Can acid reflux cause ibs: Living With IBS and GERD
Living With IBS and GERD
If you have irritable bowel syndrome, research shows that you are much more at risk for gastroesophageal reflux disease. Learn about both conditions and symptom management that may help.
By Chris Iliades, MDMedically Reviewed by Kareem Sassi, MD
Reviewed:
Medically Reviewed
IBS affects the lower GI tract and GERD occurs when stomach acid flows back into the esophagus.iStock; Everyday Health
In the alphabet soup of digestive disorders, irritable bowel syndrome (IBS) and gastroesophageal reflux disease (GERD) aren’t just problematic on their own — they often occur together.
IBS causes belly pain along with changes in bowel habits, either diarrhea or constipation. GERD causes acid reflux, commonly referred to as heartburn. Having one of these conditions can be bad enough, but many people have to deal with both.
Several studies have found a strong link between GERD and IBS.
A study published in the World Journal of Gastroenterology looked at data on more than 6,000 people and found that about 63 percent of those diagnosed with IBS had GERD symptoms, too. The research also showed that having both GERD and IBS was more common in women and that having both conditions made all symptoms worse.
A study published in The American Journal of Gastroenterology found that the odds of having GERD symptoms was 4 times higher for people living with IBS than those without IBS.
“Is there a link between IBS and GERD? Absolutely,” says Maged Rizk, MD, a gastroenterologist and the director of the Chronic Abdominal Pain Center at the Cleveland Clinic in Ohio. “I see it all the time in our clinic. If you combine the results of all the studies, GERD is probably about 4 times more common in people with IBS.”
How Are IBS and GERD Linked?
Both IBS and GERD are extremely common. You may be diagnosed with IBS, which affects up to 20 percent of people, if you have symptoms of abdominal pain at least three times a month for at least three months, and that pain cannot be explained by any disease or injury.
GERD causes acid reflux and regurgitation; about 7 percent of people with the condition experience these symptoms on a daily basis.
“The links between GERD and IBS are mostly hypothetical but probably involve an increased sensitivity of the digestive system,” Dr. Rizk says. “People with GERD and IBS become uncomfortable at a lower threshold than people without these conditions. We call that visceral hypersensitivity.”
Another link between IBS and GERD symptoms may be gastrointestinal motility, referring to the process of moving food through the digestive system. If the movements are disordered, it’s called motility disorder. Some experts now consider both IBS and GERD to be motility disorders.
“Stress and food sensitivities may be other links,” Rizk says. “There is a strong link between mental stress and digestive stress. Stress is a known trigger for both IBS and GERD symptoms.”
Treatment Options for GERD and IBS
Rizk says that diet and lifestyle changes that reduce stress should benefit both IBS and GERD.
“An elimination diet that starts with very bland and simple foods and then introduces new food groups in stages may help identify foods that trigger symptoms,” Rizk says. “Each condition may also be treated separately with medications. Antacid and acid-blocking medications are often used for GERD. Antispasmodic medications and anti-anxiety medications may be used for IBS.”
Some studies suggest that following a low-FODMAP diet helps improve IBS symptoms. This involves eliminating foods that are high in certain carbohydrates called FODMAPs, or fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.
A review published in January 2017 in the journal Gastroenterology & Hepatology found that 50 to 86 percent of people with IBS show improvement in their symptoms on a low-FODMAP diet.
Trigger foods for GERD include fatty or fried foods, tomato sauce, chocolate, mint, garlic, onions, alcohol, and caffeine.
Stress management and relaxation techniques to calm anxiety may also help ease symptoms of IBS and GERD.
Maintaining a healthy weight, quitting smoking, avoiding tight clothing, elevating the head of your bed, not lying down after a meal, and eating food slowly can all reduce the frequency of acid reflux.
RELATED: The Business of a Diet
Additional reporting by Ashley Welch.
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IBS and Acid Reflux
Irritable bowel syndrome (IBS) is a common condition that affects the large intestine, or colon.
Symptoms usually include abdominal pain, cramps, bloating, constipation, diarrhea, and gas. Other symptoms of IBS may include urgent bowel movements or the feeling of incomplete evacuation.
