scholarly journals MODERN METHODS FOR DIAGNOSING PATHOLOGY OF THE CARDIO-ESOPHAGEAL TRANSITION IN CHILDREN

Author(s):  
Igor V. Poddubny ◽  
Valentin V. Sytkov ◽  
Ivan E. Smirnov ◽  
Yuliya D. Vorobyeva ◽  
Kirill N. Tolstov

The pathology of the esophagus is diverse, therefore, disorders of the structural and functional state of the esophagus require different approaches both in the diagnosis of its pathology and in treatment. The review presents data on innovative diagnostic methods for the pathology of the cardio-esophageal transition in pediatric patients. The methods used were literature search in the databases PubMed, Medlit, RSCI, Scopus, Web of Science, EMBASE. Modern ideas about the neurophysiology of the gastroesophageal transition, the mechanisms of its antireflux function, and the pathogenesis of various pathologies of this anatomical localization, mainly gastroesophageal reflux disease (GERD), are described in both infants and school children. The features of the clinical picture of GERD depending on the age of the patient and the nature of the reflux agent are presented. The phenotypes of reflux disease are determined. The characteristics and modifications of existing original methods for studying the cardio-esophageal transition (both their advantages and disadvantages) are described in detail. The approaches to the possible optimization of management of this group of patients are proposed.

1996 ◽  
Vol 105 (1) ◽  
pp. 23-32 ◽  
Author(s):  
Nancy M. Bauman ◽  
Anthony D. Sandler ◽  
Richard J. H. Smith

Respiratory manifestations of gastroesophageal reflux disease (GERD) are being recognized with increasing frequency. We present the evaluation and management of four infants and children with unusual respiratory symptoms attributed to GERD. The advantages and disadvantages of diagnostic studies of GERD are discussed, and an evaluation and treatment protocol is presented. Treatment must be tailored to the nature and severity of the patient's presenting symptoms and includes conservative, pharmacologic, and/or surgical management.


2016 ◽  
Vol 94 (7) ◽  
pp. 485-496
Author(s):  
Yakov S. Tsimmerman ◽  
L. G. Vologzhanina

This review presents a detailed definition of gastroesophageal reflux disease (GERD) and data on its prevalence, etiological and pathogenetic factors. The clinical picture of the disease, its clinical “masks” and complications including Barrett’s oesophagus and oesophageal carcinoma are discussed. Various diagnostic methods, such as oesophagofibroscopy, targeted biopsy, morphological studies, multichannel 24 hr pH-metry, etc. are considered. Classifications of GERD is presented with special reference to the original clinico-pathogenetic classification developed by one of the authors. The effectiveness of modern methods of GERD pharmacotherapy and surgical treatment is discussed.


