GERD: Clinical Solutions of Problems in General Practice
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Abstract
The objective: To explore the features of acid level and aggravation in stomach and esophagus in patients with isolated GERD, hypertension and their comorbidity.
Patients and methods. For this study were selected 4 groups: group of patients with GERD, a group of patients with hypertension, the group of patients with comorbid hypertension and GERD and group without GERD and hypertension (total 78 patients). To all patients were performed 3-channel gastro esophageal pH monitoring. In our case, we conducted a 3-hour version of the survey with standardized provoking breakfast. All patients underwent assessment of gastric secretion by original integrative indicators that reflect basal pH, number of different types of refluxes, duration of alkalization in stomach after meal.
Results. GERD patients with hypertension and without are demonstrating an equal number of acid and all (nonacid + acid) reflux which is 18,9 against 19,8 (p>0,05). But the difference between the two groups was that in patients with concomitant hypertension observed longer refluxes 309,3 to 179,1 (p<0,05) and a total acid exposure tends to be prolonged – 25,9 to 20,9 (p>0,05).
Our analysis of the state of gastric secretion on the results of 2001 minute intra gastric pH monitoring, showed as expected more intensive acid in both groups of patients with GERD. The most «acidic» patients were GERD patients with hypertension, but compared with similar patients without hypertension, the difference was false due to the relatively small size of the samples.
Conclusion. Comorbidity of GERD and hypertension is characterized by severe pathological dysmotility in the lower third of the esophagus, unlike isolated GERD, which affects the increase in acid exposure and susceptibility to long reflux. A factor that may add to burden of GERD in combination with hypertension may be gastric hyperacidity and a clear predisposition to obesity.
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