The dynamics of results of the esophageal 24-hour multichannel intraluminal impedance-pH monitoring in patients with stable angina and gastroesophageal reflux disease against the background of the basic treatment correction
Journal Title: Сучасна гастроентерологія - Year 2019, Vol 0, Issue 3
Abstract
Due to the mutual aggravating effects in the comorbidity of the stable angina of effort (SAE) and gastroesophageal reflux disease (GERD), the necessity arises for the correction of basic therapy of each of these pathologies. Objective — to investigate the effects of the proposed treatment regimen for patients with SAE and GERD on the results of esophageal 24-hour multichannel intraluminal impedance-pH monitoring (MII-pH). Materials and methods. The study involved 88 patients with SAE of I — II functional classes with a comorbid GERD. From them, 43 patients (1 group) received basic therapy for SAE and GERD, and 45 patients (group 2) received basic therapy with the exception of prokinetics and NO donors, and inclusion of nitro-glycerine if needed only, and additional meldonium (Vasonate) capsules 500 mg 2 times daily, for 30 days. The medications were administered in medium therapeutic doses. All patients were examined with esophageal MII-pH before the treatment and 30 days after the treatment start. Results. The results of baseline esophageal MII-pH showed the signs of pathological gastroesophageal reflux, reduction in esophageal clearance, and presence of reflux-esophagitis. On the 30th day of treatment, the significantly more pronounced dynamics of the esophageal MII-pH parameters was revealed in the patients of group 2 vs results in group 1. Conclusions. Correction of the treatment scheme of patients with SAE and GERD by means of removal of prolonged NO donators (organic nitrates) and additional use of Meldonium resulted in the increased functional capacity of the lower esophageal sphincter, improved kinetic function of esophagus and effectiveness of the esophageal clearance. All these changes were accompanied by a visible regression of esophageal inflammatory damage.
Authors and Affiliations
O. S. Khukhlina, V. Yu. Drozd, A. A. Antoniv, O. I. Roschuk
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