological data , anxiety, depression and quality of life, motor disorders were under investigation.

RESULTS: At the end of the 4-week therapy, the control group had a lower frequency of heartburn (1.8 ± 0.08 vs 2.4 ± 0.6 points), intensity of heartburn (1.13 ± 0.51 vs 1.78 ± 0.89 points), healing of erosive esophagitis was more common (13 (86%) vs 5 (35%) patients), more % weakly acidic (2.5 ± 1.6 vs 0.8 ± 0.4) and % weakly alkaline time (0.44 ± 0.3 vs 0.15 ± 0.2) in the esophagus, more alkaline gastroesophageal refluxes (9.1 ± 9.8 vs 2.8 ± 3.9). By the end of the sixth month, the control group had higher frequency (3.46 ± 0,5 vs 2.28 ± 0.7 points) and the intensity of regurgitation (1.6 ± 0.5 vs 1.07 ± 0.26 points), more % weakly acidic (2.32 ± 1.86 vs 0.89 ± 0.57) and % weakly alkaline time (0.54 ± 0.72 vs 0.22 ± 0.28), lower quality of life according to GH scale and RE scale SF-36 questionnaire.

CONCLUSIONS: The superiority of an eating behavior correction strategy over inhibitors of H+,K+-ATPase therapy was demonstrated in this study. Weight loss leads to fewer symptoms of gastroesophageal reflux disease and improved gastroesophageal motility.

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About the authors

Sergey V. Tikhonov

North-West State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: sergeyvt2702@gmail.com
ORCID iD: 0000-0001-5720-3528
SPIN-code: 6921-5511

MD, Cand. Sci. (Med.)

Russian Federation, 41 Kirochnaya str., Saint Petersburg, 191015

Vladimir I. Simanenkov

North-West State Medical University named after I.I. Mechnikov

Email: visimanenkov@mail.ru
ORCID iD: 0000-0002-1956-0070
SPIN-code: 8073-2401

MD, Dr. Sci. (Med.), Professor

Russian Federation, 41 Kirochnaya str., Saint Petersburg, 191015

Natalya V. Bakulina

North-West State Medical University named after I.I. Mechnikov

Email: natalya.bakulina@szgmu.ru
ORCID iD: 0000-0003-4075-4096
SPIN-code: 9503-8950
Scopus Author ID: 7201739080
ResearcherId: N-7299-2014
http://www.researcherid.com/rid/N-7299-2014

MD, Dr. Sci. (Med.), Assistant Professor

Russian Federation, 41 Kirochnaya str., Saint Petersburg, 191015

Nadezhda B. Lishchuk

North-West State Medical University named after I.I. Mechnikov

Email: lishchuk.nadezhda@mail.ru
ORCID iD: 0000-0002-0703-9763

MD, Cand. Sci. (Med.)

Russian Federation, 41 Kirochnaya str., Saint Petersburg, 191015

Yuliya G. Topalova

North-West State Medical University named after I.I. Mechnikov

Email: juliaklukvina11@rambler.ru
ORCID iD: 0000-0003-3999-6848
SPIN-code: 1301-6443

MD

Russian Federation, 41 Kirochnaya str., Saint Petersburg, 191015

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Supplementary files

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1. Fig. 1. Dynamics of the main symptoms of GERD in the patients of the control group during 6 months of observation

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2. Fig. 2. Dynamics of the main symptoms of GERD in the patients of the intervention group within 6 months

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Copyright (c) 2021 Tikhonov S.V., Simanenkov V.I., Bakulina N.V., Lishchuk N.B., Topalova Y.G.

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