Vorotnikova N A, Eiberman A S, Chernenkov Yu V, Rodionova T V
Eksp Klin Gastroenterol. 2015(6):21-35.
The aim of the study was to improve the tactics of treatment of bronchoobstructive syndrome (BOS) in associative course with gastroesophageal reflux disease (GERD) in children.
180 children aged 6-16 with diseases of the respiratory organs with BOS and GERD symptoms were examined: 85 of them--with bronchial asthma (BA), 34--with an acute course of pneumonia, 29--with recurrent obstructive bronchitis. Comparison groups were composed of 93 children, the number of practically healthy children (the control group) was 28 persons. The analysis of risk factors of associative pathology development, roentgenographic study, investigation of the function of external respiration (FER) (peak flowmetry, spirometry), intracavitary pH-metry, esophagofibrogastroduodenoscopy (EFGDS) and ultrasonic investigation (USI) of the organs of the gastro-intestinal tract (GIT) were carried out.
Diseases of the respiratory organs with BOS in the groups of the patients under investigation in 43.9% of cases on an average associated with GERD. In a severe course of bronchial asthma GERD was detected 3,4 times more frequently in the boys, while in a lengthy course of pneumonia with BOS--1,9 times more frequently in the girls. Chronic gastritis (ChG) and chronic gastroduodenitis (ChGD) in BA were revealed in 40.6% of the patients, in pneumonia--in 45.7%, in recurrent bronchitis--in 33.3% of the patients. Peculiarities of pre-morbid background of BA and GERD associative course were exhibited by gestosis, threat of abortion, intrauterine hypoxia of the fetus, social troubles of the family. Manifestations of BA in children in 36% of cases were observed 6-12 months after the onset of GERD. The designed individual anti-reflux programs in complex therapy of respiratory organs' diseases with BOS associated with GERD reduce the frequency of exacerbations and hospitalizations of patients with BA, improve their life quality.
