Abstract
The aim of the work: to study the relationship of ultrasound parameters of the thyroid gland with the clinical course, the level of thyroid hormones and indicators of the motor-secretory function of the gastrointestinal tract in patients with gastroesophageal reflux disease (GERD) and autoimmune thyroiditis (AIT). Materials and methods. The study involved three groups of patients. The first group consisted of 22 patients with isolated GERD. The second group included 20 patients suffering from GERD in combination with AIT in the hypothyroid stage. And the third group included 20 patients suffering from isolated AIT in the hypothyroid stage. The control group consisted of 15 apparently healthy individuals of the same age and sex. All patients underwent a comprehensive examination, which included the necessary set of clinical, laboratory and instrumental research methods in accordance with the local treatment protocols such as collection of complaints and anamnesis, patient examination, physical examination, clinical and biochemical analyzes, ECG, EGD, intragastric pH-metry. The patients underwent ultrasound examination of the motor-evacuation function of the esophagus and stomach with water load and an ultrasound examination of thyroid gland. The functional activity of thyroid gland was assessed by determining the level of thyroid hormones (TSH, T4 free, T3) by ELISA and the presence of antibodies to. Results. The study involved three groups of patients: patients with isolated gastroesophageal reflux disease, patients with a combined course of GERD and AIT in the hypothyroid stage and patients with isolated AIT in the hypothyroid stage. The most pronounced complaints, a higher level of thyroid-stimulating hormone and the most pronounced ultrasound changes are noted in patients with combined pathology. Ultrasound examination of the lower third of esophagus and stomach in patients of all three groups showed the presence of regurgitation, expansion of the lumen of the lower third of esophagus and an increase in the diameter of esophageal opening of diaphragm in varying degrees, in contrast to patients in the control group. Thus according to the results of thyroid sonography and ultrasound examination of the motor function of the lower third of esophagus and stomach, the most pronounced changes were found in the second group of patients who had a combined course of GERD and AIT. Conclusions. 1. A clear correlation was established between the clinical course, an increase in the level of thyroid hormones and ultrasound picture of thyroid gland and indicators of the motor-secretory function of the gastrointestinal tract in patients with GERD and AIT; It was shown that disorders in the activity of thyroid hormones affect the formation of motor-secretory disorders in patients with GERD with concomitant AIT which mutually aggravates the course of this comorbid pathology; Ultrasound diagnostics can be used as an evaluative method in this category of patients.
Highlights
There has been a trend in recent decades towards an increase in the incidence of gastroesophageal reflux disease (GERD) especially among young people [1]
It was shown that disorders in the activity of thyroid hormones affect the formation of motor-secretory disorders in patients with GERD with concomitant autoimmune thyroiditis (AIT) which mutually aggravates the course of this comorbid pathology; 3
Ultrasound diagnostics can be used as an evaluative method in this category of patients
Summary
There has been a trend in recent decades towards an increase in the incidence of gastroesophageal reflux disease (GERD) especially among young people [1]. GERD symptoms occur in almost half of the adult population [2]. The leading symptom of GERD - recurrent heartburn which (2020), «EUREKA: Health Sciences» Number 6 significantly reduces the quality of life – is noted by up to 40 % of residents of industrialized countries. The true prevalence of GERD in the population has not been sufficiently studied which is due to low demand for medical care, frequent asymptomatic course, as well as the course of the disease under the masks of the so-called «extraesophageal» manifestations [3]. At the same time the number of GERD patients with concomitant pathology is increasing. One of these diseases is autoimmune thyroiditis (AIT). Both of these diseases have several common pathogenetic mechanisms, the main of which are thyroid hormones, which regulate the processes of motility and secretion of the gastrointestinal tract [5, 6]
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