medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2018-14-18-23medsovet-2647Research ArticleЗАБОЛЕВАНИЯ ПИЩЕВОДА И ЖЕЛУДКАESOPHAGEAL AND GASTRIC DISEASESНочная изжога – выход естьOcturnal heartburn: there is a solutionСиманенковВ. И.SimanenkoV. I.

д.м.н., профессор, заведующий кафедрой терапии и клинической фармакологии,

Санкт-Петербург

St.Petersburg

ТихоновС. В.TikhonovS. V.

к.м.н., доцент кафедры терапии и клинической фармакологии,

Санкт-Петербург

St.Petersburg

ЛищукН. Б.LishchukN. B.

ассистент кафедры терапии и клинической фармакологии,

Санкт-Петербург

St.Petersburg

ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава РоссииРоссияMechnikov North-Western State Medical University of the Ministry of Health of RussiaRussian Federation2018091020180141823Copyright © Симаненков В.И., Тихонов С.В., Лищук Н.Б., 20182018Симаненков В.И., Тихонов С.В., Лищук Н.Б.Simanenko V.I., Tikhonov S.V., Lishchuk N.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2647

Статья посвящена проблеме ночной изжоги, особенностям этиопатогенеза ночных гастроэзофагеальных рефлюксов, диагностике и рациональной терапии ночных проявлений ГЭРБ.

This article describes a problem of sleep disorders, nighttime heartburn, the peculiarities of etiopathogenesis of night gastroesophageal reflux, the possibility of diagnosis and rational therapy of nighttime heartburn.

