PMID- 30701934
OWN - NLM
STAT- MEDLINE
DCOM- 20190403
LR  - 20190403
IS  - 0040-3660 (Print)
IS  - 0040-3660 (Linking)
VI  - 90
IP  - 8
DP  - 2018 Aug 27
TI  - Modern achievements in the diagnosis and treatment of the refractory 
      gastroesophageal reflux disease.
PG  - 4-12
LID - 10.26442/terarkh20189084-12 [doi]
AB  - Purpose of the review to present up-to-date data on the causes, methods of 
      diagnosis and treatment of the refractory form of gastroesophageal reflux disease 
      (GERD). Refractory GERD is the preservation of typical symptoms of the disease 
      and/or incomplete healing of the esophageal mucosa against the background of 
      taking a standard dose of proton pump inhibitors (PPI) once a day for 8 weeks. 
      The reasons for the lack of response to the treatment are divided into related to 
      the patient, related to therapy, and not related to GERD. Diagnostic approaches 
      include x-ray examination of the esophagus and stomach, endoscopy with biopsy, 
      24-hour Impedance-pH monitoring, esophageal manometry. Depending on the reasons 
      for the lack of response to the therapy, treatment may include lifestyle changes, 
      doubling the dose of PPI, replacing PPI with another, adding H2-receptor 
      antagonists, prokinetics, antacids, alginates and adsorbents. If conservative 
      treatment is ineffective, it is possible to consider alternative methods, such as 
      surgical treatment. Refractory GERD is a serious clinical problem. The absence of 
      an answer to 8-week therapy with PPI requires a thorough differential diagnosis 
      using additional examination methods. The identification of the causes of 
      refractory to the therapy allows to optimize the approaches to its overcoming and 
      to choose the optimal treatment.
FAU - Ivashkin, V T
AU  - Ivashkin VT
AD  - I.M. Sechenov First Moscow State Medical University, Ministry of Health of the 
      Russian Federation (Sechenov University), Moscow, Russia.
FAU - Maev, I V
AU  - Maev IV
AD  - A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Ministry of 
      Health of Russia, Moscow, Russia.
FAU - Trukhmanov, A S
AU  - Trukhmanov AS
AD  - I.M. Sechenov First Moscow State Medical University, Ministry of Health of the 
      Russian Federation (Sechenov University), Moscow, Russia.
FAU - Rumyantseva, D E
AU  - Rumyantseva DE
AD  - I.M. Sechenov First Moscow State Medical University, Ministry of Health of the 
      Russian Federation (Sechenov University), Moscow, Russia.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Russia (Federation)
TA  - Ter Arkh
JT  - Terapevticheskii arkhiv
JID - 2984818R
RN  - 0 (Antacids)
RN  - 0 (Histamine H2 Antagonists)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Antacids/administration & dosage/*therapeutic use
MH  - Diagnosis, Differential
MH  - Drug Therapy, Combination
MH  - *Gastroesophageal Reflux/diagnosis/etiology/therapy
MH  - *Gastroscopy
MH  - Hernia, Hiatal/complications
MH  - Histamine H2 Antagonists/administration & dosage/*therapeutic use
MH  - Humans
MH  - Life Style
MH  - Medication Adherence
MH  - Obesity/complications
MH  - Proton Pump Inhibitors/administration & dosage/*therapeutic use
OTO - NOTNLM
OT  - gastroesophageal reflux disease
OT  - proton pump inhibitors
OT  - refractory symptoms
EDAT- 2019/02/01 06:00
MHDA- 2019/04/04 06:00
CRDT- 2019/02/01 06:00
PHST- 2019/02/01 06:00 [entrez]
PHST- 2019/02/01 06:00 [pubmed]
PHST- 2019/04/04 06:00 [medline]
AID - 10.26442/terarkh20189084-12 [doi]
PST - ppublish
SO  - Ter Arkh. 2018 Aug 27;90(8):4-12. doi: 10.26442/terarkh20189084-12.