Course features and functional condition of pancreas in adolescents with gastroesophageal reflux disease

Abstract

Chronic acid-dependent diseases and, in particular, gastroesophageal reflux disease (GERD), are urgent problems in pediatric gastroenterology. However, the clinical features and functional state of the pancreas in adolescents with reflux disease remain not fully understood. Purpose - to investigate the main parameters of quality of life, clinical features, and functional state of the pancreas in adolescents with GERD. Materials and methods. We examined 100 inpatients aged 13-17 years who were hospitalised in the period between 2016 and 2022. The diagnosis was verified according to modern protocols of diagnosis and treatment, and the results were statistically processed using the Statistica for Microsoft 7.0 software package. Results. Of the children we examined, 80.0% had endoscopically positive (non-erosive form) GERD, with 50.0% having concomitant functional pancreatic disorders. The most significant changes in blood amylase were noted in patients with comorbidity (120.5±0.1 g/(hr×L) and 33±0.3 g/(hr×L), p<0.05) and in patients with the erosive form of GERD (98.1±0.2 g/(hr×L) and 25±0.1 g/(hr×L), p<0.05). Serum lipase levels were also more pronounced in patients with comorbid GERD (70±0.1 U/L and 35±0.2 U/L, χ2=32, p<0.0001). In these teenagers, there was a violation of the quality of life according to the main parameters: heartburn, regurgitation, sleep disorders (the sum of points on three scales was 14.95±0.36 (95% confidence interval: 14.85-15.05) in combination with the appearance of pathology. 11.25±0.65 (95% confidence interval: 11.02-11.48) points - in patients with an isolated course of the disease, erosive form (р˂0.001). Conclusions. The clinical features of GERD in combination with functional pancreatic disorders include severe abdominal pain localized in the pyloric duodenal zone and left hypochondrium. In adolescents with comorbid GERD, the levels of organ-specific enzymes were more often increased compared to the control group. Quality of life was significantly changed in them too. 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 interests was declared by the authors.