Combined Therapy of Gastroesophageal Reflux Disease

Abstract

Objective: to evaluate the benefits of co-administration of the esophagoprotector Alfazox and the proton pump inhibitor (PPI) for the relief of symptoms and epithelialization of esophageal mucosal erosions in patients with gastroesophageal reflux disease (GERD). Material and methods. 40 patients with GERD with reflux esophagitis were examined. Patients were randomized into two groups: 19 patients of the first group (8 men and 11 women, age 48,0 [39,0;60,5] years) received combination therapy: pantoprazole 40 mg per day and Alfazox 10 ml four times a day; 21 patients from the second group (13 men and 8 women, age 47,0 [33,0; 64,0] years) received pantoprazole 40 mg per day. The duration of therapy was 28 days. The dynamics of the frequency and severity of symptoms of the disease were evaluated on the Likert scale. According to the EGDS data, the effectiveness of the treatment of erosive esophagitis was evaluated. Results. The advantages in reducing the severity of symptoms in the first group were noted. On the first day of combined treatment, heartburn was stopped in 64% of patients (χ2 p < 0.05). By the fourth day of treatment in this group, heartburn persisted in 11% of patients and in 42% of patients receiving pantoprazole monotherapy (χ2 p < 0.05). Combination therapy was more effective in reducing the severity and frequency of belching and dysphagia (Wilcoxon p < 0.01, χ2 p < 0.05). Against the background of combined therapy, endoscopic remission of reflux esophagitis was achieved in all patients, and erosion of the esophageal mucosa persisted in 25% of patients in the control group (χ2 p = 0.033). Conclusions. The study showed the advantages of combination therapy (PPI + Alfazox) both in achieving the symptomatic response and in improving the endoscopic picture in patients with erosive reflux esophagitis.