The bowel muscles that are responsible for moving food through the intestinal tract may contract more forcefully or more irregularly in patients with IBS. This pushes food through the system abnormally. If waste material moves too fast it can cause diarrhea. If it moves too slow it can cause constipation.
Although it may make you uncomfortable, IBS doesn’t cause inflammation, nor will it permanently damage the colon.
Gastroesophageal reflux (GERD) is a disease that may cause significant damage to the tissues and cells of the esophagus over time. It’s the chronic form of acid reflux.
GERD occurs when stomach acids back up into the esophagus due to a poor-functioning lower esophageal sphincter (LES). The LES is a band of muscle that acts as a valve between the esophagus and the stomach.
The main symptom of both acid reflux and GERD is frequent heartburn. Other symptoms may include burning in the throat or a sour liquid taste in back of the mouth.
While occasional acid reflux is normal, GERD symptoms are persistent and typically require treatment to relieve symptoms such as coughing, sore throat, and difficulty swallowing.
IBS is classified as a functional disorder. This is a condition in which symptoms are real, but physiological causes aren’t easily identifiable. Although the causes of IBS are unknown, it’s frequently exacerbated by stress.
IBS also often accompanies GERD. This dual presentation suggests that the two conditions may share common disease mechanisms, but these are not well understood.
One mechanism may be poor muscle function of the intestinal tract. Some experts suspect there may be an incoordination of the muscles that line the esophagus, stomach, and intestines, contributing to symptoms of both IBS and acid reflux.
Another observation is that individuals with both IBS and GERD report more sleep difficulties and more episodes of abdominal pain than people who just have IBS or GERD alone.
However, IBS is a complicated condition and less well-understood than GERD. Experts believe there are a variety of individual, intestinal, and environmental factors that contribute to IBS. This makes the relationship between GERD and IBS even more complicated.
Different stimuli may trigger IBS symptoms in different people. For instance, in one person things like intestinal infection or medication may cause symptoms, while other people may react to certain foods or stress.
Women are more likely than men to suffer from IBS. Often, women will find that IBS symptoms are worse during menstruation. This has led researchers to believe that hormones may play a role in the development of IBS.
Perhaps not surprisingly, IBS and acid reflux are often triggered by the same kinds of foods. Those suffering from one or both conditions may find relief by avoiding the following:
- alcoholic beverages
- caffeinated beverages, such as coffee
- carbonated beverages, such as colas
- chocolate
- citrus fruits
- fatty and fried foods
- garlic and onions
- spicy foods
- tomato-based foods, such as pizza and spaghetti sauces
- certain sugars like high fructose corn syrup and lactose
- certain sugar alcohols like sorbitol and xylitol
If trigger foods include dairy products such as milk, cheese, or ice cream, the problem may be lactose intolerance, not IBS.
People who have cramping or bloating after only eating dairy products should stop eating these foods for a period of two weeks to see if symptoms subside. If symptoms subside after avoiding dairy, speak with your doctor about the possibility of lactose intolerance. If other non-lactose foods in addition to dairy aggravate your symptoms, you are more likely to have IBS.
While medications may provide relief in many cases, the preferred treatment for most people suffering from both acid reflux and IBS is lifestyle and dietary modification.
In addition to avoiding certain foods, people with IBS or GERD may find relief by losing weight, quitting smoking, and learning stress-reduction techniques such as deep breathing, exercise, or yoga.
Although lifestyle and dietary changes can benefit many people with IBS, if you have GERD symptoms as well, certain medications may help:
- Proton pump inhibitors, such as omeprazole, are the drugs of choice for GERD sufferers.
- Antacids may be enough to relieve symptoms for people with occasional mild acid reflux.
- Anti-gas medications like simethicone (Gas-X) can work for occasional gas, bloating, and indigestion.
Buy antacids now.
Medications that focus on the management of IBS vary greatly depending on whether the main symptoms are constipation, diarrhea, or both. Your doctor can help guide your treatment.
