gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLCgastro-j-1590Research ArticleНАЦИОНАЛЬНАЯ ШКОЛА ГАСТРОЭНТЕРОЛОГОВ, ГЕПАТОЛОГОВNATIONAL COLLEGE OF GASTROENTEROLOGISTS, HEPATOLOGISTSСовременные возможности и перспективы лечения резистентных форм гастроэзофагеальной рефлюксной болезниModern options and prospects of treatment of resistant forms of gastroesophageal reflux diseaseШептулинА. А.SheptulinA. A.ГОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова Росздрава»Russian Federation2010021220102068185Copyright © Шептулин А.А., 20102010Шептулин А.А.Sheptulin A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/1590

Цель обзора. Обсудить факторы, способствующие формированию резистентности при лечении гастроэзофагеальной рефлюксной болезни (ГЭРБ), и возможные способы ее преодоления.Основные положения. Показано, что причины формирования резистентных форм ГЭРБ многообразны и связаны как с субъективными факторами (недостаточная приверженность больных к лечению), так и с объективными («ночные кислотные прорывы», эпизоды некислотного рефлюкса и др.). Возможности лечения резистентных форм ГЭРБ включают в себя повышение доз ингибиторов протонной помпы (ИПП), применение в необходимых случаях парентеральных способов их введения, комбинацию с Н2-блокаторами. Дальнейшие перспективы улучшения результатов применения кислотосупрессивных препаратов связаны с созданием новых поколений ИПП.Заключение. Резистентные формы ГЭРБ нередко встречаются в клинической практике. В настоящее время существуют различные возможности повышения эффективности их лечения.

The aim of review

The aim of review. To discuss the factors promoting resistance of gastroesophageal reflux disease (GERD) to treatment and possible ways to overcome this phenomenon.

Original positions

Original positions. It was demonstrated, that the causes of resistant forms of GERD are diverse and connected related both to subjective factors (poor patient compliance) and to objective factors («night acid breakthrough», episodes of non-acid reflux, etc.). Potentials of treatment of resistant forms of GERD include increase of proton pump inhibitors (PPI) dose, application of parenteral forms of PPI if necessary and combination to Н2-blockers. Further prospects of improvement of acidsuppressive agents action are related to development of new generations of PPIs.

Conclusion

Conclusion. Resistant forms of GERD are quite frequent in clinical practice. Now there are various options to increase treatment efficacy.

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The authors declare that there are no conflicts of interest present.