Algorithm for diagnosis and treatment of gastroesophageal reflux disease in pregnant women
Tyutyunnik V.L., Kan N.E., Mikhailova O.I., Mirzabekova D.D.
Gastroesophageal reflux disease is a chronic recurrent disorder caused by an impairment of the motor-evacuation function of the organs of the gastroesophageal zone and characterized by regularly repeated reflux of the stomach contents into the esophagus, and sometimes the duodenum. This disease leads to the appearance of clinical symptoms that worsen the quality of life of patients: damage to the mucous membrane of the distal part of the esophagus, dystrophic changes in non-keratinized stratified squamous epithelium, catarrhal or erosive/ulcerative esophagitis (reflux esophagitis), and columnar cell metaplasia in some patients. The article presents the modern data on epidemiology, etiology, pathogenesis, risk factors, clinical picture, diagnosis, and management of pregnant women with gastroesophageal reflux disease in the outpatient and inpatient environment. Particular attention is paid to the principles, methods and choice of medications for the treatment and prevention of this pathology.
Conclusion: The effectiveness of the treatment of gastroesophageal reflux disease with Gaviscon Forte has been found to reach 80–90%. The prognosis for pregnancy and childbirth with timely treatment is favorable. The algorithm for the management of pregnant women with gastroesophageal reflux disease is presented.
Authors’ contributions: Tyutyunnik V.L., Kan N.E., Mikhailova O.I., Mirzabekova D.D. – development of research design, obtaining data for analysis, review of publications on the topic of the article, processing and analysis of the material, writing the text, editing the article.
Conflicts of interest: The authors declare no possible conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Tyutyunnik V.L., Kan N.E., Mikhailova O.I., Mirzabekova D.D. Algorithm for diagnosis and treatment of gastroesophageal reflux disease in pregnant women.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (3): 165-171 (in Russian)
https://dx.doi.org/10.18565/aig.2024.22
Keywords
gastroesophageal reflux disease
algorithm for the management of pregnant women
heartburn
treatment
Gaviscon Forte
References
- Ивашкин В.Т., Маев И.В., Трухманов А.С., Лапина Т.Л., Сторонова О.А., Зайратьянц О.В., Дронова О.Б., Кучерявый Ю.А., Пирогов С.С., Сайфутдинов Р.Г., Успенский Ю.П., Шептулин А.А., Андреев Д.Н., Румянцева Д.Е. Рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению гастроэзофагеальной рефлюксной болезни. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2020; 30(4): 70-97. [Ivashkin V.T., Maev I.V., Trukhmanov A.S., Lapina T.L., Storonova O.A., Zayratyants O.V., Dronova O.B., Kucheryavyy Yu.A., Pirogov S.S., Sayfutdinov R.G., Uspenskiy Yu.P., Sheptulin A.A., Andreev D.N., Rumyantseva D.E. Recommendations of the Russian Gastroenterological Association in Diagnosis and Treatment of Gastroesophageal Reflux Disease. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2020; 30(4): 70-97. (in Russian)]. https://dx.doi.org/10.22416/1382-4376-2020-30-4-70-97.
- Altuwaijri M. Evidence-based treatment recommendations for gastroesophageal reflux disease during pregnancy: A review. Medicine (Baltimore). 2022; 101(35): e30487. https://dx.doi.org/10.1097/MD.0000000000030487.
- Mahajan R., Kulkarni R., Stoopler E.T. Gastroesophageal reflux disease and oral health: A narrative review. Spec. Care Dentist. 2022; 42(6): 555-644. https://dx.doi.org/10.1111/scd.12726.
- Жилина А.А., Ларева Н.В., Лузина Е.В., Томина Е.А., Жигжитова Е.Б., Устинова Е.Е. Эпидемиология гастроэзофагеальной рефлюксной болезни. Современное состояние проблемы. Сибирское медицинское обозрение. 2019; (3): 5-9. [Zhilina A.A., Lareva N.V., Luzina E.V., Tomina E.A., Zhigzhitova E.B., Ustinova E.E. Epidemiology of gastroesophageal reflux disease. Current state of the problem. Siberian Medical Review. 2019; (3): 5-9. (in Russian)]. https://dx.doi.org/10.20333/2500136-2019-3-5-9.
- Шептулин А.А., Успенская Ю.Б. Особенности клиники, диагностики и лечения гастроэзофагеальной рефлюксной болезни при беременности. Клиническая медицина. 2020; 98(6): 414-18. [Sheptulin A.A., Uspenskaya Yu.B. Features of the clinic, diagnosis and treatment of gastroesophageal reflux disease during pregnancy. Clinical Medicine. 2020; 98(6): 414-18. (Russian)].
- Козлова И.В., Пахомова А.Л., Лекарева Л.И. Диагностические и лечебные подходы при изжоге у беременных. Экспериментальная и клиническая гастроэнтерология. 2017; 5: 43-7. [Kozlova I.V., Pakhomova A.L., Lekareva L.I. Diagnostic and therapeutic approaches for heartburn in pregnant women. Experimental and Clinical Gastroenterology. 2017; (5): 43-7. (in Russian)].
