SCIENTIFIC SUBSTANTIATION OF THE INTERRELATION BETWEEN 24-HOUR pH-IMPEDANCE MONITORING AND CIRCADIAN BIOMARKERS IN GERD AND ACID-RELATED STOMACH DISEASES
Keywords:
Keywords: pH-impedance monitoring, circadian biomarkers, GERD, peptic ulcer disease, flare prediction, chronotherapy.Abstract
Gastroesophageal reflux disease (GERD) and acid-related stomach diseases (chronic gastritis, duodenitis, gastric and duodenal ulcer disease) are among the most prevalent pathologies in modern gastroenterology. In the pathogenesis of these diseases, an imbalance between gastric juice acid-aggressive factors and mucosal resistance plays a leading role. In the human body, gastric acid secretion, gastric motility, and mucosal barrier state obey distinct circadian (daily) rhythms. Although 24-hour pH-impedance monitoring is currently considered the "gold standard" for determining the character and acidity of refluxes, the temporal correlation and pathogenetic relationship between these indicators and fluctuations in circadian biomarkers (cortisol, melatonin, pepsinogen I/II, and gastrin-17) remain insufficiently substantiated scientifically.
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