Gastroesophageal reflux disease: diagnosis and treatment references

Abstract

Introduction. Gastroesophageal reflux disease is a common clinical pathology of the upper digestive tract, due to the reflux of the gastric or duodenal content within the esophagus, caused by a failure of the antireflux mechanisms, namely the lower esophageal sphincter.Aim of the study. To study the clinical features, the diagnostic methods and the therapeutic treatment in patients with gastroesophageal reflux disease Materials and methods. The retrospective study was conducted on 120 patients, admitted at the Department of Gastroenterology, within "Timofei Moșneaga" Republican Clinical Hospital. The study included two groups of patients: 60 patients, hospitalized during 2017- 2018 years and 60 patients admitted during 2018-2019, aged between 18- 80 years old. The data regarding the patients’ complaints, anamnesis, methods of diagnosis and treatment outcomes have been studied and interpreted. Results. The study showed a higher incidence of female patients in both study groups. According to the age criterion, 33.33% of patients were aged between 51 -70 years old and only 1.66% - aged under 20. The most common patients ‘complaints (more than 50%) included as following: 85.8% of cases presented epigastric pain, 53.3% - belching and 52.5%- heartburn , followed by 48.3%- mouth bitterness, 44.1 % - nausea and 30.8% -bloating. The least recorded complaints were regurgitations in 5% of cases and dysphagia - 4.1%. Both groups of patients were diagnosed based on the presence of the classic symptoms of GERD, positive response to PPI treatment, upper digestive endoscopy and chest X-ray assessment. According to the study, during the period 2017 -2018, the treatment of patients with GERD was mainly aimed at reducing the gastric acid secretion by administering omeprazole - 71.7% and pantoprazole - 18.4%. In 2018-2019 years, patients with GERD underwent a treatment for increasing the intestinal motility, by administrating metoclopramide - 68.4%, followed by the proton pump inhibitors -pantoprazole - 30%, omeprazole - 21.7% and antacids - 28.4%. Conclusions. The study of the gastroesophageal reflux disease particularities in patients from the Department of Gastroenterology has proved that the diagnosis should be based on the presence of the classic symptoms, changes detected in the upper digestive endoscopy and the presence of the reflux on the chest X-Ray assessment. The treatment regimens included both the suppression of gastric acidic secretion and the increase of the intestinal motility, thus diminishing the action of the harmful factors on LES and esophageal mucosa.