JOURNAL OF BIOLOGICAL REGULATORS & HOMEOSTATIC AGENTS Vol. 32, no. 4, 973-981 (2018)
Emerging from gastroesophageal reflux (EMERGE): An Italian survey – I the viewpoint of the gastroenterologist.
M. BIANCHETTI 1, S. PERALTA 2, R. NICITA 3, S.E. ARAGONA 4, G. CIPRANDI 4 and the EMERGE STUDY GROUP*
1 Gastroenterologia – Humanitas Mater Domini, Castellanza (VA), Italy
2 Endoscopia Digestiva – Policlinico P. Giaccone, Università di Palermo, Palermo, Italy
3 Gastroenterologia – ASP 5, Reggio Calabria, Italy
4 Center of Regenerative Medicine – Humanitas Mater Domini, Castellanza (VA), Italy
5 Ospedale Policlinico San Martino, Genoa, Italy
*EMERGE Study Group: A. Arrigoni, D. Artuso, M. Astegiano, C. Azzinnari, E. Battaglia, C. Belcari, Bendia, P. Benedicenti, M. Bianchetti, G. Brandimarte, I. Buoncompagni, M. Cabras, S. Camilleri, Capece, S. Caronna, C. Cassieri, F. Castaldo, T. Catalano, C. Citarella, F. D’amore, G. D’alia, F. D’arpa, A. Dattola, N. De Bortoli, A. De Medici, S. Di Marzo, R. Di Mitri, A. Di Napoli, V. D’onofrio, Dughera, W. Elisei, G. Errico, L. Familiari, P. Familiari, R. Frasca, A. Frunzio, M. Gatti, S. Genova, Grosso, R. Gullotta, D.R. Iannuzziello, G. Indennitate, G. Leonardi, C. Luigiano, B. Macchiarella, T. Maisto, M.G. Mancino, A. Mancino, G. Manes, R. Marin, G.R. Mastinu, A. Moi, L.M. Montalbano, N. Monterosso, A. Morabito Loprete, L. Morlando, R. Nicita, C. Ogliari, N. Paiano Primaldo, G. Paliani, A.P. Palieri, D. Pardocchi, A. Pati, G. Pedretti, S. Peralta, A. Pisani, P. Plomaritis, A.C. Privitera, R. Pumpo, F. Quatraro, D. Raimondo, G. Rivellini, L. Rizzo Giovanni, M. Romano, R. Salerno, E. Savarino, Scarpulla, E. Sinagra, M. Soncini, G. Tammaro, C. Trovato, R. Vassallo, M. Vinti, C.M.P. Virgilio.
Gastroesophageal reflux disease (GERD) is defined as a “disease that develops when the reflux of stomach contents induces troublesome symptoms and/or complications”. From a therapeutic point of view, many options have been proposed, including proton pump inhibitors (PPI), antihistamines (H2-receptor antagonists), antacid chemical compounds, antireflux barrier (using alginates), prokinetics, inhibitors of gastric sphincters, protection of mucosal tissue, neuromodulators, nociceptor antagonists, lifestyle modification, and surgery. A new medical compound has been recently launched in Italy: Marial® (manufactured by Aurora, Milan, Italy) containing magnesium alginate and E-Gastryal®. The aim of this survey was to analyse the patients’ characteristics and the prescriptive approach considering both the past or current treatments and clinical features during a visit in 56 gastroenterological centers, distributed in the whole of Italy. One thousand eight hundred forty-nine patients (46.5% males, and 53.5% females, mean age 48.59 years) were visited. Patients with positive reflux symptoms index (RSI+) had higher GIS scores than RSI- subjects. PPIs (both as monotherapy or plus add-on) were the most common medication prescribed before the visit. There was a significant change of prescription to Marial® at the visit. More precisely,, Marial® was preferentially prescribed to about a quarter of the patients, particularly to those with lower GIS score, whereas PPI plus add-on option was preferred for patients with higher GIS score. In conclusion, the current experience demonstrated that GERD may be managed considering a patient-centred work-up by using the GIS questionnaire. GIS score may be able to define the medication choice that includes also the new medical compound Marial®.