Pathophysiological aspects of gastroesophageal reflux disease, comorbid with diseases of the upper gastrointestinal tract

Purpose of the study. Development of diagnostic methods and detection of pathophysiological interrelations as targets of pathogenetic therapy of patients with gastroesophageal reflux disease (GERD) with comorbid gastrointestinal pathology. Material and methods. 433 patients were examined by esophagogastroduodenoscopy (EGD) in combination with acid-perfusion test (APT) with irrigation of the esophageal mucosa 0,1N HCL, congo red chromoscopy stomach, the identifying Helicobacter pylori (HP) in gastroduodenal mucosa. Results. The severity of reflux esophagitis (RE) in GERD found a direct correlation with subcompensated pyloric stenosis associated with duodenal ulcer, axial hernia and asthma. The age of patients with GERD was accompanied by a direct correlation with the degree of RE (χ², p=0,002), which directly correlated with the volume of the hungry stomach, exceeding 90 ml (ANOVA, p=0,015). APT reflected a statistically significant category correlation with severity of RE (χ², p=0,006). The degree of HP-infection of antral mucosa was accompanied by hypersecretion of HCL according to congo red chromoscopy and directly correlated with the severity of RE (Kruskal-Wallis, p<0,001). Conversely, the degree of HP-infection of the body of the stomach was inversely correlated with peak acid production, which suggests the HP-induced hypochlorhydria. The conclusion. Congo red chromoscopy and APT during endoscopy allows simultaneously detect acid production of the stomach and the early signs of non-erosive GERD in patients with unchanged and slightly altered esophageal mucosa for developing of managing patients with comorbid gastrointestinal pathology.

гастроэзофагеальная рефлюксная болезнь, коморбидность, кислото-перфузионный тест, хромоскопия с конго красным, эзофагогастродуоденоскопия, gastroesophageal reflux disease, comorbidity, acid-perfusion test, congo red chromoscopy, esophagogastroduodenoscopy