If you have symptoms of GERD, IBS, or other intestinal problems, see your doctor for a thorough exam. Depending on your symptoms, you will likely need evaluation and testing to determine your diagnosis and which treatment options are best for you.
Reflux esophagitis (GERD) – treatment, symptoms and diagnosis of reflux esophagitis (GERD) in “SM-Clinic”
This disease is treated by a Gastroenterologist
- What is reflux esophagitis (GERD)?
- Symptoms of gastroesophageal reflux disease
- Causes and course of GERD
- Diagnosis of gastroesophageal reflux disease (GERD)
- Treatment of gastroesophageal reflux disease (GERD)
- Surgical treatment of gastroesophageal reflux disease (GERD)
- Doctors
Symptoms of gastroesophageal reflux disease
Characteristic symptoms of gastroesophageal reflux disease are heartburn, pain in the sternum, sour belching, regurgitation, nausea, painful and difficult passage of food, discomfort after eating, flatulence.
Errors in the diet (fatty, carbonated drinks, alcohol), smoking, physical activity, wearing clothes with a tight belt can provoke an increase in symptoms.
Gastroesophageal reflux disease (GERD, reflux esophagitis) is one of the most common diseases of the esophagus, episodically its symptoms, primarily heartburn, occur in half of the adult population of the country, men and women get sick equally often, usually between the ages of 20 and 45 years.
GERD is an insidious disease, without proper treatment it can lead to serious complications, including cancer of the esophagus. The danger is aggravated by the fact that despite the mass of unpleasant symptoms that spoil their lives, many people are in no hurry to see a doctor, preferring to muffle the symptoms with heartburn pills.
Causes and course of GERD
Factors contributing to the development of GERD are hiatal hernia (esophageal hernia), stress, obesity, pregnancy, smoking, taking certain medications (calcium antagonists, anticholinergics, beta-blockers, etc.
).
The immediate cause of gastroesophageal reflux disease is prolonged contact of gastric contents with the mucosa of the esophagus. Dysmotility leads to the fact that the acidic gastric environment not only enters the esophagus, but also stays there for a long time.
Incorrect work (weakness) of the lower esophageal sphincter, which should prevent the reverse movement of masses, causes the entry of gastric contents into the esophagus, and insufficient peristalsis of the esophagus and a decrease in esophageal clearance cause slow emptying of the stomach and the withdrawal of this aggressive environment. This imbalance of protective functions leads to the development of reflux esophagitis.
Prolonged exposure of acid and bile to the esophageal mucosa leads to its chronic inflammation and erosive and ulcerative changes, foci of altered mucosa of the lower esophagus often serve as a source of cancer growth.
At the initial stages of the disease, separate areas of erosion of the distal esophagus are noted, at the second stage, individual foci of inflammation merge into a common area, then at the third stage, the inflammatory process covers the entire surface of the mucosa, ulcers appear.
The fourth stage is a chronic esophageal ulcer, stenosis, cylindrical metaplasia of the esophageal mucosa (Barrett’s esophagus).
Patients with reflux disease are at an increased risk of acquiring various diseases of the paranasal sinuses, diseases of the trachea, larynx and lungs (ischemic heart disease with angina pectoris and / or heart rhythm disturbances, reflux laryngitis and pharyngitis, recurrent pneumonia, bronchial asthma, dental erosion, etc. ).
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If you experience these symptoms, we recommend that you make an appointment with your doctor. Timely consultation will prevent negative consequences for your health.
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Diagnosis of gastroesophageal reflux disease (GERD)
Various methods are used to diagnose GERD.
The main method is endoscopic – it allows you to get confirmation of the presence of reflux esophagitis, to assess its severity. Histological analysis of biopsy specimens of the esophageal mucosa provides additional information on the degree of dystrophic changes in the epithelial layer.
Contrast radiography of the esophagus allows you to identify reflux as such, that is, to fix the ingress of contrast from the stomach into the esophagus. X-ray examination of the esophagus may also indicate the presence of hiatal hernia, stricture of the esophagus, diffuse esophagospasm of the diaphragm.
Esophageal manometry (esophagomanometry) – allows you to evaluate the contractile activity of the esophagus, to study the indicators of the movement of its wall and the activity of the esophageal sphincters.