ГЭРБночная изжогаГЭРночной кислотный прорывантисекреторная терапиядекслансопразолGERDnighttime heartburnGERantisecretory therapydexlansoprazole.ReferencesКовальзон В.М. Основы сомнологии. Физиология и нейрохимия цикла бодрствование – сон. М.: Бином. Лаборатория знаний, 2012. 240 с.Kovalzon VМ. Fundamentals of somnology. Physiology and neurochemistry of wakefulness-sleep cycle. M: Binom. Laboratoriya Znaniy, 2012. 240 p.Ковальзон В.М. Нейрофизиология и нейрохимия сна. Сомнология и медицина сна. Избранные лекции. Под ред. Я.И. Левина, М.Г. Полуэктова. М., 2013: 67-91.Kovalzon VМ. Neurophysiology and neurochemistry of sleep. Somnology and sleep medicine. Selected lectures. Under the editorship of Levin YaI, Poluekov MG. M., 2013: 67-91International classification of sleep disorders: Diagnostic and Coding Manual. 2nd ed. Westchester, Illinois: American Academy of Sleep Medicine, 2005. 298 p.International classification of sleep disorders: Diagnostic and Coding Manual. 2nd ed. Westchester, Illinois: American Academy of Sleep Medicine, 2005. 298 p.Левин Я.И., Ковров Г.В., Полуэктов М.Г. и др. Инсомния, современные диагностические и лечебные подходы. М.: Медпрактика-М, 2005. 115 с.Levin YaI, Kovrov GV, Poluektov MG. Insomnia, modern diagnostic and therapeutic approaches. M.: Medpraktika-M, 2005. 115 p.Полуэктов М.Г., Левин Я.И. Инсомния. Сомнология и медицина сна. Избранные лекции. Под ред. Я.И. Левина и М.Г. Полуэктова. М.: Медфорум-альфа, 2013:192-220.Poluektov MG, Levin YaI. Insomnia. Somnology and medicine sleep. Selected lectures. Under the editorship of Levin YaI, Poluekov MG. М.: Medforum-alpha, 2013: 192-220Roth T. Insomnia: definition, prevalence, etiology, and consequences. J Clin Sleep Med, 2007, 3(5): 7-10.Roth T. Insomnia: definition, prevalence, etiology, and consequences. J Clin Sleep Med, 2007, 3(5): 7-10.Ляшенко Е.А., Левин О.С. Расстройства сна в клинической практике. Современная терапия в психиатрии и неврологии, 2017, 1: 22-28.Lyashenko EA, Levin OS. Sleep disorders in clinical practice. Sovremennaya Terapiya v Psikhiatrii i Nevrologii, 2017, 1: 22-28.Полуэктов М.Г. Клинический алгоритм диагностического и лечебного выбора при инсомнии. Эффективная фармакотерапия, 2013, 12: 22-28.Poluektov MG. Clinical algorithm for diagnostic and therapeutic choice in insomnia. Effektivnaya Farmakoterapiya, 2013, 12: 22-28Vakil N, van Zanden SV, Kahrilas P et al. The Monreal definition and classification of gas troesophageal reflux disease: A global evidence-based consensus. Am J Gastroenterol, 2006, 101: 1900-1920.Vakil N, van Zanden SV, Kahrilas P et al. The Monreal definition and classification of gas troesophageal reflux disease: A global evidence-based consensus. Am J Gastroenterol, 2006, 101: 1900-1920.Лазебник Л.Б., Машарова А.А., Бордин Д.С. и др. Результаты многоцентрового исследования «Эпидемиология гастроэзофагеальной рефлюксной болезни в России» («МЭГРЭ»). Тер. арх., 2011, 1: 5-50.Lazebnik LB, Masharova AA, Bordin DS, et al. Results of Multicenter Gastroesophageal Reflux Disease Epidemiology in Russia (MEGRE) study. Ter. Arkh., 2011, 1: 5-50.Ивашкин В.Т., Маев И.В., Трухманов А.С. и др. Клинические рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению гастроэзофагеальной рефлюксной болезни. Рос. журн. гастроэнтерол. гепатол. колопроктол., 2017, 27(4): 75-95.Ivashkin VT, Maev IV, Trukhmanov AS. The Russian Gastroenterological Association clinical guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Ros. Zhurn. Gastroenterol. Gepatol. Koloproktol, 2017, 27 (4): 75-95Farup C, Kleinman L, Sloan S et al. The impact of nocturnal symptoms associated with gastroesophageal reflux disease on health-related quality of life. Arch Intern Med, 2001, 161: 45-52.Farup C, Kleinman L, Sloan S et al. The impact of nocturnal symptoms associated with gastroesophageal reflux disease on health-related quality of life. Arch Intern Med, 2001, 161: 45-52.Janson C, Gislason T, De Backer W et al. Daytime sleepiness, snoring and gastrooesophageal reflux amongst young adults in three European countries. J Intern Med, 1995, 237: 277-285.Janson C, Gislason T, De Backer W et al. Daytime sleepiness, snoring and gastrooesophageal reflux amongst young adults in three European countries. J Intern Med, 1995, 237: 277-285.Janson C, De Backer W, Gislason T et al. Increased prevalence of sleep disturbances and daytime sleepiness in subjects with bronchial asthma: A population study of young adults in three European countries. Eur Respir J, 1996, 9: 