THE PROTECTIVE ACTION OF MELATONIN IN GASTROESOPHAGEAL REFLUX DISEASE

Background. It is known that the degree of damage to the mucous membrane (MM) of the esophagus in gastroesophageal reflux disease (GERD) depends on the severity of the impairment of its protective properties. The role of melatonin in the protection of the MM of the gastrointestinal tract (GIT) from the damaging effects of endogenous and exogenous factors is currently being studied. Objective. To study the characteristics of melatonin daily rhythm secretion in patients with endoscopically positive GERD and to assess the relationship of its level to the degree of MM damage to the esophagus. Materials and methods. 59 patients with reflux esophagitis (RE) were examined. The level of melatonin metabolite was determined: 24-hour urinary 6-sulfatoxymelatonin (6-SOMT) and separately in day and night urine output. The night/day index has been calculated. Results. In patients with erosive RE, the level of 6-SOMT in 24-hour urine and in day urine output is significantly lower than in patients with non-erosive RE. In patients with non-erosive RE, the shift of melatonin synthesis peak to daytime has been noted. The correlation between the degree of damage to the esophageal MM and 6-SOMT urine level has been established. Conclusion. The results of the study prove the esophagoprotective action of melatonin on the MM of the esophagus in patients with endoscopically positive GERD. It is its enteral synthesis that allows for the high level of melatonin in daytime in patients with RE.