Treatment of gastroesophageal reflux disease (GERD)
After a comprehensive diagnosis, a gastroenterologist comprehensively assesses the patient’s health, analyzes the severity and nature of the course of the disease and selects an individual treatment regimen.
The goal of treatment of gastroesophageal reflux disease is to relieve its symptoms, treat esophagitis, prevent or eliminate complications of the disease, and improve the patient’s quality of life. Treatment for GERD can be conservative or surgical.
Non-surgical treatment of gastroesophageal reflux disease (GERD)
Non-surgical treatment is indicated for mild to moderate reflux disease.
Properly selected antireflux therapy can reduce reflux, reduce the damaging properties of refluxate (gastric contents), improve esophageal clearance and protect the esophageal mucosa.
An effective antireflux treatment is based on lifestyle changes, in particular, it is necessary to normalize body weight, seriously adjust the diet, the amount and time of eating (avoid fatty, sour, foods that increase gas formation, as well as chocolate, coffee, carbonated drinks) . It is very important to exclude smoking and drinking alcohol, you should refrain from taking drugs that depress the function of the lower esophageal sphincter.
Patients should avoid overeating, as well as stress on the abdominal muscles.
Antireflux drug therapy includes regular intake of antacids and alginic acid derivatives, prokinetics and antisecretory drugs that reduce gastric acidity, protect the esophageal mucosa, activate peristalsis, increase the activity of esophageal sphincters and improve esophageal and gastric motility in general.
With complex drug therapy of moderate reflux esophagitis, most patients experience a significant reduction in symptoms and an improvement in quality of life.
The basic course of treatment should be at least one month, and then within 6-12 months the patient should receive maintenance treatment. Without supportive treatment, the likelihood of recurrence of erosive esophagitis is high – it reaches 90% within a year.
It should be borne in mind that many antacid preparations contain a large amount of aluminum in their composition, and, accordingly, their long-term, unsystematic use leads to its accumulation in the body, which in old age increases the risk of developing Alzheimer’s disease.
Surgical treatment of gastroesophageal reflux disease (GERD)
The question of surgical treatment of GERD arises when conservative therapy does not give the expected effect, despite repeated courses of drug therapy and adherence to all recommendations for normalizing lifestyle. Conservative treatment can reduce the severity of symptoms and prevent complications from developing, but does not eliminate the cause of the disease.
If, despite active medical treatment of GERD, you continue to suffer from heartburn, pain and other symptoms of reflux disease for more than a year, then it’s time to think about consulting with an experienced surgeon.
The indication for surgical treatment of reflux esophagitis is also a complicated course of the disease: bleeding, ulcerative lesions, peptic strictures of the esophagus, development of Barrett’s esophagus with high-grade epithelial dysplasia. Especially often, indications for surgery occur when GERD is combined with a hernia of the esophageal opening of the diaphragm.
SM-Clinic employs experienced surgeons who successfully perform surgical treatment of gastroesophageal reflux disease.
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Hepatitis A
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Duodenitis
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fatty liver disease
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Constipation
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intestinal candidiasis
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intestinal colic
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food poisoning
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Gastroesophageal reflux disease and coronary heart disease – is there a mutual burden syndrome? | Alekseeva
1. El-Serag H.B., Sweet S., Winchester C.C. et al. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. gut. 2014;63:871-80.
2. Liu Y., He S., Chen Y. et al. Acid Reflux in Patients with Coronary Artery Disease and Refractory Chest Pain. internal medicine. 2013;52(11):1165-71.
3. Mohammed S.B., Gadad A., Nayak B.S., Beharry V.
Prognosis of the Midlife-Elderly from ECG Testing to Gastroesophageal Reflux Disease and Coronary Artery Disease. J Fam Med Dis Prev. 2016;2:029.10.23937/2469-5793/1510029.
4. Bhuiya F., Pitts S.R., McCaig L.F. Emergency department visits for chest pain and abdominal pain: United States, 1999–2008. NCHS data brief, no 43. Hyattsville, MD: National Center for Health Statistics. 2010.
