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Information × Registration Number 0217U006810, 0112U008495 , R & D reports Title Gastroesophageal reflux disease with comorbidity, polyrmorbidity and extraesophageal manifestation: the path to improving diagnostics, treatment and prevention. popup.stage_title Head Chernobrovyi Viacheslav Mykolaiovich, Доктор медичних наук Registration Date 30-11-2017 Organization Dovganeuk Inna popup.description2 By means of epidemiological survey of the 1431 adults living in GP-districts, it was determined that one third (34,38%) of population asking for medical service is affected by GERD. The combination of GERD and gastric dyspepsia (including FD), irritable bowel syndrome is a common phenomenon and is found in 47.3% and 24.14% of the examined patients respectively. In the complex regression model of the emergence of gastroesophageal symptoms in patients with gastric dyspepsia (including FD), the greatest influence has the increasing of BMI but other factors (concomitant IBS, HP status, tobacco smoking, gender, age) have a significantly less effect. Exceeding the threshold of BMI> 25 kg/m ^2 in dyspeptic patients can be criteria of GERD with a sensitivity of 60.9% and a specificity of 67.0%. In cases of extraesophageal manifestation of GERD and resistance to PPI, an important diagnostic tool is pH monitoring and its original modifications, which provide the following informativeness : a) 24 hours multichannel intraluminal impedance pH-monitoring (MII-pH-M) with the acid reflux identification - 76.8% sensitivity and 76.9% specificity; b) 200 minutes MII-pH-M with the acid reflux identification - 93.3% and 76.9% respectively; c) 24-hour combined pH-monitoring of the stomach and esophagus revealing a paradoxical esophageal acidification phenomenon - 77.8% and 85.7% respectively; d) 24 hours MII-pH-M with the definition of the basal impedance level - 94.1% and 81.2% respectively. In the treatment patients with GERD by PPI, due to the expressed comorbidity with obesity and non-alcoholic fatty liver, pantaprazole has obvious advantage. Individualized controlled treatment by PPI can be realized by the measurement of serum pepsinogen-I, whose absolute increase of <7.0 ?g/l in a weekly course of a double standard dose, should be considered as an inadequate acid-depressant effect which is observed in 16% of all cases. Product Description popup.authors Гар Н.М. Заїка С.В. Ксенчин О.О. Мелащенко С.Г. Півторак Н.А Палій І.Г. Чернова І.В. popup.nrat_date 2020-04-02 Close