Manifestations Of GERD Research Articles

The role of gastroesophageal reflux disease in the middle ear pathology formation

The extraesophageal reflux effect investigation on the middle ear structures in adults is of considerable interest. The gastroesophageal reflux disease associated otitis media formation mechanism is closely related to such concepts as nasopharyngeal reflux and laryngopharyngeal reflux. It has been established that the pathophysiological mechanism originates in the nasopharynx and further spread to the middle ear structures. The tympanic cavity mucous membrane under the gastric enzymes influence is prone to remodeling, which results in the various chronic inflammation types gradual formation. The study purpose was to analyze medical literature from 1990 to 2024, aimed at studying the middle ear cavity inflammation causes and mechanisms formed by the gastric contents influence. As materials and methods, this article uses publications in such scientific databases as PubMed, eLIBRARY, Science Direct, Research Gate. The analyzed scientific materials provide insight into the relationship between the tympanic cavity inflammation formation and extraesophageal manifestations of GERD, as well as the potential negative H. Pylori impact on the middle ear structures. Conclusions. A detailed understanding of the middle ear cavity inflammation formation by pathophysiological mechanisms of the extraesophageal reflux influence, consisted of various gastrointestinal tract components had been obtained. The potential H. Pylori role in the tympanic cavity mucous membrane alteration remains controversial. This is due to the large number of scientific publications conflicting results in this research field. Major scientific studies confirm that gastroesophageal reflux disease acts as a risk factor for the different types middle ear cavity inflammation formation

REVIEW OF CLASSICAL AND NEW DIAGNOSTIC METHODS REFLUX-ASSOCIATED ENT PATHOLOGY: PROTON PUMP INHIBITOR TEST, OROPHARYNGEAL PH-MONITORING

To determine the advantages and effectiveness of modern methods for diagnosing extraesophageal manifestations of GERD in relation to the classical ones. Methodology. This paper presents a literature review from Pubmed, Web of Science, Willey Online Library and Google Scholar sources over the past 10 years on the diagnosis of extraesophageal manifestations of GERD. We selected 73 articles on the epidemiology and diagnosis of GERD, of which 13 were on a new oropharyngeal pH probe (Restech). Based on the literature sources studied by us, we analyzed the effectiveness and accuracy of a new method for diagnosing extraesophageal manifestations of GERD by the pharyngeal probe test (Restech) in comparison with more classical research methods – a symptom questionnaire, a scale of clinical manifestations, a test with proton pump inhibitors and 24-hour pH probe testing of the esophagus.

CHANGES IN SERUM SOMATOSTATIN AND GASTRIN LEVELS IN PATIENTS AFTER CHOLECYSTECTOMY AND GASTROESOPHAGEAL REFLUX DISEASE.

The aim: To study of changes in the level of serum gastrin (GN) and somatostatin (SST) in patients with GERD after ChECT and determined their characteristics from clinical forms of GERD. Materials and methods: 64 patients with different clinical forms of GERD were examined. The patients with GERD were divide into 2 clinical groups. Group 1 included 34 patients with GERD after ChECT, among them there were 14 males (41.2 %) and 20 females (58.8 %), with the average age of 40.2 ± 3.2 years. Group 2 consisted of 30 patients with GERD without ChECT. Among them there were 18 males (60.0 %) and 12 females (40.0%), with the average age of 38.9 ± 4.7 years. All patients were tested for serum SST and GN level by enzyme-linked immunosorbent assay (ELISA). Results: In all patients with GERD of both group there was a significant increase in the level of serum SST. At the same time, a more higher indicators have been established in 2 Group of patients (increase up to 0.702 ± 0.029 pg / ml - p <0.01). Noteworthy is the change in the level of SST in the serum in both groups of the examined patients depending on the clinical form of GERD, with the maximum increase in patients with atypical manifestation of GERD. The analysis of the level of GN in blood serum indicates its decrease in the examined patients. In this case, the most pronounced changes were found in patients with extraesophageal clinical signs of GERD. Conclusions: 1. In patients after ChECT gastroesophageal reflux disease often has atypical symptoms (mostly cardiac and bronchopulmonary forms in 45.0% and 25.0 % of examend patients). 2. There was detected an increase in the level of blood SST of patients with GERD while there was observed a decrease in the GN indicator in the serum, especially in its atypical forms. 3. Duodenogastric reflux is often diagnosed during endoscopic examination of patients with GERD after cholecystectomy. At the same time, its severity correlates with the level of SST in blood serum (r=0.76; p<0.01 in the typical form and r= 0.72; p<0.05 in the atypical clinical form of GERD).

