Correction of eating behavior in patients with erosive reflux esophagitis

Abstract

AIM: To compare the efficacy of 1-month inhibitors of H+,K+-ATPase therapy and eating behavior correction over 6 months with initial 1-month and 5-month maintenance inhibitors of H+,K+-ATPase therapy in overweight and obese patients with erosive esophagitis. \nMATERIALS AND METHODS: The randomized clinical study included 29 patients 54.8 13.5 years with erosive esophagitis. 13 (45%) patients were overweight, 16 (55%) obese, 26 (90%) had abdominal obesity. The patients were randomized into 2 groups: control group 15 patients received 20 mg of omeprazole twice a day during 4 weeks and 20 mg of omeprazole once a day during 5 months; intervention group 14 patients participated in the eating behavior correction program and received 20 mg of omeprazole once a day for 4 weeks initially. Clinical symptoms, the endoscopic and histological data , anxiety, depression and quality of life, motor disorders were under investigation. \nRESULTS: At the end of the 4-week therapy, the control group had a lower frequency of heartburn (1.8 0.08 vs 2.4 0.6 points), intensity of heartburn (1.13 0.51 vs 1.78 0.89 points), healing of erosive esophagitis was more common (13 (86%) vs 5 (35%) patients), more % weakly acidic (2.5 1.6 vs 0.8 0.4) and % weakly alkaline time (0.44 0.3 vs 0.15 0.2) in the esophagus, more alkaline gastroesophageal refluxes (9.1 9.8 vs 2.8 3.9). By the end of the sixth month, the control group had higher frequency (3.46 0,5 vs 2.28 0.7 points) and the intensity of regurgitation (1.6 0.5 vs 1.07 0.26 points), more % weakly acidic (2.32 1.86 vs 0.89 0.57) and % weakly alkaline time (0.54 0.72 vs 0.22 0.28), lower quality of life according to GH scale and RE scale SF-36 questionnaire. \nCONCLUSIONS: The superiority of an eating behavior correction strategy over inhibitors of H+,K+-ATPase therapy was demonstrated in this study. Weight loss leads to fewer symptoms of gastroesophageal reflux disease and improved gastroesophageal motility.