5. Kato H., Ishii T., Akimoto T., Urita Y., Sugimoto M. Prevalence of linked angina and gastroesophageal reflux disease in general practice. World J Gastroenterol. 2009;15(14):1764-68.
6. Chauhan A., Petch M.C., Schofield P.M. Cardio-oesophageal reflex in humans as a mechanism for “linked angina”. Eur Heart J. 1996;17(3):407-13.
7. Gritsenger V.R., Lipatova T.E., Gubanova G.V. Functional features of stable exertional angina associated with gastroesophageal reflux disease. Innovations in science: Sat. Art. by mother. XVIII Intern. scientific-practical. conf. Part II. Novosibirsk: SibAK; 2013:112-20
8.
Dobrzycki S., Baniukiewicz A., Korecki J. et al. Does gastroesophageal reflux provoke the myocardial ischemia in patients with CAD? Int J Cardiol. 2005;104:67-72.
9. Fedoseeva O.S. The relationship of gastroesophageal reflux disease and coronary heart disease: features of the clinical course and instrumental diagnostics: Abstract of the thesis. dis. …cand. honey. Sciences. Moscow, 2012.
10. Firsova L.D., Pichugina I.M., Yanova O.B., Berezina O.I., Bordin D.S. Clinical and pathogenetic features of esophagospasm. Ter arch. 2015;87(4):36-40
11. Manfrini O., Bazzocchi G., Luati A., Borghi A., Monari P., Bugiardini R. Coronary spasm reflects inputs from adjacent esophageal system. Am J Physio. Heart Circ Physiol. 2006;290(5):2085-91.
12. Salvado R., Watson T. J., Herbella F. et al. Association of gastroesophageal reflux and O2 desaturation: a novel study of simultaneous 24-h MII-pH and continuous pulse oximetry. J Gastrointest Surg. 2009;13:854-61.
13.
Giamberardino M.A., Costantini R., Affaitati G., Fabrizio A., Lapenna D.,
14. Tafuri E., Mezzetti A. Viscero-visceral hyperalgesia: characterization in different clinical models. Pain. 2010;151(2):307–22.
15. Kozlova I.V., Loginov S.V., Shvarts Yu.G. Gastroesophageal reflux and degree of esophagitis in patients with coronary heart disease: influence on myocardial repolarization and heart rate variability. Wedge honey. 2004;9:33–5
16. Chen C.L., Orr W.C., Yang C.C., Kuo T.B. Cardiac autonomic regulation differentiates reflux disease with and without erosive esophagitis. Scand J Gastroenterol. 2006;41(9):1001-6.
17. Eremina E.Yu., Zvereva S.I., Ryabova E.A. Significance of heart rate variability in patients with gastroesophageal reflux disease. Med Alf. 2017;19(2):32–4
18. Floria M., Barboi O., Grecu M., Cijevschi Prelipcean C., Balan G., Drug V.L. Atrial fibrillation and sympathovagal balance in patients with gastroesophageal reflux disease. Turk J Gastroenterol.
2017;28(2):88–93.
19. Johansson S., Wallander M.A., Ruigómez A. et al. Is there any association between myocardial infarction, gastro-oesophageal reflux disease and acid-suppressing drugs? Aliment Pharmacol Ther, 2003;18:973–8.
20. Lei W-Y., Wang J-H., Wen S-H., Yi C-H., Hung J-S., Liu T-T. et al. Risk of acute myocardial infarction in patients with gastroesophageal reflux disease: A nationwide population-based study. PLoS One 2017;12(3):e0173899.
21. Rieder F., Biancani P., Harnett K., Yerian L., Falk G.W. Inflammatory mediators in gastroesophageal reflux disease: impact on esophageal motility, fibrosis and carcinogenesis. Am J Physiol Gastrointest Liver Physiol. 2010;98(5):571–81.
22. Oparin A., Vnukova A. Uloga endotelne disfunkcije and mehanizmu nastanka Acta Clin Croat. 2017;56(4):635-9.
23. Howarth D., Oldfield G., Booker J. et al. Esophageal dysfunction in patients with atypical chest pain investigations with esophageal scintigraphy and myocardial perfusion imaging: an outcome study.