The role of laryngopharyngeal reflux in the development of nasopharyngeal manifestations of GERD in preschoolers

Purpose. To study the level of vitamin D and the levels of antimicrobial peptides in the blood of children suffering from gastroesophageal reflux disease with nasopharyngeal symptoms, to find out how they depend on the composition of refluxate in LFR and how they affect microbial colonization in the nasopharynx.&#x0D; Materials and methods. The clinical study was conducted on the basis of the ENT and the Gastroenterology Departments of the Municipal Non-Commercial Enterprise “City Children's Hospital no. 5" of Zaporizhia City Council. By clinical examination and pH monitoring in the esophagus, the following groups of children 3 to 6 years were established: the 1st group of 22 children with gastroesophageal reflux disease with nasopharyngeal signs, the 2nd group of 22 children with gastroesophageal reflux disease without nasopharyngeal signs. Children were assigned to 1st group on the basis of the presence of clinical manifestations that indicated like a high GER. For children with nasopharyngeal manifestations of GERD, there are not only complaints specific to GERD, as well as symptoms that may indicate LFR: cough after eating and morning hoarseness, redness of the larynx and swelling of the vocal cords.The control group (the 3rd group) consisted of 22 children without pathology from the gastrointestinal tract and ENT systems. The children were tested for the levels of 25(ОН)D3, 1,25(ОН)2D, vitamin D binding protein (DBP), α­defensins 1–3 and cathelicidins. Microbial contamination of the mucous membrane of the nasopharyngeal zone was carried out. As far as the distribution differed from normal one (p&lt;0.05), the data are presented as median and inter-quartile ranges Me (Q25; Q75). The results were processed in Microsoft Excelfor Windows 4.0 and Statistica 6.0.&#x0D; Results. Vitamin D deficiency was revealed in all children of the 1st group (with GERD with LFR). Also, the level of 25(OH)D3 was statistically significantly lower than in children with GERD without LFR and in children of the control group. So, in children of the 1st group, the level 25(ОН)D3 was equel to 13.3 (11.6; 14.9) ng / ml, while in the children of 2nd group it was equal to 21.6 (20.3; 22.9) ng / ml at p &lt; 0.0001 and in children of the control group it was equal to 24.6 (22.8; 28.2) ng / ml at p &lt; 0.0001. The study of the level of antimicrobial peptides showed their significant decrease in children with LFR: the level of α­defensins 1–3 was equel to 2535.0 (1950.0; 3120.0) pg / ml and cathelicidins was equel to 17.9 (5.8; 33.3) ng / ml, which showed a significant statistical difference at p &lt;0.01 compared to other groups. It was noted that in children with acidic and mixed LFR, the level of cathelicidins is lower than in children with alkaline reflux. Thus, in most children with LFR, Haemophilus influenza was detected in nasopharyngeal cultures. Haemophilus influenza in the nose was sown only in children with mixed and acid reflux (30.0% and 80.0%, respectively). This is not typical of children with alkaline reflux. Also, more than two microorganisms were found in half of children with mixed and acid reflux, which was also not registered in children with alkaline reflux (p = 0.05). It was determined that in children with nasopharyngeal manifestations of GERD with Haemophilus influenza in the throat and nose at the same time higher parameters of the total number of acid reflux (180.0 (91.0; 310.0)), the number of prolonged acid reflux (8.0 (4.0; 12.0)) and the percentage of acid reflux per day (20.0 (11.0; 37.6)), which is significant at р˂0,05 than in children when the pathogen was detected only in the throat and in children who do not detected this microorganism Thus, the data obtained confirm that pathological manifestations from the ENT organs are a consequence of the LFR due to GERD.&#x0D; Conclusions. Our study indicates the aggressive effect of acid reflux on the nasopharyngeal mucosa in children suffering from gastroesophageal reflux disease with LFR. Thus, the lack of anti-inflammatory action of cathelicidins due to their increased utilization and reduced formation in conditions of vitamin D deficiency, leads to significant colonization by gram-negative flora, which can contribute to severe disease.