2132-2138.Janson C, De Backer W, Gislason T et al. Increased prevalence of sleep disturbances and daytime sleepiness in subjects with bronchial asthma: A population study of young adults in three European countries. Eur Respir J, 1996, 9: 2132-2138.Janson C, Gislason T, De Backer W et al. Insomnia and sleep. Prevalence of sleep disturbances among young adults in three European countries. Sleep, 1995, 18: 589-597.Janson C, Gislason T, De Backer W et al. Insomnia and sleep. Prevalence of sleep disturbances among young adults in three European countries. Sleep, 1995, 18: 589-597.Kruse-Anderson S, Wallin L, Madsen T. Acid gastroesophageal reflux and oesophageal pressure activity during postprandial and nocturnal periods: a study in subjects with and without pathologic acid gastro-oesophageal reflux. Scand J Gastroenterol, 1987, 22: 926-930.Kruse-Anderson S, Wallin L, Madsen T. Acid gastroesophageal reflux and oesophageal pressure activity during postprandial and nocturnal periods: a study in subjects with and without pathologic acid gastro-oesophageal reflux. Scand J Gastroenterol, 1987, 22: 926-930.Farup C, Kleinman L, Sloan S et al. The impact of nocturnal symptoms associated with gastroesophageal reflux disease on health-related quality of life. Arch Intern Med, 2001, 161: 45-52.Farup C, Kleinman L, Sloan S et al. The impact of nocturnal symptoms associated with gastroesophageal reflux disease on health-related quality of life. Arch Intern Med, 2001, 161: 45-52.Dean BB, Aguilar D, Johnson LF et al. The relationship between the prevalence of nighttime gastroesophageal reflux disease and disease severity. Dig Dis Sci, 2009, 55: 952-959.Dean BB, Aguilar D, Johnson LF et al. The relationship between the prevalence of nighttime gastroesophageal reflux disease and disease severity. Dig Dis Sci, 2009, 55: 952-959.Mody R, Bolge SC, Kannan H et al. Effects of gastroesophageal reflux disease on sleep and outcomes. Clin Gastroenterol Hepatol, 2009, 7: 953-959.Mody R, Bolge SC, Kannan H et al. Effects of gastroesophageal reflux disease on sleep and outcomes. Clin Gastroenterol Hepatol, 2009, 7: 953-959.Shaker R, Castell DO, Schoenfeld PS et al. Nighttime heartburn is an under-appreciated clinical problem that impacts sleep and daytime function: the results of a Gallup survey conducted on behalf of the American Gastroenterological Association. Am J Gastroenterol, 2003, 98: 1487-1493.Shaker R, Castell DO, Schoenfeld PS et al. Nighttime heartburn is an under-appreciated clinical problem that impacts sleep and daytime function: the results of a Gallup survey conducted on behalf of the American Gastroenterological Association. Am J Gastroenterol, 2003, 98: 1487-1493.Dent J, Armstrong D, Delaney B et al. Symptom evaluation in reflux disease: workshop background, processes, terminology, recommendations, and discussion output. Gut, 2004, 53(4): 1-24.Dent J, Armstrong D, Delaney B et al. Symptom evaluation in reflux disease: workshop background, processes, terminology, recommendations, and discussion output. Gut, 2004, 53(4): 1-24.Harding SM. Gastroesophageal reflux during sleep. Sleep Med Clin, 2007, 2: 41-50.Harding SM. Gastroesophageal reflux during sleep. Sleep Med Clin, 2007, 2: 41-50.Sozzi M, Valentini M, Polefti M. Nocturnal gastric acidity pattern in gastro-oesophageal reflux disease with or without oesophagitis. Ital J Gastroenterol, 1995, 27: 413-418.Sozzi M, Valentini M, Polefti M. Nocturnal gastric acidity pattern in gastro-oesophageal reflux disease with or without oesophagitis. Ital J Gastroenterol, 1995, 27: 413-418.Mainie I et al. Acid and non-acid reflux in patient with persistent symptoms despite acidsupperesive therapy: a multicenter study using combined ambulatory impedance-pHmonitoring. Gut, 2006, 55: 1398.Mainie I et al. Acid and non-acid reflux in patient with persistent symptoms despite acidsupperesive therapy: a multicenter study using combined ambulatory impedance-pHmonitoring. Gut, 2006, 55: 1398.Sharma N et al. An analysis of persistent symptoms in acid-suppressed patients undergoing impedance-pHmonitoring. Clin Gastroenterol Hepatol, 2008, 6: 521.Sharma N et al. An analysis of persistent symptoms in acid-suppressed patients undergoing impedance-pHmonitoring. Clin Gastroenterol Hepatol, 2008, 6: 521.Karamanolis G et al. Esophageal pH and bilitec monitoring in patients with persisting symptoms on PPI therapy. Dig Dis Scl, 2008, 53: 2387.Karamanolis G et al. Esophageal pH and bilitec monitoring in patients with persisting symptoms on PPI therapy. Dig Dis Scl, 2008, 53: 2387.Clinard V et al. GERD-related sleep disturbances. US Pharm, 2012, 37(1): 36-39.Clinard V et al. GERD-related sleep disturbances. US Pharm, 2012, 37(1): 36-39.Hershcovici T, Fass R. Management of gastroesophageal reflux disease that does not respond well to proton pump inhibitors. Curr Opin Gastroenterol, 2010, 26(4): 367–78.Hershcovici T, Fass R. Management of gastroesophageal reflux disease that does not respond well to proton pump inhibitors. Curr Opin Gastroenterol, 2010, 26(4): 367–78.