2017 ◽  
Vol 4 (2) ◽  
pp. 65-71
Author(s):  
Oleksandra Slobodianiuk

Slobodianiuk O.L.In recent years much attention has been paid to the upper digestive tract diseases in children, particularly GERD, as a reason t,hat has an impact on quality of life even in children of school age and thereafter in young adults. Scientists came to a consensus that all examinations which are used in pediatric practice must be maximally available, simple and non-invasive to the extent practical for child’s condition.The question about practicability of performing esophagogastroduodenoscopy for all patients with complaints of heartburn and with other symptoms of GERD, the question relative to performing ultrasonography of the esophagus for children as an additional method of examination, usage of questionnaire in pediatric practice, formation of disease course prediction algorithm, and identification of preventive measures specific to every patient remain open.Therefore the goal of this research is to provide an overview of modern literature with reference to problematic issues of clinical evidence, risk factors, diagnostics, prediction of gastroesophageal reflux disease course in children of different age (regarding main causative and pathogenic factors, clinical evidence (esophageal and extra-esophageal), diagnostic methods and modern approaches to gastroesophageal reflux disease treatment).Key words: gastroesophageal reflux disease, non-invasive diagnostics, risk factors, prediction of disease course. СУЧАСНІ ПОГЛЯДИ НА ГЕРХ У ДІТЕЙ: ПРОБЛЕМИ ТА ПЕРСПЕКТИВИСлободянюк О.Л.Останнім часом багато уваги приділяється захворюванням верхніх відділів травного тракту у дітей, зокрема й ГЕРХ,  як причині, що призводить до порушення якості життя вже у дітей шкільного віку, а в подальшому і у людей молодого віку. Вчені дійшли консенсусу, що всі обстеження, які використовуються в педіатричній практиці повинні бути максимально доступними, простими та неінвазивними, наскільки це дозволяє стан дитини.Залишається відкритим питання про доцільність проведення ФЕГДС всім пацієнтам зі скаргами на печію та іншими симптомами ГЕРХ , питання щодо застосування УЗД стравоходу у дітей як додаткового методу обстеження, використання опитувальників в педіатричній практиці, формування алгоритмів прогнозування перебігу захворювання та визначення профілактичних заходів  індивідуально для кожного пацієнта.Отже, метою цієї роботи було виконати огляд сучасної літератури з проблемних питань клінічних проявів, факторів ризику, діагностики, прогнозування перебігу гастроезофагеальної рефлексної хвороби у дітей різного віку (з питань основних етіологічних та патогенетичних факторів, клінічних проявів (стравохідних та позастравохідних), методів діагностики та сучасних підходів до лікування гастроезофагеальної рефлексної хвороби).Ключові слова: гастроезофагеальна рефелюксна хвороба, неінвазивна діагностика, фактори ризику, прогнозування перебігу.  СОВРЕМЕННЫЕ ВЗГЛЯДЫ НА ГЕРБ У ДЕТЕЙ: ПРОБЛЕМЫ И ПЕРСПЕКТИВЫСлободянюк А.Л.В последнее время больше внимания уделяется заболеванием верхних отделов пищеварительного тракта у детей, в том числе и ГЭРБ, как причине, которая приводит к нарушению качества жизни уже у детей школьного возраста, а в дальнейшем и у людей молодого возраста. Ученые пришли к консенсусу, что все обследования, которые используются в педиатрической практике должны быть максимально доступными, простыми и неинвазивными, насколько это позволяет состояние ребенка. Остается открытым вопрос о целесообразности проведения ФЭГДС всем пациентам с жалобами на изжогу и другими симптомами ГЭРБ, вопросы применения УЗИ пищевода у детей в качестве дополнительного метода обследования, использование опросников в педиатрической практике, формирование алгоритмов прогнозирования течения заболевания и определения профилактических мероприятий индивидуально для каждого пациента.Итак, целью этой работы было выполнить обзор современной литературы по проблемным вопросам клинических проявлений, факторов риска, диагностики, прогнозирования течения гастроэзофагеальной рефлексной болезни у детей разного возраста (по вопросам основных этиологических и патогенетических факторов, клинических проявлений (пищеводных и внепищеводных), методов диагностики и современных подходов к лечению гастроэзофагеальной рефлексной болезни).Ключевые слова: гастроэзофагеальная рефелюксная болезнь, неинвазивная диагностика, факторы риска, прогнозирование течения.


2003 ◽  
Vol 25 (1) ◽  
pp. 93-98 ◽  
Author(s):  
H. E. Wiersma ◽  
C. J. van Boxtel ◽  
J. J. Butter ◽  
W. M. C. van Aalderen ◽  
T. Omari ◽  
...  

Author(s):  
Ciro Esposito ◽  
Agnese Roberti ◽  
Maria Escolino ◽  
Mariapina Cerulo ◽  
Alessandro Settimi ◽  
...  