CHANGES IN SERUM GHRELIN AND ITS RELATIONSHIP WITH OF BODY MASS INDEX IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE AND SPONDYLOARTHRITIS.

The aim: To determine the features of changes in serum ghrelin levels and its relationship with the body mass index in patients with GERD and spondyloarthritis (SpA) with lesions of the cervical and thoracic spine. Materials and methods: The examined patients included 80 patients with SpA with cervical and thoracic spine lesions in combination with GERD. The examined patients with SpA with predominant cervical and thoracic spine lesions were divided into two groups depending on the clinical course of GERD, namely: group I included 33 (41.2%) patients with typical esophageal manifestations of GERD (13 males (39.4%), 20 females (60.6%)), and group II consisted of 47 (58.8%) patients with atypical extraesophageal manifestations of GERD (among them were 17 (36.2%) males and 30 (63.2%) females). Results: All patients were tested for serum ghrelin by enzyme-linked immunosorbent assay. Analysis of clinical manifestations of atypical GERD (group II patients) revealed that most often patients with SpA of the cervical and thoracic spine were diagnosed with dental and otolaryngological masks of reflux disease (40.4 % and 25.5 % of patients, respectively). Maximum serum ghrelin levels were detected in patients with SpA with cardiac GERD (355.02 ± 4.75 ng/ml), while minimum values were found in patients with dental signs of reflux disease (298.17 ± 5.16 ng/ml - p <0.05). Conclusions: 1. In patients with SpA with cervical and thoracic spine lesions, GERD often has atypical symptoms (mostly dental and otolaryngological forms in 40.4% and 25.5% of patients). 2. In patients with SpA with esophageal clinical signs of GERD, normal weight or underweight is more common, while in patients with extraesophageal forms of GERD overweight or obesity of varying severity prevails. 3. In patients with SpA and GERD, an increase in serum ghrelin levels was found in patients with cardiac manifestations of reflux disease (355.02 ± 4.75 ng/ml). 4. The relationship between BMI changes in patients with SpA and GERD and increased serum ghrelin levels was found, namely: in group II patients with overweight and obesity a direct correlation was found, and in group I patients with underweight an inverse correlation was fund.

CHANGES IN SERUM GHRELIN AND ITS RELATIONSHIP WITH OF BODY MASS INDEX IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE AND SPONDYLOARTHRITIS

The aim: To determine the features of changes in serum ghrelin levels and its relationship with the body mass index in patients with GERD and spondyloarthritis (SpA) with lesions of the cervical and thoracic spine. Materials and methods: The examined patients included 80 patients with SpA with cervical and thoracic spine lesions in combination with GERD. The examined patients with SpA with predominant cervical and thoracic spine lesions were divided into two groups depending on the clinical course of GERD, namely: group I included 33 (41.2%) patients with typical esophageal manifestations of GERD (13 males (39.4%), 20 females (60.6%)), and group II consisted of 47 (58.8%) patients with atypical extraesophageal manifestations of GERD (among them were 17 (36.2%) males and 30 (63.2%) females). Results: All patients were tested for serum ghrelin by enzyme-linked immunosorbent assay. Analysis of clinical manifestations of atypical GERD (group II patients) revealed that most often patients with SpA of the cervical and thoracic spine were diagnosed with dental and otolaryngological masks of reflux disease (40.4 % and 25.5 % of patients, respectively). Maximum serum ghrelin levels were detected in patients with SpA with cardiac GERD (355.02 ± 4.75 ng/ml), while minimum values were found in patients with dental signs of reflux disease (298.17 ± 5.16 ng/ml – p &lt;0.05). Conclusions: 1. In patients with SpA with cervical and thoracic spine lesions, GERD often has atypical symptoms (mostly dental and otolaryngological forms in 40.4% and 25.5% of patients). 2. In patients with SpA with esophageal clinical signs of GERD, normal weight or underweight is more common, while in patients with extraesophageal forms of GERD overweight or obesity of varying severity prevails. 3. In patients with SpA and GERD, an increase in serum ghrelin levels was found in patients with cardiac manifestations of reflux disease (355.02 ± 4.75 ng/ml). 4. The relationship between BMI changes in patients with SpA and GERD and increased serum ghrelin levels was found, namely: in group II patients with overweight and obesity a direct correlation was found, and in group I patients with underweight an inverse correlation was fund.

