scholarly journals Biochemical Manifestations of Gastroesophageal Reflux Disease Progression in Children: A Single Center Case-Control Study

2020 ◽  
Vol 10 (12) ◽  
pp. 4368
Author(s):  
Gabriela Ghiga ◽  
Nicoleta Gimiga ◽  
Daniel Vasile Timofte ◽  
Oana Maria Rosu ◽  
Vladimir Poroch ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Ph Monitoring ◽  
Clinical Manifestations ◽  
Endoscopic Examination ◽  
Control Group ◽  
Healthy Children ◽  
High Blood Glucose ◽  
Biochemical Alterations

Gastroesophageal reflux disease (GERD) is a common digestive condition, representing one of the most frequent reasons for medical examination, especially in pediatric gastroenterology departments. GERD could be associated with biochemical alterations representing either its systemic manifestations or markers of complications. The aim of our paper was to evaluate biochemical parameters secondary to GERD in children. Two hundred and sixty-seven children of both genders aged between 1 month and 18 years who displayed suggestive symptoms for this condition were included in the study and were monitored for a period of 5 years. Depending on the range of symptoms and technical possibilities, the following procedures/investigations were performed: esophageal pH monitoring and imagistic or endoscopic examination, besides specific biochemical investigations. The cohort was sub-divided into two groups: one that included 213 children with confirmed GERD who represented the study group and 54 healthy children where GERD had been excluded, the control group. Out of all the investigated children, 39.0% displayed low hemoglobin values, 43.7% displayed low values of erythrocyte indices (MCH), and 68.5% had increased erythrocyte sedimentation rate (ESR) values, while increased eosinophil levels were recorded in 46.9% of the cases. Such parameters were proven to be a biomarker of suspected eosinophilic esophagitis, whereas 32.9% of the cases displayed high blood glucose values that could be correlated with gastroesophageal reflux symptoms. Other measured parameters (such as magnesium, aminotransferases and proteins) remained within the normal limits, without statistically significant differences compared to in the control group. This condition is diagnosed based on invasive investigations, which are often difficult to accept by the patients’ parents. The biochemical modifications correlated to the clinical manifestations can anticipate the progression of the disease, thus limiting the necessity of performing invasive diagnosis tests.

scholarly journals Neuropsychiatric features of children with systemic somatovegetative disorders (by the example of atopic dermatitis, bronchial asthma and gastroesophageal reflux disease)

2019 ◽  
Vol 10 (3) ◽  
pp. 40-48
Author(s):  
T. S. Petrenko ◽  
K. Yu. Retyunskiy ◽  
M. D. Borovskikh ◽  
D. R. Devyatkina ◽  
A. V. Pereshitova ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Bronchial Asthma ◽  
Reflux Disease ◽  
Energy Functional ◽  
Control Group ◽  
Healthy Children ◽  
Central Nervous System Damage ◽  
Neuropsychological Disorders

Objective: to study the clinical neuropsychiatric and neuropsychological features of children suffering from systemic somatovegetative disorders.Materials and methods: the study involved children from 5 to 12 years old with an established diagnosis of bronchial asthma — 108 children; atopic dermatitis — 105 children; gastroesophageal reflux disease — 112 children; the control group consisted of 60 same age healthy children. All children underwent clinical-anamnestic, neurological, psychopathological and neuropsychological research.Results: the children with systemic somatovegetative disorders have a significantly high incidence of pathogenic factors of central nervous system damage in early stages of ontogenesis (pathology of pregnancy and childbirth). Early sensory and motor deprivation due to somatic suffering aggravates neuropsychiatric deficiency. Neuropsychological disorders were predominantly represented by a violation of the perception of their body, lack of kinesthetic and motor functions, spatial and quasi-spatial representations.Conclusion: the clinical dynamics of neuropsychiatric disorders in children with systemic somatovegetative disorders corresponds to the dynamics of residual cerebral organic impairment with a stage-age changes of syndromes. The revealed neuropsychological disorders correspond to preferential damage to the first (energy) functional block of the brain.

scholarly journals The study of oral liquid microcrystallization in children with gastro-esophageal reflux disease

2014 ◽  
Vol 87 (4) ◽  
pp. 269-276
Author(s):  
Aurelia Spinei ◽  
Alina Monica Picos ◽  
Ina Romanciuc ◽  
Antonela Berar ◽  
Ana Maria Mihailescu
Keyword(s):  
Electron Microscope ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Control Group ◽  
Study Group ◽  
Healthy Children ◽  
Esophageal Reflux ◽  
Oral Liquid ◽  
Scanning Electron