2019 ◽  
Vol 16 (1) ◽  
pp. 41-50
Author(s):  
Elena-Roxana Săraru ◽  
Răzvan Peagu ◽  
Ana-Maria Călin-Necula ◽  
Alexandru Moldoveanu ◽  
Carmen Fierbinţeanu-Braticevici

AbstractGastroesophageal reflux disease (GERD) is one of the most common chronic gastrointestinal ailments worldwide, with a high prevalence and extremely costly diagnostic and therapeutic management. A hygienic-dietary regimen, accompanied by weight loss, are important factors for improving the symptoms of reflux disease. Various ways of correct diagnosis and for therapeutic management have been attempted over the years, of which themost widely used diagnostic method is empirical therapy with proton pump inhibitors. Also, questionnaires, upper digestive endoscopy with biopsies, barium radiography, ambulatory monitoring of esophageal pH, pH-impedance and esophageal manometry are widely used. Upper gastrointestinal endoscopy has a good specificity, but a low sensitivity for GERD. Also, the GERQ questionnaire has a good sensitivity and specificity in the accuracy of GERD diagnostic. Barium swallow use belongs to the past, and is recommended mostly for the detection of anatomical anomalies and not for the diagnosis of reflux disease. 24-hour ambulatory monitoring of esophageal pH is the study of choice to confirm the diagnosis of reflux disease in patients without endoscopic modifications suggestive of GERD. The association of impedance to esophageal pH monitoring is the gold standard for diagnosing GERD, making it possible to differentiate between acid reflux, weakly acid and non-acid episodes, and is also useful for diagnosing other conditions that mimic the GERD's clinical symptoms.


2020 ◽  
pp. 24-29
Author(s):  
M.G. Aksionchyk ◽  
◽  
K.Y. Marakhousk ◽  
V.I. Averin ◽  
◽  
...  

The aim is to evaluate clinical data and data of intraesophageal 24-hour pH/impedance measurement in pediatric patients with corrected esophageal atresia. Material and methods. A retrospective analysis was carried out on the basis of inpatient records of 43 pediatric patients with corrected esophageal atresia (CEA) aged from 1 to 14 years, who were examined at the State Institution «Republican Scientific and Practical Center of Pediatric Surgery» from November 2017 to March 2020. Average age of the group: 5.09±1.2 years, of which 23 boys (53.5%), 20 girls (46.5%). All patients with CEA underwent esophagogastroduodenoscopy (EGD) and intraesophageal 24-hour pH/impedance measurement while off acid-suppressive therapy. Results. Depending on the results of pH/impedance measurement, the patients with CEA were divided into two groups: CEA with gastroesophageal reflux disease (GERD) – 20 (54.1%) and CEA without GERD – 17 (45.9%). The most common symptom in patients with CEA was cough in both groups, in 26 (70.27%) children. Only in 4 out of 37 patients with CEA no symptoms during the time of the study were registered. Upper gastrointestinal tract endoscopy showed that 16 (43.2%) children with CEA had grade A esophagitis (according to the Los Angeles classification), 1 (2.7%) had gastric metaplasia of the esophageal mucosa, and 6 (16.2%) had chronic gastritis. EGD data did not reveal any significant differences between CEA patients with GERD and CEA patients without GERD (P=0.819). When comparing pH/impedance parameters, a significant difference (P<0.005) was obtained for the following parameters: reflux index, number of reflux episodes, distal mean nocturnal baseline impedance (MNBI) and duration of the longest reflux episode. In addition, the positive association of symptoms with episodes of refluxes (>95%) in the group of CEA patients without GERD was significantly higher than in CEA patients with GERD: 3/20 (15%) versus 8/17 (47.06%). Conclusions. The prevalence of GERD in patients with CEA in this study was 54.06%. Extraesophageal symptoms (in particular, cough) are prevalent in patients with CEA (70.3%). GERD can be asymptomatic in patients with CEA. In this study, 15% of CEA patients with confirmed GERD were asymptomatic. Patients with CEA in the study groups rarely had typical GERD symptoms (heartburn, regurgitation, chest pain and belching). The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institutions indicated in the article. Informed consent of parents and children was obtained for the research. The authors declare no conflicts of interest. Key words: corrected esophageal atresia, gastroesophageal reflux disease, esophagitis, children, esophageal 24-hour pH/impedance measurement.


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