The frequency of symptoms of reflux in the esophagus and triggers of heartburn

Introduction. The heterogeneity of GERD pathogenesis determines the differences in diagnostic and therapeutic tactics. The personalization of therapy includes individual nuances of the metabolism of proton pump inhibitors and modification of risk factors: reduction of excess body weight, the abolition of tobacco smoking, alcohol intake, optimization of the pattern of eating behavior, the exclusion of drugs affecting the lower esophageal sphincter, normalization of the permeability of the mucous membrane of the esophagus. Aim. To investigate pathological changes in the esophagus according to endoscopic examination protocols and the frequency of factors predisposing to the occurrence of reflux symptoms in the esophagus. Materials and methods. In retrospective study of the EGDS protocols (n = 208), esophagitis was assessed (Los Angeles classification, 1994) and at the same time, risk factors for heartburn were investigated by questionnaire in a hospital cohort of patients (n = 50). The analysis of these protocols and respondents’ responses took into account differences by gender and age (WHO). Results and discussion. Among patients with convincing endoscopic signs of GERD in a random sample of EGDS protocols, men predominated. The frequency of detection of pathological changes in the esophagus associated with GERD was at the level of 19.5%, stage C esophagitis was recorded 2 times more often, while stage D esophagitis and Baretta esophagus were recorded only in men. Age-related patterns have been established: stage D esophagitis, Barette’s esophagus and peptic stricture of the esophagus were detected among elderly and senile patients. Among the triggers of heartburn, respondents most often chose a certain pattern of eating behavior. Obesity was a significant risk factor in women, while smoking and taking calcium channel blockers were significant in men. Conclusion. Prolonged use of proton pump inhibitors is indicated in a limited proportion of patients suffering from heartburn. To diversify GERD therapy, diagnostic measures are needed to clarify the mechanism of reflux into the esophagus.