- Рыжкова О.В. Гастроэзофагеальная рефлюксная болезнь. Учебное пособие. ФГБОУ ВО ИГМУ Минздрава России, кафедра факультетской терапии. Иркутск: ИГМУ; 2020. 64 с. [Ryzhkova O.V. Gastroesophageal reflux disease. Textbook. Federal State Budgetary Educational Institution of Higher Education ISMU of the Ministry of Health of Russia, Department of Faculty Therapy. Irkutsk: IGMU; 2020. 64 p. (in Russian)].
- Тютюнник В.Л., Елохина Т.Б. Профилактика и лечение гастроэзофагеальной рефлюксной болезни у беременных. Русский медицинский журнал. 2009; 17(16): 1049-52. [Tyutyunnik V.L., Elokhina T.B. Prevention and treatment of gastroesophageal reflux disease in pregnant women. Russian Medical Journal. 2009; 17(16): 1049-52. (in Russian)].
- Евсютина Ю.В., Трухманов А.С. Ведение пациентов с рефрактерной ГЭРБ. РМЖ. 2015; 28: 1684-8. [Evsyutina Yu.V., Trukhmanov A.S. Management of patients with refractory GERD. RMJ. 2015; (28): 1684-8. (in Russian)].
- Dağlı Ü., Kalkan İH. Treatment of reflux disease during pregnancy and lactation. Turk. J. Gastroenterol. 2017; 28 (Suppl. 1): S53-S56. https://dx.doi.org/10.5152/tjg.2017.14.
- Ткаченко Е.И., Успенский Ю.П., Каратеев А.Е., Бакулин И.Г., Пахомова И.Г. Гастроэзофагеальная рефлюксная болезнь: патогенетические основы дифференцированной тактики лечения. Экспериментальная и клиническая гастроэнтерология. 2009; 2: 104-14. [Tkachenko E.I., Uspensky Yu.P., Karateev A.E., Bakulin I.G., Pakhomova I.G. Gastroesophageal reflux disease: pathogenetic foundations of differentiated treatment tactics. Experimental and Clinical Gastroenterology. 2009; (2): 104-14. (in Russian)].
- Ших Е.В., ред. Гастроэзофагеальная рефлюксная болезнь. Клинические проявления, медикаментозная терапия. М.: ГЭОТАР-Медиа; 2019. 160 с. [Shikh E.V., ed. Gastroesophageal reflux disease. Clinical manifestations, drug therapy. Moscow: GEOTAR-Media; 2019. 160 p. (in Russian)].
- Бордин Д.С., Машарова А.А., Дроздов В.Н., Фирсова Л.Д., Кожурина Т.С. Диагностическое значение альгинатного теста при гастроэзофагеальной рефлюксной болезни. Экспериментальная и клиническая гастроэнтерология. 2010; 12: 102-7. [Bordin D.S., Masharova A.A., Drozdov V.N., Firsova L.D., Kozhurina T.S. Diagnostic value of the alginate test for gastroesophageal reflux disease. Experimental and Clinical Gastroenterology. 2010; (12): 102-7. (in Russian)].
- Мубаракшина О.А., Сомова М.Н., Мубаракшин Э.А. Роль альгинатов в фармакотерапии гастроэзофагеальной рефлюксной болезни в период беременности. Акушерство и гинекология. 2015; 5: 96-100. [Mubarakshina O.A., Somova M.N., Mubarakshin E.A. The role of alginates in the pharmacotherapy of gastroesophageal reflux disease during pregnancy. Obstetrics and Gynecology. 2015; (5): 96-100. (in Russian)].
- Инструкция по медицинскому применению препарата «Гевискон Форте», номер регистрационного удостоверения ЛС-002447 от 17.04.2017. [Instructions for medical use of the drug Gaviscon Forte, registration certificate number LS-002447 dated 04/17/2017. (in Russian)].
- Strugala V., Bassin J., Swales V.S., Lindow S.W., Dettmar P.W., Thomas E.C. Assessment of the safety and efficacy of a raft-forming alginate reflux suppressant (Liquid Gaviscon) for the treatment of heartburn during pregnancy. ISRN Obstet. Gynecol. 2012: 2012: 481870. https://dx.doi.org/10.5402/2012/481870.
Received 31.01.2024
Accepted 07.03.2024
About the Authors
Victor L. Tyutyunnik, Professor, MD, PhD, Leading Researcher of Research and Development Service, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(903)969-50-41, tioutiounnik@mail.ru,Researcher ID: B-2364-2015, SPIN-код: 1963-1359, Authors ID: 213217, Scopus Author ID: 56190621500, https://orcid.org/0000-0002-5830-5099
Natalia E. Kan, Professor, MD, PhD, Deputy Director of Science, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(926)220-86-55, kan-med@mail.ru, Researcher ID: B-2370-2015, SPIN-код: 5378-8437, Authors ID: 624900, Scopus Author ID: 57008835600, https://orcid.org/0000-0001-5087-5946
Olga I. Mikhailova, PhD, Researcher, 2nd Maternity Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str. 4, +7(926)564-68-13, omikhaylova@gmail.com, https://orcid.org/0000-0001-7569-8704
Dzhamilia D. Mirzabekova, graduate student, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str. 4, +7(906)110-51-13, +7(920)984-94-07, Jamilya1705@yandex.ru, https://orcid.org/0000-0002-2391-3334
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