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. / References
- Delshad SD, Almario CV, Chey WD, Spiegel BMR.
Prevalence of Gastroesophageal Reflux Disease
and Proton Pump Inhibitor-Refractory Symptoms.
Gastroenterology. 2020;158(5):12501261.e2.
https://doi.org/10.1053/j.gastro.2019.12.014.
- Zerbib F, Bredenoord AJ, Fass R, Kahrilas PJ,
Roman S, Savarino E et al. ESNM/ANMS consensus
paper: Diagnosis and management of refractory
gastro-esophageal reflux disease.
Neurogastroenterol Motil. 2021;33(4):e14075.
https://doi.org/10.1111/nmo.14075.
- Rettura F, Bronzini F, Campigotto M,
Lambiase C, Pancetti A, Berti G et al.
Refractory Gastroesophageal Reflux Disease: A
Management Update. Front Med (Lausanne).
2021;8:765061. https://doi.org/10.3389/fmed.2021.765061.
- Davis TA, Gyawali CP. Refractory
Gastroesophageal Reflux Disease: Diagnosis and
Management. J Neurogastroenterol Motil.
2024;30(1):1728. https://doi.org/10.5056/jnm23145.
- Savarino V, Marabotto E, Zentilin P, De
Bortoli N, Visaggi P, Furnari M et al. How safe
are heartburn medications and who should use
them?. Expert Opin Drug Saf. 2023;22(8):643652.
https://doi.org/10.1080/14740338.2023.2238592.
- , , .
. .: -; 2019. 648 .
: https://www.rosmedlib.ru/book/ISBN9785970448748.html.
-
Domingues G, Moraes-Filho JPP, Fass R.
Refractory Heartburn: A Challenging Problem in
Clinical Practice. Dig Dis Sci.
2018;63(3):577582. https://doi.org/10.1007/s10620-018-4927-5.
-
Gyawali CP, Yadlapati R, Fass R, Katzka D,
Pandolfino J, Savarino E et al. Updates to the
modern diagnosis of GERD: Lyon consensus 2.0.
Gut. 2024;73(2):361371. https://doi.org/10.1136/gutjnl-2023-330616.
-
, , , ,
. -
. .
2017;89(2):7683. https://doi.org/10.17116/terarkh201789276-83.
Maev IV, Barkalova EV, Ovsepyan MA, Kucheryavyi
YuA, Andreev DN. Possibilities of pH impedance
and high-resolution manometry in managing
patients with refractory gastroesophageal reflux
disease. Terapevticheskii Arkhiv.
2017;89(2):7683. (In Russ.) https://doi.org/10.17116/terarkh201789276-83.
- , , ,
, , .
.
. 2018;90(5):93100. : https://ter-arkhiv.ru/0040-3660/article/view/32780.
Ivashkin VT, Maev IV, Trukhmanov AS, Storonova
OA, Kucheryavyi YA, Barkalova EV et al. High
resolution manometry and new classification of
esophageal motility disorders. Terapevticheskii
Arkhiv. 2018;90(5):93100. (In Russ.) https://ter-arkhiv.ru/0040-3660/article/view/32780.
-
, , .
. .
2012;(4):1822. : https://umedp.ru/articles/gastro_4_2012/podkhody_k_individualizatsii_lecheniya_gastroezofagealnoy_reflyuksnoy_bolezni.html.
Maev IV, Dicheva DT, Andreev DN. Approaches to
the individualization of the treatment of
gastroesophageal reflux disease. Effective
Pharmacotherapy. 2012;(4):1822. (In Russ.)
Available at: https://www.gastroscan.ru/literature/authors/6449.
- Yadlapati R, Gyawali CP, Pandolfino JE,
Chang K, Kahrilas PJ, Katz PO et al. AGA
Clinical Practice Update on the Personalized
Approach to the Evaluation and Management of
GERD: Expert Review. Clin Gastroenterol Hepatol.
2022;20(5):984994.e1. https://doi.org/10.1016/j.cgh.2022.01.025.
-
Fass R, Zerbib F, Gyawali CP. AGA Clinical
Practice Update on Functional Heartburn: Expert
Review. Gastroenterology. 2020;158(8):22862293.
https://doi.org/10.1053/j.gastro.2020.01.034.
-
Aziz Q, Fass R, Gyawali CP, Miwa H, Pandolfino
JE, Zerbib F. Functional Esophageal Disorders.
Gastroenterology. 2016;150(6):13681379. https://doi.org/10.1053/j.gastro.2016.02.012.
-
, , , , , .
.
, , .
2020;30(4):7097. https://doi.org/10.22416/1382-4376-2020-30-4-70-97.
Ivashkin VT, Maev IV, Trukhmanov AS, Lapina TL,
Storonova OA, Zayratyants OV et al.
Recommendations of the Russian
Gastroenterological Association in Diagnosis and
Treatment of Gastroesophageal Reflux Disease.
Russian Journal of Gastroenterology, Hepatology,
Coloproctology. 2020;30(4):7097. (In Russ.)
https://doi.org/10.22416/1382-4376-2020-30-4-70-97.
- Broekaert D, Fischler B, Sifrim D, Janssens
J, Tack J. Influence of citalopram, a selective
serotonin reuptake inhibitor, on oesophageal
hypersensitivity: a double-blind,
placebo-controlled study. Aliment Pharmacol Ther.
2006;23(3):365370. https://doi.org/10.1111/j.1365-2036.2006.02772.x.
- Ostovaneh MR, Saeidi B, Hajifathalian K,
Farrokhi-Khajeh-Pasha Y, Fotouhi A, Mirbagheri
SS et al. Comparing omeprazole with fluoxetine
for treatment of patients with heartburn and
normal endoscopy who failed once daily proton
pump inhibitors: double-blind placebo-controlled
trial. Neurogastroenterol Motil.
