The problem of the diagnosis and treatment of gastroesophageal reflux disease has recently attracted the attention of doctors from different countries of the world due to the increasing prevalence of gastroesophageal reflux disease, especially in elderly patients, a wide range of extraesophageal complaints, and the development of serious complications. The purpose of the work was to investigate the prevalence of respiratory extraesophageal symptoms of gastroesophageal reflux disease in elderly patients using a modified questionnaire (MQ) of GERD-Q. Material and methods. We examined 60 patients with typical gastroesophageal reflux disease complaints (38 women, 22 men), with an average age of 65.5 ± 7.4 years. We conducted the study by questioning the patients with typical gastroesophageal reflux disease complains, data of the EPGDS and spirometry. Typical and respiratory extraesophageal symptoms of gastroesophageal reflux diseases were verified using the MQ GERD-Q (10 questions 0-3 points for each). Additionally, patients were questioned about their eating behavior, smoking, drinking coffee and alcohol. The efficacy of the antysecretory therapy to symptoms of gastroesophageal reflux disease with omeprazole 40 mg/d on 7 days and 1 month after initiation of treatment was evaluated using the MQ GERD-Q. Results and discussion. In 75% of patients, the respiratory extraesophageal symptoms of gastroesophageal reflux disease were detected (25% had "lower" type, 50% had "upper" type). With the help of EGDS, gastroesophageal reflux disease without esophagitis was found in 73.3% of patients with respiratory extraesophageal symptoms of gastroesophageal reflux disease D, and esophagitis of the I-II stage was diagnosed in 26.7% of patients. Signs of bronchoobstructive syndrome according to spirometry data were found in 18.2% of patients with gastroesophageal reflux disease without esophagitis and in 44.5% of patients with gastroesophageal reflux disease with esophagitis. The intensity of bronchoobstructive syndrome manifestations directly correlated with the duration of gastroesophageal reflux disease and presence of harmful habits. According to the results obtained by the MQ GERD-Q, the score in patients with respiratory extraesophageal symptoms of gastroesophageal reflux disease without esophagitis averaged 15.25 ± 2.15, and in patients with respiratory extraesophageal symptoms of gastroesophageal reflux disease with esophagitis it was 21.82 ± 4.14. The evaluation of the treatment results with MQ GERD-Q showed a positive dynamics in reducing of the amount of points in the questionnaire after 1 week to 12.61 ± 2.12 in patients with respiratory extraesophageal symptoms of gastroesophageal reflux disease without esophagitis and up to 18.32 ± 3.11 in patients with respiratory extraesophageal symptoms of gastroesophageal reflux disease with esophagitis. After 4 weeks, the sum of points on the MQ GERD-Q was 6.58 ± 1.76 and 8.64 ± 2.34, respectively. Conclusion. Thus, in elderly patients, the frequency of respiratory extraesophageal symptoms of gastroesophageal reflux disease increased in comparison with the general population. The severity of the symptoms of respiratory extraesophageal symptoms of gastroesophageal reflux disease ("lower" type, bronchoobstructive syndrome) correlated with the progression of gastroesophageal reflux disease, the development of esophagitis and the wrong lifestyle. Treatment with omeprazole at a dose of 40 mg/d for 4 weeks was effective in all patients according to the MQ GERD. Having received the incomplete disappearance of respiratory extraesophageal symptoms of gastroesophageal reflux disease, we recommended the patient to continue the prescribed therapy for up to 8 weeks and to modify the lifestyle.
Keywords: gastroesophageal reflux disease, respiratory extraesophageal symptoms, GERD-Q, diagnosis, treatment
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