Correction of eating behavior in patients with erosive reflux esophagitis

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.

Keywords

gastroesophageal reflux disease / erosive esophagitis / overweight / obesity / esophageal pH-impedance / inhibitors of H+,K+-ATPase / proton pump inhibitors / eating behavior correction / weight loss

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Tikhonov S.V., Simanenkov V.I., Bakulina N.V., Lishchuk N.B., Topalova Y.G.