Background and aim. Patients with disabilities have a higher prevalence of caries and dental erosions than general population. This particularity may be assessed by the study of microcrystallization of saliva. We investigated the oral liquid microcrystallization in children with gastroesophageal reflux disease (GERD), a condition associated with dental erosions. Material and methods. 54 children have been clinically examined: 27 children suffering from GERD with ages between 13 and 15, were included in the study group, and 27 healthy children - the control group. The study of crystallographic changes of the oral liquid was performed using the method developed by Shatohina, Razumov SN, Shabalin VN (2006) with the scanning electron microscope VEGA TESCAN TS 5130 MM. Results. The degree of microcrystalization of the oral liquid in children with GERD was considerably reduced, (1.73±0.11 points) and was lower than in children in the control group (3.22±0.16 points) (p<0.01, RR=2). The degree of micro-crystallization of oral liquid in children with GERD was 1.86 times lower than in healthy children. This was correlated with the duration of gastroesophageal reflux. Conclusion. The study of structural particularities of dehydrated droplet of oral liquid in children with GERD has elucidated a number of markers of the changes produced in the oral cavity. These can be used in the screening research in prevention of caries and dental erosions. 

scholarly journals The results of daily monitoring of salivary pepsin levels in young children with regurgitation syndrome

2021 ◽  
pp. 19-24
Author(s):  
S.I. Ilchenko ◽  
◽  
T.V. Mozheiko ◽  
А.О. Fialkovska ◽  
N.V. Mishina ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Young Children ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Clinical Manifestations ◽  
Main Group ◽  
Diagnostic Methods ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Children ◽  
Daily Monitoring

Regurgitation syndrome in infants is one of the manifestations of gastroesophageal reflux disease (GER), which can be both an age-related physiological condition and pathological one with the risk of gastroesophageal reflux disease (GERD) developing. Differential diagnosis of GERD in infants and young children is difficult due to invasiveness and low availability of the recommended diagnostic methods, in particular esophageal pH3metry. Today, the search for new non-invasive and simple, but sensitive and specific, methods for diagnosing GERD in pediatric practice is relevant and promising. Purpose — to determine the dynamic patterns of the salivary pepsin level in young children within the framework of daily monitoring and depending on the clinical manifestations of regurgitation. Materials and methods. 55 children from 3 to 18 months were examined, among them was 38 children with visible regurgitation syndrome and 17 healthy children without clinical manifestations of the regurgitation syndrome. The intensity of regurgitation was assessed using a five-point scale «ESPGHAN». A reflux questionnaire was used for screening diagnostics of pathological GER in children. Salivary pepsin level was determined three times a day by enzyme-linked immunosorbent assay (ELISA pepsin). Statistical processing was performed using «Statistica v.6.1» software package. Results. Regurgitation syndrome was registered in all children of the main group according to their current complaints. The results of reflux questionnaire showed the following data: half of the children (52.6%) had no signs of GER, possible reflux was revealed in 31.6% of children, and probable reflux was revealed in 15.8% of children. The results of daily monitoring of salivary pepsin level in infants showed that it was significantly higher in children with regurgitation than in control group, both in terms of average daily values and intermediate values. It was found that the maximum pepsin activity in children was immediately after regurgitation. There were no significant differences between the three saliva samples and the average daily pepsin index in the children of the main group, which may indicate the presence of latent episodes of reflux during the day. Сhildren with a high risk of GERD according to the reflux questionnaire had significantly higher values of salivary pepsin on an empty stomach and its average daily level, which has sufficient specificity and predictive value according to the ROC analysis results. Conclusions. Determination of salivary pepsin levels in infants can be included in screening noninvasive tests for the GER diagnosis. The use of these tests to predict the risk of extraesophageal damage requires further study. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: regurgitation, GER, GERD, pepsin, children.

scholarly journals Clinical features of gastroesophageal reflux disease in children with different genotypes of C825T polymorphic loci of GNB3 gene

2017 ◽  
Vol 86 (3) ◽  
pp. 207
Author(s):  
Marta Dats-Opoka ◽  
Halyna Makukh
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Nutritional Status ◽  
Clinical Features ◽  
Reflux Disease ◽  
Control Group ◽  
Healthy Children ◽  
Polymorphic Loci ◽  
Increased Risk ◽  
Significant Difference

