Articolul precedent |
Articolul urmator |
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Ultima descărcare din IBN: 2023-05-24 08:56 |
SM ISO690:2012 CUMPĂTĂ, Veronica, ŢURCANU, Adela, CUMPATA, Serghei. Viziune modernă în boala de reflux gastroesofagian refractară. In: Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, 21-23 octombrie 2020, Chişinău. Chişinău: USMF, 2020, p. 211. |
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Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu” 2020 | ||||||
Congresul "Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”" Chişinău, Moldova, 21-23 octombrie 2020 | ||||||
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Pag. 211-211 | ||||||
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Rezumat | ||||||
Background. Despite adequate therapy with proton pump inhibitors (PPIs), up to 30% of patients with typical manifestations of gastroesophageal reflux disease (GERD) continue to show symptoms or endoscopic signs of esophagitis. The factors that cause refractory GERD are many and varied. Objective of the study. The assessment of the patient should include an evaluation of the severity and intensity of persistent signs in correlation with aggravating factors, followed by imaging, endoscopic examinations and monitoring of esophageal pH with/without impedance. Material and Methods. An objective analysis of symptoms includes specific questionnaires before and after treatment. Imaging and endoscopic examination reveal organic changes or functional disorders. 24 h pH-metry and / or impedance are used to determine the degree of acid exposure of the esophageal mucosa and the correlation with the clinical features in refractory GERD. Results. The causes of refractory GERD are different: factors related to drug administration, non-acid reflux, functional disorders, residual acid reflux, metabolism and bioavailability of PPIs, other diseases that may mimic the symptoms of GERD or are associated with heartburn. Lifestyle changes improve the quality of life, being recommended to the patient with refractory GERD. Also, various therapies are indicated - other groups of drugs, invasive procedures, complementary and alternative therapies - which determine the optimization of GERD treatment and which are oriented towards the etiopathogenetic factor of treatment failure. Conclusion. Management of patients with refractory GERD is a major clinical challenge for the gastroenterologist, and the multitude of potential therapies that vary in efficacy, invasiveness, and accessibility need to be individualized for each patient |
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Cuvinte-cheie refractory GERD, failure, PPI, BRGE refractară, eșec, IPP |
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