Application of “Polyana Kvasova” Mineral Water in the Complex Therapy of Patients with Gastro-esophageal Reflux Disease and Osteochondrosis of the Spine

Aim: To investigate the effectiveness of complex therapy using “Polyana Kvasova” mineral water in patients with GERD and osteochondrosis (OH) of the cervical and thoracic spine. Materials and Methods: The examined patients included 56 Helicobacter pylori (HP)-positive patients with GERD and OH of the cervical and thoracic spine. The examined patients were divided into 2 groups depending on the scheme of complex treatment. All HP-positive patients with GERD and OH underwent standard triple anti-helicobacter therapy and itopride hydrochloride. Group I patients (n=26) received only the above-mentioned regimen. Patients of the II group (n=30) were additionally prescribed 100-150 ml of “Polyana Kvasova” carbonated bicarbonate-sodium mineral water (MW) as a natural antacid, warm, still 4 times a day (1.5 hours before meals and after 45 minutes after – both in the morning and evening) within 1 month. Results: The complex therapy carried out had a positive effect on the endoscopic picture of GERD in patients with cervical and thoracic OH. The decrease in the severity of RE was accompanied by an increase in the number of GERD patients in whom the erosive form of reflux esophagitis was not detected during repeated fibroesophagogastroduodenoscopy (FEGDS) (mainly in the II group of examined patients – 10.0% of patients, p&lt;0.05). The additional prescription of “Polyana Kvasova” MW to the complex treatment increased the frequency of eradication of HP infection by 9.2% – p&lt;0.05 at the background of more pronounced normalization of clinical and endoscopic signs of GERD. Conclusions: 1. GERD is often manifested by atypical extraesophageal symptoms (up to 25.0-27.3% of cases) in patients with OH of the cervical and thoracic spine. 2. The use of standard triple AHT in combination with itopride hydrochloride is an effective method of correcting esophageal and extraesophageal clinical manifestations of GERD in patients with cervical and thoracic spine OH. 3. The additional prescription of “Polyana Kvasova” MW as part of the complex therapy of patients with GERD and OH of the cervical and thoracic regions is a safe, effective method for reducing clinical symptoms, the severity of esophageal lesions with repeated FEGD, and also contributes to increasing the frequency of HP infection eradication in the data patients.

Epidemiological study of the previousness of the symptoms of gastroesophageal refl ux disease in residents of the baykal territory with account of ethnic peculiarities of the population

Aim. Study of the prevalence of gastroesophageal refl ux disease among residents of the Trans- Baikal Territory, taking into account its ethnic composition.Materials and methods. By the method of random household walk, the study included persons over 18 years of age. The GerdQ questionnaire was applied. Additionally, passport data, information on smoking, alcohol use, coff ee, anthropometric data, social status, membership in a particular ethnic group (Buryats, Europoids) are collected. Four groups were analyzed: the 1st Caucasians, who scored 8 or more points on the GerdQ questionnaire and the 2nd — Caucasians, who scored less than 8 points, the 3rd group—the Buryats, who scored 8 or more points, and the 4th—Buryats, not scored 8 points. For statistical processing used the program Statistica 10.0, the diff erences were considered signifi cant when p&lt; 0.05.Results. 371 profi les were selected for analysis. 8 or more points on the GerdQ questionnaire scored 48 people (12.9%). 236 people—Caucasians (63.6%) and 135 Buryat people (36.4%), while the latter had more rare manifestations of GERD (38 Caucasians (16.1%) and 10 Buryats (7.4%) p = 0.009). The average age of persons of the 1st group was 53.4 ± 17.47 years and exceeded that of the 2nd group (46.2 ± 19.2 years), p = 0.035. Manifestations of GERD in Buryats were observed at a younger age and did not diff er between the 3rd and 4th groups. There was no correlation between GERD symptoms and bad habits (smoking, alcohol). The dependence of GERD symptoms with coff ee consumption and obesity has not been established.Conclusion. The prevalence of symptoms of gastroesophageal reflux disease in the territory of the Trans- Baikal Territory is below the national indicators, which is probably related to the ethnic composition of the population. Age-related features of the identification of symptoms of GERD are characteristic only for Caucasians.