Лобанова Е. Ночной кислотный прорыв: тема для диалога. МедФарм Вестник Поволжья, 2011, 43.Lobanova E. Nocturnal acid breakthrough: theme for dialogue. MedFarm Vestnik Povolzhya, 2011, 43.Peghini PL, Katz PO, Castell DO. Ranitidine controls nocturnal gastric acid breakthrough on omeprazole: a controlled study in normal subjects. Gastroenterology, 1998, 115: 1335-1339.Peghini PL, Katz PO, Castell DO. Ranitidine controls nocturnal gastric acid breakthrough on omeprazole: a controlled study in normal subjects. Gastroenterology, 1998, 115: 1335-1339.Васильев Ю.В. Ингибиторы протонного насоса. Лечащий врач, 2007, 1: 3–7.Vasiliev YuV. Proton pump inhibitors. Lechashchy Vrach, 2007, 1: 3-7.Krznaric Z, Ljubas KD Rustemovic N, Vranesic BD, Ostojic R, Markos P, Scarpignato C. Pharmaceutical principles of acid inhibitors: unmet needs. Dig Dis, 2011, 29(5): 469-475.Krznaric Z, Ljubas KD Rustemovic N, Vranesic BD, Ostojic R, Markos P, Scarpignato C. Pharmaceutical principles of acid inhibitors: unmet needs. Dig Dis, 2011, 29(5): 469-475.Hatlebackk JG, Katz PO, Kuo B, Castell DO. Nocturnal gastric acidity and breakthrough on different regimens of omeprazole 40 mg daily. Aliment Pharmacol Ther, 1998, 12: 1235-1240.Hatlebackk JG, Katz PO, Kuo B, Castell DO. Nocturnal gastric acidity and breakthrough on different regimens of omeprazole 40 mg daily. Aliment Pharmacol Ther, 1998, 12: 1235-1240.Fock KM, Ang TL, Bee LC, Lee EJ. Proton pump inhibitors: do differences in pharmacokinetics translate into differences in clinical outcomes? Clin Pharmacokinet, 2008, 47(1): 1-6.Fock KM, Ang TL, Bee LC, Lee EJ. Proton pump inhibitors: do differences in pharmacokinetics translate into differences in clinical outcomes? Clin Pharmacokinet, 2008, 47(1): 1-6.Bredenoord AJ, Smout AJ. Refractory gastrooesophageal reflux disease. Aliment Pharmacol Ther, 2007, 26(9): 1259-1265.Bredenoord AJ, Smout AJ. Refractory gastrooesophageal reflux disease. Aliment Pharmacol Ther, 2007, 26(9): 1259-1265.Пасечников В.Д., Пасечников Д.В. Клиническое значение феномена ночного кислотного прорыва при применении ингибиторов протонной помпы. Фарматека, 2004, 13(90): 28-32.Pasechnikov VD, Pasechnikov DV. Clinical significance of nocturnal acid breakthrough phenomenon in using proton pump inhibitors. Pharmateca, 2004, 13 (90): 28-32.Calleja JL, Bixquert M, Maldonado J. Impact of nocturnal heartburn on quality of life, sleep, and productivity: the SINERGE study. Dig Dis Sci, 2007, 52: 2858-2865.Calleja JL, Bixquert M, Maldonado J. Impact of nocturnal heartburn on quality of life, sleep, and productivity: the SINERGE study. Dig Dis Sci, 2007, 52: 2858-2865.Dubois RW, Aguilar D, Fass R et al. Consequences of frequent nocturnal gastrooesophageal reflux disease among employed adults: symptom severity, quality of life and work productivity. Aliment Pharmacol Ther, 2007, 25: 487-500.Dubois RW, Aguilar D, Fass R et al. Consequences of frequent nocturnal gastrooesophageal reflux disease among employed adults: symptom severity, quality of life and work productivity. Aliment Pharmacol Ther, 2007, 25: 487-500.Dean BB, Crawley JA, Schmitt CM et al. The burden of illness of gastro-oesophageal reflux disease: impact on work productivity. Aliment Pharmacol Ther, 2003, 17: 1309-1317.Dean BB, Crawley JA, Schmitt CM et al. The burden of illness of gastro-oesophageal reflux disease: impact on work productivity. Aliment Pharmacol Ther, 2003, 17: 1309-1317.Manocchia M, Keller S, Ware JE. Sleep problems, health-related quality of life, work functioning and health care utilization among the chronically ill. Qual Life Res, 2001, 10: 331-345.Manocchia M, Keller S, Ware JE. Sleep problems, health-related quality of life, work functioning and health care utilization among the chronically ill. Qual Life Res, 2001, 10: 331-345.Schey R et al. Sleep deprivationis hyperalgesic in patients with gastroesophageal reflux disease. Gastroenterology, 2007, 133: 1787-1795.Schey R et al. Sleep deprivationis