Introduction. Considering the steady growth of the gastroesophageal reflux disease (GERD) in children in recent decades, the difficulty of GERD diagnosing in children, the variety of GERD clinical and morphological features as well as the factors that cause it, including genetic predisposition, a detailed analysis of each of them remains relevant.Aim. To analyze the peculiarities of nutritional status in children with GERD and its correlation with the different genotypes of C825T polymorphic loci of GNB3 gene as well as its association with different GERD clinical manifestations.Material and Methods. The analysis of GERD clinical features was carried out and the nutritional status in 100 children of school age was estimated. Molecular and genetic research of C825T loci of GNB3 gene using PCR method (rs5443) was carried out in the studied group (100 children) and in 40 healthy children that formed the control group.Results. The distribution of the genotypes of C825T polymorphic loci of the GNB3 gene in children with GERD and healthy children in the control group did not have any statistically significant difference (χ2 = 0.27, р = 0.87). Among more than a half of the children in both groups, the GNB3 825ST heterozygous genotype were detected (54.0% of the experimental group and 57.5% of the control group), according to de Vries et al. data is a factor of GERD increased risk. The association between the genotype of C825T locus of GNB3 gene and the data of intragastric endoscopy with pH monitoring was found: in patients with hyperacidic GERD the genotype 825CT was predominantly revealed, and in children with normal and hypoacidic GERD a higher frequency of the 825TT genotype was found. In children with GERD having a lack of the nutritional status (61%), the genotype 825CT (61.82%, p = 0.013) and 825TT (100%, p = 0.005) of the GNB3 gene were detected significantly more often.Conclusions. The distribution of the genotypes of C825T polymorphic loci of the GNB3 gene in children with GERD was determined. Differences in GERD development depending on the different GNB3 genotypes were not detected. The distribution of the genotypes of C825T loci of the GNB3 gene remained unchanged at different GERD clinical manifestations. The presence of 825CT and 825TT genotypes of GNB3 gene in patients with GERD is associated with a decrease in physical development signs. The association between genotype of C825T loci of GNB3 gene and pH intragastric endoscopy data was identified: in patients with hyperacidity GERD 825CC genotype was usually found, and in children with normal- and hypoacidity GERD 825TT genotype was usually found.

scholarly journals Clinical features and prevalence of gastroesophageal reflux disease in infants attending a pediatric gastroenterology reference service

2010 ◽  
Vol 47 (1) ◽  
pp. 66-71 ◽  
Author(s):  
Yu Kar Ling Koda ◽  
Marcos J Ozaki ◽  
Kelly Murasca ◽  
Eliana Vidolin
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Clinical Features ◽  
Reflux Disease ◽  
Ph Monitoring ◽  
Clinical Manifestations ◽  
Esophageal Ph Monitoring ◽  
Pediatric Gastroenterology ◽  
Esophageal Ph ◽  
Significant Difference

CONTEXT: In infants, it is not always easy to distinguish between pathological and physiological gastroesophageal reflux based only on clinical criteria. In Brazil, studies about gastroesophageal reflux disease in infants are few and are even rare those that used prolonged esophageal pH monitoring for its evaluation. OBJECTIVE: To describe the clinical features of gastroesophageal reflux disease and to determine its prevalence in infants with gastroesophageal reflux attending a tertiary Pediatric Gastroenterology Service and submitted to esophageal pH monitoring for investigation. METHODS: Descriptive study in 307 infants in whom esophageal pH monitoring (Mark III Digitrapper, Synectics Medical AB, Sweden) was performed during the period December, 1998-December, 2008. The clinical features studied were age group (1-12 months and 13-24 months), and clinical manifestations that motivated the indication of pH monitoring. RESULTS: One hundred twenty-four (40.4%) were female and 183 (59.6%) male with mean age 12.2 ± 6.2 months (1-23 months). The prevalence of gastroesophageal reflux disease was 18.2% (56/307). One hundred forty-eight (48.2%) were 1-12 months old and 159 (51.8%), 13-24 months. No significant difference was found between the prevalence of these two age groups (P = 0.3006). Gastroesophageal reflux disease was more frequent in those with digestive manifestations (24.2%), crisis of cyanosis/apnea (23.8%) and mixed manifestations (21.5%). Respiratory manifestations were the most frequent indication (39.1%) of pH monitoring. However, the prevalence of gastroesophageal reflux disease was lower (12.5%) in this group compared with in those with digestive manifestations (P = 0.0574), crisis of cyanosis/apnea (P = 0.0882) and mixed manifestations (P = 0.1377). All infants that presented clinical manifestations as crisis of cyanosis/apnea and abnormal pH-metry were < 3 months of age. CONCLUSIONS: In our Service, the prevalence of gastroesophageal reflux disease associated with acid reflux in infants revealed elevated. Infants with crisis of cyanosis/apnea constitute risk population for gastroesophageal reflux disease in which diagnostic investigation needs to be considered.

