Aim. The aim of the study was to determine causes of proton pump inhibitors. (PPIs) inefficacy in some patients suffering from gastroesophageal reflux disease (GERD). Material and methods. In our study of 154 GERD patients, 50 received omeprazole. 51 - lansoprazole and 53 - pantoprazole in a standard daily dose. GERD symptoms (heartburn and regurgitation) were scored by Likert scale: the patients' quality of life (SF-36) and their mental status (SMALL) were examined. Upper gastrointestinal endoscopy. 24-h intraesophageal pH monitoring, esophageal manometry and pharmacokinetic study were performed. Results. The treatment with a standard dose of PPIs was ineffective in 21 (13.6%) patients. Causes of PPIs inefficacy in 4.5% patients were rapid PPI metabolism and in 9.1% - "driving gear" of symptoms formation related with psychic dysadaptation.

Aim. To assess prevalence of gastroesophageal reflux disease (GERD) in Russia in MEGRE trial in 6 cities of the Russian Federatiion (Kazan, Kemerovo, Krasnoyarsk, Ryazan, St-Petersburg, Saransk).Material and methods. Mayo Clinic questionnaire (USA) adapted for Russia was used to question 7812 people over 18 years of age from of random population sample. The symptoms (heartburn and regurgitation) were classified as frequent if they arose once a week and more often for the last 12 months, rare symptoms arose less often than once a week. The responders with frequent heartburn and/or regurgitation were regarded as persons with epidemiological quantitative criteria of GERD.Results. Heartburn occurred in 47.5% responders: frequent in 9%, rare in 38.5%. Regurgitation occurred in 42.9%: frequent in 7.6%, rare in 35.3%. GERD prevalence was 13.3% (city range 11.3-14.3%). Frequent GERD symptoms are associated with frequent gaseous eructation (24.3%), chronic cough (22.9%), chest pain (15.1%), dysphonia (11.4%.). To stop heartburn, 88% responders took antacids, 32% - blockers of histamine H-2-receptors and only 23% - inhibitors of proton pump. Only 52.8% responders with frequent chest pain and 29.3% those with frequent hearburn visited a doctor.Conclusion. The population-based trial MEGRE conducted by international methodology in 6 cities of Russia demonstrated that GERD prevalence is 13.3%. Most of the patients pay little attention to the symptoms, do not seek medical advice and, therefore, receive no adequate treatment.

There are demonstrated results of a prospective comparative study on clinical efficacy and tolerability of Panum (INN: pantoprazole) under the sponsorship of Unique Pharmaceutical Laboratories (India). Were evaluated the results of a 28-day course of treatment of 30 patients with GERD, including those with severe reflux esophagitis (erosive and ulcerative), who received 40 mg of pantoprazole as monotherapy. Was found an algorithm with an intermediate control efficacy to individualizing the approach to therapy. As a result 16,7% of patients with severe reflux esophagitis required increasing the dose of pantoprazole to 80 mg/day in two divided doses, and the rest (83,3%) patients to achieve clinical and endoscopic remission of GERD was sufficient single dose of 40 mg of the drug. The results of this study indicated the efficacy and safety of the Panum drug in the treatment of GERD, including its complicated forms