Gastrointestinal diseases

Gastroenterology deals with diagnostics and inoperative therapies (e.g. drug therapy) and prevention of diseases of the gastrointestinal tract.

Some of the socially-significant gastrointestinal diseases among the population in Bulgaria are ulcers (e.g. stomach ulcer and duodenal ulcer). Other common diseases are digestive disorders (dispepsia), gastroesophageal reflux disease (GERD), Zollinger-Ellison syndrome, aspiration of acidic gastric contents and others.

Gastroesophageal reflux disease (GERD)

Appearance of heartburn (acid reflux) is a symptom of gastroesophageal reflux disease. This condition is characterized by "return" of gastric acids in the esophagus - reflux.

Burning sensation in the chest or under the neck is caused by acids, which go to the esophagus. Other symptoms of GERD are vomiting, chronic cough, wheezing in the chest, as well as difficulty in swallowing.

In the lower end of the esophagus, through which swallowed food passes, the lower esophageal sphincter (LES) is found. The LES is a ring of muscles, which act as one-way valve, which allows food to pass inside the stomach. A normal function of LES is to close itself after swallowing so that it hinders return of gastric juices, which are rich in acids, to the esophagus.

GERD appears when LES is not functioning correctly, allowing gastric acids to leak in the esophagus and to burn its lower part. Acids returning to the esophagus can damage it, due irritation and inflammation. LES can be weaker in some people, who are born with such LES. Additionally, fatty, spicy food, as well as some medicinal products, tight clothes, smoking, alcohol intake, heavy physical activity or change in body position (e.g. bending or lying down) are factors, which can lead to relaxation of LES, thus causing reflux.

GERD is treatable disease.The rate and severit of symptoms can be reduced through change in diet and antacids intake. Weiht-loss, smoking cessation and alcohol intake cessation can help GERD treatment. Improvements in diet and sleep are with beneficial effect on disease response.

In case symptoms persist after above-mentioned change in lyfestyle, administration of medicinal products is mandatory. Some of the widely-used medicinal products are the proton-pump inhibitors (PPIs), which include BIOPRAZOL^® and RABIOXIN^® of INBIOTECH. 

"PPIs remain main group" of medicinal products "for treatment and control of GERD". Rabeprazol is characterized by robust, fast and long-lasting action and can be taken together with other medicinal products. It can be first choice for large percentage of patients with GERD, especially with severe forms of the disease, as well as for polymorbid patients. 

It is recommended to alternate differet PPI molecules every 3 to 6 months for patients under long-term treatment.


Infection with Helicobacter pylori

The most common infection in humans is the infection with Helicobacter pylori. This infection is widespread and half of humanity is affected by it (50%). This infection is a cause for morbdity in the gastroduodenal area, as well as in more distant organs and systems. With genetically substantiated morbodity, Helicobacter pylori bacteria is etiopathogenetic factor  for developmet of atrophic gastritis with or without intestinal metaplasia, acute and chronic gastritis, duodenal ulcer, gastric ulcer and others. This infection is defined as socially-significant, due to the fact that it leads to socially-significant diseases. 

Gastric ulcer & duodenal ulcer

Gastric ulcer and duodenal ulcer is characterized with defect on the gastric and duodenal mucosa, which is localized. This localized defect passes through the mucosa's entire thickness and affects deeper-positioned lyers of its wall. 

Gastrc and duodenal ulcers are caused when there is ongoing inflammation and when gastric acid and pepsin (digestive enzyme) blocks mechanisms, which protect mucous membranes of the stomach and of the duodenum.