Introduction. In the adult population, a high prevalence of the gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS) can vary from 3 to 79%. As for children, there are a few works on the overlap between functional dyspepsia and IBS, GERD and functional constipation.
Aim. To determine the prevalence of overlap of the GERD syndrome with irritable bowel syndrome and functional dyspepsia in school-age children.
Materials and methods. The study included ninety eight cases including 71 boy and 27 girls, aged of 7 to 17 years (mean age 11.4 ± 2.1 years) suffered from erosive GERD. The comparison group consisted of 30 patients (11 boys and 19 girls), of mean age of 12.7 ± 1.8 years without erosive GERD). The criterion for inclusion in the main group was the presence of erosive changes in the esophagus according to fibrogastroduodenoscopy, in the comparison group the — manifestation of heartburn, with occurrence, at least twice a week over the past three months and the absence of erosive changes in the esophagus according to fibrogastroduodenoscopy. The exclusion criterion was the presence of organic pathology with sides of the upper (peptic ulcer, etc.) and lower parts of the digestive tract (ulcerative colitis, Crohn’s disease, etc.)
Results. Every fourth GERD patient (25.8%) has an overlap with functional bowel diseases, while GERD is more often combined with IBS with diarrhea (15.6%) than IBS with constipation/functional constipation (10.2%). Overlap of IBS with postprandial distress syndrome is much less common — only in 7.0% of children.
Conclusion. School-age GERD children are characterized by frequent overlap with functional bowel diseases, the frequency of which reaches 25.8%. The combination of all three diseases (IBS, GERD and postprandial distress syndrome) was observed in 2.3% of cases. These patterns are typical for patients with both erosive and non-erosive forms of GERD.
THE AIM: To study the characteristics of phosphorus-calcium metabolism in patients with neurogenic disorders of urination, taking into account the severity of the manifestations of connective tissue dysplasia. PATIENTS AND METHODS. The study included 90 children, including 60 children with neuro-muscular dysfunction of the bladder (NMDB) and 30 children with enuresis from the age of 5 to 15 years. The diagnosis was established based on a comprehensive examination and according to industry standards. Connective tissue dysplasia was diagnosed in children with the detection of 6 or more small external or visceral manifestations involving 3 or more organs from different systems. Assessment of the severity (severity) of connective tissue dysplasia was carried out according to the point system proposed by T.I. Kadurina et al. Each group was divided into subgroups depending on the severity of the manifestations of connective tissue dysplasia. The determination of the level of calcium and phosphorus in the blood and urine, as well as the calculation of the calcium-creatinine coefficient followed by a comparison of the results in these groups and subgroups. To assess the significance of differences, the Mann-Whitney test was calculated, p <0.05 was considered significant. RESULTS. he level of calcium and phosphorus in the urine was slightly higher in children with enuresis, especially in the morning portion of urine, where the concentration of calcium was 26% higher than in patients with NMDB. At the same time, the value of calcium /creatinine coefficient was significantly higher in the group of patients with enuresis and was 2 times higher than the normative indicators, which indicates the importance of hypercalciuria in the development of enuresis. СONCLUSION. According to the obtained data, the severity of calciuria, determined by the value of the calcium-creatinine coefficient, is significantly higher in patients with enuresis than with NMDB.
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