scholarly journals Р. LEU72MET MUTATION OF GHRELIN GHRL GENE IN CHILDREN WITH GASTROESOPHAGEAL REFLUX DISEASE

2017 ◽  
Vol 3 ◽  
pp. 10-17
Author(s):  
Marta Dats-Opoka ◽  
Halyna Makukh ◽  
Oleg Hnateyko
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Molecular Genetic ◽  
Control Group ◽  
Healthy Children ◽  
Molecular Genetic Study ◽  
Homozygous Genotype ◽  
The One ◽  
Development Risk

Gastroesophageal disease (GERD) is the one of most spread diseases that injures an esophagus. Taking into account the large number of factors that can cause GERD development already in child age, including genetic predisposition, it is necessary to analyze each of them in detail. Aim of this work was to analyze a frequency and possible association type of р. Leu72Met mutation of GHRL gene in children with gastroesophageal reflux disease. The analysis of clinical parameters and course of disease in the group of 100 schoolchildren with GERD was carried out. The molecular-genetic study of c.214C>A locus of GHRL gene by CPR method (rs696217) was carried out in patients with GERD and 40 healthy children from the control group. In 82% of children with GERD was revealed a GHRL 214СС (Leu/Leu) homozygous genotype, at 58% among children from the control group. GHRL 214СА (Leu/ Met) genotype was registered three times more seldom in children of the studied group comparing with ones from the control group: 15,0% and 42,5%, respectively. It was established, that GHRL 214CС genotype presence conditions the increase of GERD development risk in 3,4 times. On the contrary, GHRL 214CА genotype manifests a reliable protective effect that is essentially decreased GERD development risk in a child at such genotype – 0,24 comparing with a conventional unit. There was established alleles and genotypes distribution of c.214C>A (р.Leu72Met) locus of GHRL gene in children with GERD. GHRL 214CС genotype is associated with threefold increase of GERD risk development. Gender differences as to GERD development risk at different genotypes of ghrelin gene were established. At GHRL 214СС (Leu/Leu) genotype the relative GERD risk for boys increased in more than 6 times. There were not established any differences in alleles and genotypes distribution depending on erosive or surface inflammatory changes of a gastrointestinal tract mucosa.

Gastroesophageal Reflux Disease and Idiopathic Lung Fibrosis. From Heartburn to Lung Transplant, and Beyond

2021 ◽  
pp. 000313482199868
Author(s):  
Fernando A. M. Herbella ◽  
Marco G. Patti
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Lung Fibrosis ◽  
Bronchiolitis Obliterans ◽  
Lung Transplant ◽  
Ph Monitoring ◽  
Objective Evaluation ◽  
Bronchiolitis Obliterans Syndrome ◽  
Laparoscopic Operation

Idiopathic pulmonary fibrosis (IPF) and gastroesophageal reflux disease (GERD) are undoubtedly related. Even though it is not clear yet which one is the primary disease, they certainly interact increasing each other’s severity. Symptoms are unreliable to diagnose GERD in patients with IPF, and objective evaluation with pH monitoring and/or bronchoalveolar lavage analysis is mandatory. Pharmacological treatment with proton pump inhibitors (PPIs) may bring control of IPF in few patients, but PPIs do not control reflux but just change the pH of the gastric refluxate. Surgical therapy based on a fundoplication is safe and effective as it controls any type of reflux, independently from the pH of the gastric refluxate. In patients waiting for lung transplantation (if they can tolerate a laparoscopic operation under general anesthesia), a fundoplication before the operation might block the progression of IPF, while after transplantation it might prevent rejection by preventing the bronchiolitis obliterans syndrome.

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