Population comorbidity of gastrointestinal tract lesions in schoolchildren with GERD

Due to the lack of clear criteria in the diagnosis of gastroesophageal reflux disease (GERD) in children, it becomes appropriate to study the pathology, the factors of its formation and clinical course, including the association with manifestations of diseases of adjacent organs. The ethnic aspect is poorly studied. Aim: to evaluate the population characteristics of comorbidity of clinical manifestations of GERD with SD (dyspepsia syndrome) and IBS (irritable bowel syndrome) in schoolchildren of the Republic of Tyva with erosive and ulcerative defects of the gastroduodenal mucosa. Material and methods. The study was conducted in the Republic of Tyva: 1079 schoolchildren aged 7-17 years were clinically examined. GERD was defined in accordance with the pediatric consensus on pathology. IBS and SD were diagnosed based on Rome IV criteria. Subsequently, 129 children with gastrointestinal complaints underwent endoscopic examination of the upper gastrointestinal tract. The subjects were divided into two groups depending on the presence of GERD. Results. Erosive and ulcerative pathology of the gastroduodenal mucosa was more often detected in schoolchildren with GERD (p=0.032), mainly in the form of erosions (p=0.010) and significantly more often among Tuvans compared to Caucasians (p=0.004). The highest frequency of defects of the gastroduodenal mucosa was detected in schoolchildren with GERD, who also had manifestations of dyspepsia (in 27.8%). In children with GERD, the frequency of the destructive process was 2 times higher when associated with the clinical picture of IBS (p=0.185) and significantly higher than in children without GERD, but with IBS (p=0.036). In general, in children with an association of GERD and IBS, erosions were diagnosed more than 3 times more often than in other children. Conclusion. An association of GERD and erosive changes in the gastroduodenal mucosa is observed. The expediency of endoscopic examination of schoolchildren in the presence of an overlap of GERD with IBS for the purpose of diagnosing erosive pathology increases.

children, GERD, SD, IBS, comorbidity, population

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