2014;26(5):670678. https://doi.org/10.1111/nmo.12313.
- Dickman R, Maradey-Romero C, Fass R. The
role of pain modulators in esophageal disorders
- no pain no gain. Neurogastroenterol Motil.
2014;26(5):603610. https://doi.org/10.1111/nmo.12339.
- Patel D, Fass R, Vaezi M. Untangling
Nonerosive Reflux Disease From Functional
Heartburn. Clin Gastroenterol Hepatol.
2021;19(7):13141326. https://doi.org/10.1016/j.cgh.2020.03.057.
- .
. .: . .. ; 2019.
52 . : http://szgmu-psychiatry.ru/f/antidepressanty.pdf.
- Viazis N, Keyoglou A, Kanellopoulos AK,
Karamanolis G, Vlachogiannakos J, Triantafyllou
K et al. Selective serotonin reuptake inhibitors
for the treatment of hypersensitive esophagus: a
randomized, double-blind, placebo-controlled
study. Am J Gastroenterol.
2012;107(11):16621667. https://doi.org/10.1038/ajg.2011.179.
- , .
.
, . 2014;(2):1524.
: https://www.elibrary.ru/rxbwvz.
Kucheriavy YuA, Andreev DN. Prospects of
acid-related diseases treatment. Klinicheskie
Perspektivy Gastroehnterologii, Gepatologii.
2014;(2):1524. (In Russ.) Available at: https://www.elibrary.ru/rxbwvz.
-
, , , .
:
. .
2019;91(8):411. https://doi.org/10.26442/00403660.2019.08.000387.
Maev IV, Andreev DN, Kucheryavyy YuA, Shaburov
RI. Current advances in the treatment of
gastroesophageal reflux disease: a focus on
esophageal protection. Terapevticheskii Arkhiv.
2019;91(8):411. https://doi.org/10.26442/00403660.2019.08.000387.
- Gabbard S, Vijayvargiya S. Functional
heartburn: An underrecognized cause of
PPI-refractory symptoms. Cleve Clin J Med.
2019;86(12):799806. https://doi.org/10.3949/ccjm.86a.19006.
-
Yamasaki T, Fass R. Reflux Hypersensitivity: A
New Functional Esophageal Disorder. J
Neurogastroenterol Motil. 2017;23(4):495503.
https://doi.org/10.5056/jnm17097.
- Rodriguez-Stanley S, Ciociola AA, Zubaidi S,
Proskin HM, Miner PB Jr. A single dose of
ranitidine 150 mg modulates oesophageal acid
sensitivity in patients with functional
heartburn. Aliment Pharmacol Ther.
2004;20(9):975982. https://doi.org/10.1111/j.1365-2036.2004.02217.x.
- Patel A, Sayuk GS, Gyawali CP. Prevalence,
characteristics, and treatment outcomes of
reflux hypersensitivity detected on pH-impedance
monitoring. Neurogastroenterol Motil.
2016;28(9):13821390. https://doi.org/10.1111/nmo.12838.
- Broeders JA, Bredenoord AJ, Hazebroek EJ,
Broeders IA, Gooszen HG, Smout AJ. Effects of
anti-reflux surgery on weakly acidic reflux and
belching. Gut. 2011;60(4):435441. https://doi.org/10.1136/gut.2010.224824.
- Khajanchee YS, Hong D, Hansen PD, Swanström
LL. Outcomes of antireflux surgery in patients
with normal preoperative 24-hour pH test results.
Am J Surg. 2004;187(5):599603. https://doi.org/10.1016/j.amjsurg.2004.01.010.
-
, , ,
, , .
.
.
.
. 2021;192(8):5117. https://doi.org/10.31146/1682-8658-ecg-192-8-5-117.
Lazebnik LB, Golovanova EV, Volel BA,
Korochanskaya NV, Lyalyukova EA, Mokshina MV et
al. Functional gastrointestinal disorders.
Overlap syndrome. Clinical guidelines.
Experimental and Clinical Gastroenterology.
2021;192(8):5117. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-19285117.
- , , .
:
.
. 2021;(5):3037. https://doi.org/10.21518/2079-701X-2021-5-30-37.
Andreev DN, Zaborovsky AV, Lobanova EG.
Gastroesophageal reflux disease: new approaches
to optimizing pharmacotherapy. Meditsinskiy
Sovet. 2021;(5):3037. (In Russ.) https://doi.org/10.21518/2079-701X-2021-5-30-37.
- Gweon TG, Park JH, Kim BW, Choi YK, Kim JS,
Park SM et al. Additive Effects of Rebamipide
Plus Proton Pump Inhibitors on the Expression of
Tight Junction Proteins in a Rat Model of
Gastro-Esophageal Reflux Disease. Gut Liver.
2018;12(1):4650. https://doi.org/10.5009/gnl17078.
- Yoshida N, Kamada K, Tomatsuri N, Suzuki T,
Takagi T, Ichikawa H, Yoshikawa T. Management of
recurrence of symptoms of gastroesophageal
reflux disease: synergistic effect of rebamipide
with 15 mg lansoprazole. Dig Dis Sci.
2010;55(12):33933398. https://doi.org/10.1007/s10620-010-1166-9.
- Hong SJ, Park SH, Moon JS, Shin WG, Kim JG,
Lee YC et al. The Benefits of Combination
Therapy with Esomeprazole and Rebamipide in
Symptom Improvement in Reflux Esophagitis: An
International Multicenter Study. Gut Liver.
2016;10(6):910916. https://doi.org/10.5009/gnl15537.
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