hyperalgesic in patients with gastroesophageal reflux disease. Gastroenterology, 2007, 133: 1787-1795.Hakki Onen S et al. The effects of total sleep deprivation, selective sleep interruption and sleep recovery on pain tolerance thresholds in healthy subjects. J Sleep Res, 2001, 10: 35-42.Hakki Onen S et al. The effects of total sleep deprivation, selective sleep interruption and sleep recovery on pain tolerance thresholds in healthy subjects. J Sleep Res, 2001, 10: 35-42.Tack J. Pathophysiology of Gastroesopageal Reflux Disease. Gastroenterology, 2018, 154: 277-288.Tack J. Pathophysiology of Gastroesopageal Reflux Disease. Gastroenterology, 2018, 154: 277-288.Gaddam S, Maddur H et al. Risk Factors for nocturnal reflux reflux in a large GERD cohort. J Clin Gastroenterology, 2011, 45(9): 764-768.Gaddam S, Maddur H et al. Risk Factors for nocturnal reflux reflux in a large GERD cohort. J Clin Gastroenterology, 2011, 45(9): 764-768.Leggett CL et al. Obstructive sleep apnea is a risk factor for Barrett’s esophagus. Clin Gastroenterol Hepatol, 2013, 11: 1542-3565.Leggett CL et al. Obstructive sleep apnea is a risk factor for Barrett’s esophagus. Clin Gastroenterol Hepatol, 2013, 11: 1542-3565.Lagergren J, Bergstrom R, Lindgren A, Nyren O. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med, 1999, 340: 825-831.Lagergren J, Bergstrom R, Lindgren A, Nyren O. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med, 1999, 340: 825-831.DeMeester TR, Johnson LF, Guy JJ et al. Patterns of Gastroesophageal reflux in health and disease. Ann Surg, 1996, 184: 459-470.DeMeester TR, Johnson LF, Guy JJ et al. Patterns of Gastroesophageal reflux in health and disease. Ann Surg, 1996, 184: 459-470.Peura D. The effects of increasing body mass index on heartburn severity, frequency and response to treatment with dexlansoprazole or lansoprazole. Aliment Pharmacol Ther, 2013, 37: 810-818.Peura D. The effects of increasing body mass index on heartburn severity, frequency and response to treatment with dexlansoprazole or lansoprazole. Aliment Pharmacol Ther, 2013, 37: 810-818.Zhang W. Pharmacokinetics and safety of dexlansoprazole mr in adolescents with symptomatic GERD. Gastroenterology, 2007, 132: 285-293.Zhang W. Pharmacokinetics and safety of dexlansoprazole mr in adolescents with symptomatic GERD. Gastroenterology, 2007, 132: 285-293.Fass R, Chey WD, Zakko SF. Clinical trial: the effects of the proton pump inhibitor dexlansoprazole MR on daytime and nighttime heartburn in patients with non-erosive reflux disease. Aliment Pharmacol Ther, 29: 1261-1272.Fass R, Chey WD, Zakko SF. Clinical trial: the effects of the proton pump inhibitor dexlansoprazole MR on daytime and nighttime heartburn in patients with non-erosive reflux disease. Aliment Pharmacol Ther, 29: 1261-1272.Fass R, Johnson DA. The effect of dexlansoprazole MR on nocturnal heartburn and GERDrelated sleep disturbances in patients with symptomatic GERD. Am J Gastroenterol, 2011, 106: 421-431.Fass R, Johnson DA. The effect of dexlansoprazole MR on nocturnal heartburn and GERDrelated sleep disturbances in patients with symptomatic GERD. Am J Gastroenterol, 2011, 106: 421-431.Metz DC, Howden CW, Perez MC, Larsen L, O’Neil J, Atkinson SN. Clinical trial: dexlansoprazole MR, a proton pump inhibitor with dual delayed-release technology, effectively controls symptoms and prevents relapse in patients with healed erosive. Aliment Pharmacol Ther, 2009, 29: 742-754.Metz DC, Howden CW, Perez MC, Larsen L, O’Neil J, Atkinson SN. Clinical trial: dexlansoprazole MR, a proton pump inhibitor with dual delayed-release technology, effectively controls symptoms and prevents relapse in patients with healed erosive. Aliment Pharmacol Ther, 2009, 29: 742-754.Fass R et al. Management of heartburn notresponding to proton pump inhibitors. Gut, 2009, 58(2): 295-309.Fass R et al. Management of heartburn notresponding to proton pump inhibitors. Gut, 2009, 58(2): 295-309.Kukulka M, Eisenberg C, Nudurupati S. Comparator pH study to evaluate the singledose pharmacodynamics of dual delayedrelease dexlansoprazole 60 mg and delayedrelease esomeprazole 40 mg. Clin and Experimental Gastroenterology, 2011, 4: 213-220.Kukulka M, Eisenberg C, Nudurupati S. Comparator pH study to evaluate the singledose pharmacodynamics of dual delayedrelease dexlansoprazole 60 mg and delayedrelease esomeprazole 40 mg. Clin and Experimental Gastroenterology, 2011, 4: 213-220.

The authors declare that there are no conflicts of interest present.