Gastroesophageal Reflux Disease and Barrett's Esophagus: Optimization of Patient Management and Cancer Prevention Measures (Literature Review and Resolution of the Expert Council of the Russian Gastroenterolog
Abstract
Aim:
to summarize current clinical guidelines and meta-analyses data, and to present the main statements of the Expert Council of the Russian Gastroenterological Association regarding the optimization of endoscopic diagnosis, morphological verification, pharmacotherapy, and management strategies for patients with gastroesophageal reflux disease (GERD) and Barrett’s esophagus.
Key points.
In the Russian Federation, GERD is a highly prevalent disease: according to a meta-analysis involving over 30,000 individuals, the frequency of heartburn and/or regurgitation occurring once a week or more is 25 %. Proton pump inhibitors (PPIs) represent the cornerstone drug class for the treatment of GERD. Rebamipide targets altered epithelial permeability and mucosal inflammation. Combination therapy with PPIs and rebamipide improves symptoms in patients with non-erosive reflux disease, leading to positive morphological changes in the esophageal mucosa and improved control of nocturnal esophageal acid exposure. Ursodeoxycholic acid (UDCA) may be added to GERD therapy in the presence of biliary reflux or reflux gastritis. The clinical significance of GERD is determined not only by its high prevalence, chronic relapsing course, and impaired quality of life, but also by its precancerous potential. In individuals with GERD, the prevalence of Barrett’s esophagus is approximately 7 %, while the incidence of adenocarcinoma and/or high-grade dysplasia in the presence of low-grade dysplasia is 1.73%…
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