Gastroduodenal zone condition in schoolchildren with erosive form of gastroesophageal reflux disease
Abstract
Introduction. Gastroesophageal reflux disease (GERD) is a disorder with specific symptoms such as regurgitation and heartburn caused by recurrent reflux of gastric contents into the esophagus due to temporary relaxation or low pressure of the lower esophageal sphincter. Isolated esophagitis accounts for slightly less than 1.5% of the spectrum of chronic inflammatory diseases of the digestive system. Esophageal inflammation is often combined with damage to other organs and systems. In particular, according to some studies, combined esophageal damage is found in 15% of children with gastritis and in 38.1% with gastroduodenitis. A number of studies have shown a relationship between gastroesophageal reflux disease and atrophic Helicobacter gastritis in adult patients. The relationship between GERD, the severity of the inflammatory process, and erosive changes in the gastroduodenal zone has previously been studied in children. The aim of the study. To study changes in the gastroduodenal zone and their impact on the course of the erosive form of gastroesophageal reflux disease in school-age children. Materials and methods. Ninety-eight school-age children with erosive GERD, aged 7 to 18 years (mean age 11.4±2.1 years, including 71 boys and 27 girls) were included. The comparison group consisted of 30 children with nonerosive GERD (mean age 12.7±1.8 years, 11 boys and 19 girls). The symptoms and condition of the gastroduodenal mucosa were assessed using the results of fibrogastroduodenoscopy and histological examination of gastric mucosa biopsies. Results. In 80.6% of patients with the erosive form of gastroesophageal reflux disease, signs of hyperemic gastropathy were determined according to the endoscopic examination data. Of these, 16.3% of children were diagnosed with acute erosions of the gastroduodenal zone. Another 2% of those examined had ulcerative changes in the duodenal bulb. H. pylori infection was 70.4% of those examined. According to histological examination data, 55.6% of children with erosive GERD had mildly expressed weakly active gastritis, 22.2% had moderately expressed weakly active gastritis, and another 8.9% had moderately expressed moderately active gastritis. These changes do not have a significant effect on the clinical course of GERD and the severity of erosive esophagitis.
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