J Nucl Cardiol. 2003;10:490-7.
24. Fujiwara Y., Fass R. Gastroesophageal reflux disease and sleep disturbances. J Gastroenterol. 2012;47:760–9.
25. Emilsson Ö.I., Bengtsson A., Franklin K.A., Torén K., Benediktsdóttir B., Farkhooy A., Weyler J., Dom S., De Backer W., Gislason T., Janson C. Nocturnal gastro-oesophageal reflux, asthma and symptoms of OSA: a longitudinal, general population study. Eur Respir J. 2013;41(6):1347-54.
26. Fedorova S.O., Kozlova N.M., Lavrik S.Yu. Obstructive sleep apnea syndrome associated with gastroesophageal reflux disease. Sib honey journal. 2016;142(3):5-8
27. Senaratna C.V. et al. Prevalence of obstructive sleep apnea in the general population: A systematic review. Sleep Med Rev. 2016. Http://dx.doi.org/10.101 6/j.smrv.2016.07.002
28. Labarca G., Cruz N.R., Descalzi F. Compromiso multisistémico en apnea obstructive delsueño. Rev Med Chile. 2014;142:748-57.
29. Pan L., Xie X., Liu D. et al. Obstructive sleep apnoea and risks of all-cause mortality: preliminary evidence from prospective cohort studies.
Sleep Breath. 2016;20:345-53.
30. Shaydyuk O.Yu. Influence of sleep apnea syndrome on the clinical course and quality of life of patients with coronary heart disease. Roscard magazine. 2012;5(97):70-4.
31. Pikulev D.V., Alekseeva O.P., Dolbin I.V. Ischemic heart disease and gastroesophageal reflux disease: features of the combined course. Honey almanac. 2012; 1(20): 43-9
32. Minushkin O.N., Shuleshova A.G., Bondareva K.A., Danilov D.V. Therapy of erosive esophagitis formed by “mixed” reflux in patients with coronary artery disease. Honey advice. 2018;14:73-7
33. Jansson C., Nordenstedt H., Wallander M.A. et al. Severe symptoms of gastro-oesophageal reflux disease are associated with cardiovascular disease and other gastrointestinal symptoms, but not diabetes: a population-based study. Aliment Pharmacol Ther. 2008;27:58–65.
34. Oparin A.A. The role of melatonin in comorbid pathology of gastrointestinal diseases with arterial hypertension and coronary heart disease.
News of medicine and pharmacy. 2013;6:89-92
35. Mikhailova Z.D., Shalenkova M.A. The role of melatonin in patients with acute coronary syndrome. Cardiology: News. Opinions. Education. 2017;2(13):39-44
-related quality of life after therapy with omeprazole in patients with coronary artery disease and recurrent angina-like chest pain. A double-blind, placebo-controlled trial of the SF-36 survey. Health and Quality of Life Outcomes. 2011;9:77.
37. Talwar V., Wurm P., Bankart M.J., Gershlick A.H., de Caestecker J.S. Clinical trial: chest pain caused by presumed gastrooesophageal reflux in coronary artery disease: controlled study of lansoprazole vs. placebo. Aliment Pharmacol Ther. 2010;32:191–9.
38. Swiatkowski M., Budzyński J., Kłopocka M., Pulkowski G., Suppan K., Fabisiak J., Morawski W., Majer M. Suppression of gastric acid production may improve the course of angina pectoris and the results of treadmill stress test in patients with coronary artery disease.
Med Sci Monit. 2004;10(9):524–9.
39. Liuzzo J.P., Ambrose J.A., Diggs P. Proton pump inhibitors for patients with coronary artery disease associated with reduced chest pain, emergency department visits, and hospitalizations. clinical cardiology. 2005;28(8):369–74.
40. Budzyński J., Pulkowski G., Kłopocka M., Augustyńska B., Sinkiewicz A., Suppan K. et al. Original research Treatment with double dose of omeprazole increases endorphin plasma levels in patients with coronary artery disease. Arch Med Sci. 2010;6(2):201-07.
