Gastroesophageal reflux disease: Clinical variants and therapeutic tactics

Abstract

Gastroesophageal reflux disease (GERD) is currently one of the most common nosologies, which affects people of different ages, but mostly able-bodied ones, patients of 40–60 years of age. Without effective or appropriate treatment, people with this disease can expect many complications, including severe ones: bleeding, distal oesophageal stenosis, electrolyte abnormalities associated with cardiac and conduction disorders, and the development of severe anaemia. These factors significantly complicate medical treatment and increase economic costs in the ensuing time. The disease is classified as an acid-dependent disease, although the acid-induced damage is not indicated in the definition and consideration of pathogenesis, as the primary diagnosis of diseases begins with an assessment of the clinical variant of the disease course, which also forms an adequate examination program. We proposed for discussion a new classification of GERD course variants, which will help facilitate diagnosis, find adequate pharmacological targets and increase the effectiveness of treatment. Acid-dependent and acid-independent variants are the main GERD course variants according to the proposed classification. Given this, we examined a group of 60 patients treated with the combination of guaiazulene with dimethicone, which impacts the protection of esophageal mucosa from aggressive reflux, reduces the number of refluxes (duodenoesophageal) and has a local anti-inflammatory effect. The overall effectiveness was 87%, and it halved the treatment time, which confirmed the very concept of the clinical classification of GERD course variants. We hope that the proposed classification of GERD course variants will be favourably accepted by the gastroenterology community, discussed and will serve as an effective tool for the treatment of this severe group of patients.