DOI: https://doi.org/10.22141/2308-2097.52.4.2018.154140

Clinical efficacy of ursodeoxycholic acid in the comprehensive treatment of patients with obesity and gastroesophageal reflux disease

Ye.S. Sirchak

Abstract


Background. Disorders in the body of patients with obesity have a systemic metabolic nature, including a negative impact on the state of the gastrointestinal tract. There was found a correlation between obesity and digestive diseases such as hepatic and pancreatic steatosis, gallstone disease, as well as gastroesophageal reflux disease (GERD). The administration of ursodeoxycholic acid (UDCA) as a part of comprehensive therapy of patients with obesity and GERD is pathogenetically justified, given its ability to influence metabolic processes in the body, as well as its protection of the mucous membrane of the upper gastrointestinal tract when exposed to aggressive refluxate. Objective: to study the clinical efficacy of the UDCA preparation (Ursofalk) in the comprehensive treatment of patients with obesity and GERD. Materials and me­thods. Ninety four patients with obesity of different classes and GERD were examined. They were divided into two clinical groups: group I (n = 44) received a standard treatment of GERD using a proton pump inhibitor against the background of lifestyle changes, compliance with dietary recommendations; group II (n = 50) in addition to the above-mentioned treatment received UDCA preparation Ursofalk (Dr. Falk Pharma GmbH, Germany) for 3 months. Results. GERD in patients with obesity is manifested by extraesophageal symptoms with an incidence of up to 40.9 % of cases. The prescription of proton pump inhibitor in combination with UDCA in obese patients leads to a significant reduction in heartburn, dysphagia, and extraesophageal manifestations of reflux disease by the end of weeks 2–4 of treatment. Comprehensive therapy using UDCA in the examined patients also contributed to a decrease in body weight (up to 5 kg per one month of treatment), mainly in obesity class І and ІІ. Conclusions. The use of Ursofalk in the comprehensive treatment of patients with GERD and obesity is a pathogenetically grounded mean for reducing and normalizing clinical manifestations of the disease, especially their extraesophageal forms. Comprehensive therapy of patients with GERD and obesity on the background of lifestyle modification and dietary recommendations should include UDCA preparation for faster, more effective and safe normalization of body weight with treatment duration of at least 3 months.


Keywords


obesity; gastroesophageal reflux disease; treatment; ursodeoxycholic acid

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