41. Oudit G.Y., Bakal J.A., McAlister F.A., Ezekowitz J.A. Use of oral proton pump inhibitors is not associated with harm in patients with chronic heart failure in an ambulatory setting. Eur J Heart Fail. 2011;13(11):1211–5.
42. Akiomi Y. et al. Associations of Acid Suppressive Therapy With Cardiac Mortality in Heart Failure Patients. J Am Heart Assoc. 2017;6:e005110.
43. Shiraev T.P., Bullen A. Proton Pump Inhibitors and Cardiovascular Events: A Systematic Review.
Heart Lung Circ. 2018;27(4):443-50.
44. Shah N.H., Le Pendu P., Bauer-Mehren A., Ghebremariam Y.T., Iyer S.V., Marcus J.et al. Proton Pump Inhibitor Usage and the Risk of Myocardial Infarction in the General Population. PLoS One 2015;10(6):e0124653.
45. Pello Lázaro A.M., Cristóbal C., Franco-Peláez J.A., Tarín N., Aceña Á., Carda R. et al. Use of Proton-Pump Inhibitors Predicts Heart Failure and Death in Patients with Coronary Artery Disease. PLoS One 2017;12(1):e0169826.
46. Komarov A.L., Shakhmatova O.O., Muraseeva V., Novikova E.S., Guskova E.V., Panchenko E.P. Taking proton pump inhibitors and the prognosis of patients after elective percutaneous coronary interventions. Ter arch. 2018; 9:92-100
47. Wen H., Jin T., Xue K., Weijie C., Zengzhang L. Influence of proton pump inhibitors on clinical outcomes in coronary heart disease patients receiving aspirin and clopidogrel: A meta-analysis. medicine. 2018;97:3(e9638).
48. Ito T., Jensen R.T.
Association of long-term proton pump inhibitor therapy with bone fractures and effects on absorption of calcium, vitamin B12, iron, and magnesium. Curr Gastroenterol Rep. 2010;12:448-57.
49. Cheungpasitporn W, Thongprayoon C, Kittanamongkolchai W, Srivali N,
50. Edmonds PJ, Ungprasert P, O’Corragain OA, Korpaisarn S, Erickson SB.
51. Proton pump inhibitors linked to hypomagnesemia: a systematic review and
52. meta-analysis of observational studies. Renfail. 2015;37:1237–1241.
53. Toh J., Ong E., Wilson R. Hypomagnesaemia associated with long-term use of proton pump inhibitors. Gastroenterol Rep (Oxf). 2014;3(3):243-53.
54. Cheungpasitporn W., Thongprayoon C., Kittanamongkolchai W., Srivali N., Edmonds P.J., Ungprasert P., O’Corragain O.A., Korpaisarn S., Erickson S.B. Proton pump inhibitors linked to hypomagnesemia: a systematic review and meta-analysis of observational studies. Renfail. 2015;37:1237–41.
55. Drapkina O.M., Shepel R.
N. Relationship between vitamin B12 deficiency, risk of developing cardiovascular diseases and aging processes. Rational pharmacotherapy in cardiology. 2017;13(1):100-06
56. Okamoto T., Hatakeyama S., Hosogoe S. et al. Proton pump inhibitor as an independent factor of progression of abdominal aortic calcification in patients on maintenance hemodialysis. PLoS One 2018;13(7):e0199160.
57. Batchelor R., Kumar R., Gilmartin-Thomas J.F.M., Hopper I., Kemp W., Liew D. Systematic review with meta-analysis: risk of adverse cardiovascular events with proton pump inhibitors independent of clopidogrel. Aliment Pharmacol Ther. 2018;48:780-96.
58. Chen C.H., Lin C.L., Kao C.H. Association between gastroesophageal reflux disease and coronary heart disease: A nationwide population-based analysis. medicine. 2016;95(27):e4089.
59. Chung S.J., Kim D., Park M.J. et al. Metabolic syndrome and visceral obesity as risk factors for reflux oesophagitis: a cross-sectional case–control study of 7078 health check-up Koreans.