Saratov JOURNAL of Medical and Scientific Research

Semikina T.M.

Saratov State Medical University n.a. V.I. Razumovsky Department of Hospital Therapy of Medical Faculty

Assessment of the dynamics of formation and influence of combined course of chronic cholecystitis and gastroesophageal reflux disease on quality of life of patients

Year: 2020, volume 16 Issue: №2 Pages: 442-446
Heading: Internal Diseases Article type: Original article
Authors: Kunitsyna M.A., Zhukova Е.V., Semikina Т.М., Kashkina E.I.
Organization: Saratov Regional Clinical Hospital, Saratov State Medical University
Summary:

Purpose: to analyze the dynamics of formation and changes in the quality of life of multimorbid patients with chronic cholecystitis and gastroesophageal reflux disease (GERD). Material and Methods. 186 patients were examined: 82 patients were diagnosed with chronic cholecystitis in combination with GERD, 58 were diagnosed-only with chronic cholecystitis and 46 were diagnosed-only with GERD. The diagnosis of GERD was established according to modern criteria adopted by the International Consensus Group that studied the reflux disease and was confirmed by the results of daily esophageal pH measurements. Chronic cholecystitis was diagnosed on the basis of complaints, laboratory and clinical data and was confirmed by ultrasound analysis. The quality of life of patients was assessed using the SF-36 questionnaire. Results. In most cases gastroesophageal reflux (GERD) develops over the background of chronic cholecystitis (53.4%) while the reverse situation occurs only in 25.5% of cases. Simultaneous development of both diseases was observed only for 18.9% of patients. In most cases (45.1 %) GERD manifests itself during the 2nd to 4th year of chronic cholecystitis. The quality of life in patients with GERD has been ascertained to be lower than in those with chronic cholecystitis. The summary index of physical health in patients with chronic cholecystitis made 171.4±0.4 scores, while in the GERD group it did not exceed 146.8±0.2. Similar tendency was observed in the summary index of psychological health: in patients with GERD it was 26.3% (p<0.05) lower than in those with chronic cholecystitis. With polymorbidity developed against the background of chronic cholecystitis, the summary index of physical health reduces from 171.4±0.4 to 140.9±1.1 scores (p<0.05), while that of psychological health — from 254.8±0.6 to 144.5±0.8. In patients with GERD, chronic cholecystitis is practically non-essential for the state of physical health, while their psychological health declines substantially: from 188.5±0.6 to 144.5±0.8 scores (p<0.05). Conclusion. The risk of GERD development against the background of chronic cholecystitis is 1.9 times higher that of the reverse process. GERD usually develops over the 2nd to 4th year of chronic cholecystitis. Development of multimorbid state decreases the quality of life for patients with GERD and chronic cholecystitis with psychological health aspects being the most affected according to SF-36 questionnaire. The primary cause of the decreased quality of life for patients diagnosed with chronic cholecystitis and GERD is the almost twofold increase in the number of GERD exacerbations per year due to formation of multimorbid state.

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The treatment of gastroesophageal reflux disease in menopausal women suffering from diabetes mellitus type II

Year: 2016, volume 12 Issue: №4 Pages: 556-560
Heading: Internal Diseases Article type: Original article
Authors: Semikina Т.М., Kunitsyna M.A., Kashkina E.l.
Organization: Saratov State Medical University
Summary:

Purpose: to develop criteria for the selection of optimal tactics of supporting treatment of nonerosive gastroesophageal reflux disease with proton pump inhibitors in menopausal women suffering from diabetes mellitus type II. Material and Methods. 186 patients aged 45-59 who suffer from gastroesophageal reflux disease have been followed up, 46 of which suffer from diabetes mellitus type II as well. The climacteric syndrome's morbidity has been assessed in accordance with the modified menopause index; the level of glycated hemoglobin has been measured by the Abbott analyzer produced in the USA. Results. It is established that irrespective of the supporting treatment, the gastroesophageal reflux disease remittance was shorter in direct proportion with increase of the HbA1c level and the value of the modified menopause index in menopausal women suffering from diabetes mellitus type II. Conclusion. When the climacteric syndrome was mild or moderate, taking 20 mg Omeprazole once a day and "on demand" has comparable results, therefore this group of women prefer the "on demand" regimen as it lowers the risk of osteoporosis progression and further bone fracture. Taking 20 mg Omeprazole once a day, every other day, and "on demand" allows the disease remittance to prolong for a year and longer in less than 30% of women suffering from severe climacteric syndrome and having HbA1c>9.0%; however, this number may grow up to 70% of women in case they follow medical advice and reduce their carbohydrate input to 11 carbohydrate units and less.

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