Sorting out the Relationship between Gastroesophageal Reflux Disease and Sleep.

Gastroesophageal reflux disease is one of the most common conditions encountered by primary care physicians, gastroenterologists, foregut surgeons and otolaryngologists. While approximately 50% of patients experience nocturnal reflux symptoms, the relationship between gastroesophageal reflux disease and sleep is often overlooked. The aim of this review is to provide an update on the current understanding of this relationship and its clinical implications. Recent studies pertaining to the association between GERD and sleep with focus on sleep disturbances, obstructive sleep apnea, extraesophageal manifestations of GERD and treatment are discussed. There is a close relationship between GERD and sleep disturbances, but the nature of this relationship remains to be elucidated. Similarly, new data supports the association between GERD and obstructive sleep apnea, but whether this association is independent of confounding risk factors remains unresolved. Extraesophageal manifestations due to nocturnal GERD are primarily respiratory and can be explained by microaspiration and vagally-induced bronchospasm. Treatment of nocturnal GERD, both pharmacologically and surgically, improves sleep quality. Conversely, pharmacologic treatment of sleep disorders can improve nocturnal GERD symptoms. There is a bi-directional relationship between GERD and sleep. GERD is associated with various sleep disturbances. Sleep deficiency can exacerbate GERD. There is an association between extraesophageal manifestations and nocturnal GERD. Treatment directed towards GERD can improve sleep experience, and treatment directed to improve sleep can improve GERD symptoms.

Vertigo in association with gastro-esophageal reflux disease

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Gastroesophageal reflux (GERD) is a condition which develops when the reflux of stomach contents cause troublesome symptoms. Symptoms of GERD are either esophageal: heartburn and regurgitation, or extra-esophageal: chronic cough, recurrent sinusitis, and globus sensation in the throat. One of the extra-esophageal manifestations of GERD is otitis media with effusion, very common among children. The aim of our study was to find the prevalence of GERD and &lt;em&gt;Helicobacter Pylori&lt;/em&gt; (&lt;em&gt;H. Pylori&lt;/em&gt;) among patients with peripheral vertigo.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The present descriptive study was conducted on randomly selected patients attending outpatient department (OPD) of in community health center, Chenani for a period of one year from August 2018 to July 2019. Patients were selected without the pathology of central nervous system for the further analysis. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; 85 (75.89%) patients had gastro-esophageal reflux disease. Tendency of GERD was found higher among females (54.12%). Positive &lt;em&gt;H. pylorus&lt;/em&gt; was found for 21 patients (24.71%). 65 (74.71%) patients with vertigo positive had GERD. When acid refluxes into the upper GI system, it can affect the tubes that lead to the inner ear. When these tubes become irritated, swelling can occur, causing a loss of balance and common with GERD that occurs when lying down after a meal.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; It present data confirms the hypothesis that one of the peripheral vertigo causes could be GERD, by way of a mechanism which may include reflux of gastric acids causing inflammation or local infection. The present study found a definite prevalence of GERD and &lt;em&gt;H. Pylori&lt;/em&gt; among patients with peripheral vertigo.&lt;/p&gt;

ASSESSMENT OF THE IMPACT OF ANTIREFLUX THERAPY ON THE COURSE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

The aim: To examine the effect of antireflux therapy on the course of COPD. Materials and methods: Under observation were 60 patients who were hospitalized in the «Transcarpathian Regional Clinical Hospital named after Andrei Novak» with a diagnosis of COPD II gr B in combination with GERD and 36 patients diagnosed with GERD who were treated on an outpatient basis. To study the effectiveness of antireflux therapy and its impact on the course of COPD, patients are divided into 2 groups: 1 group (main) (n = 60) – patients with COPD in combination with GERD, group 2 (control) (n = 36) – patients with isolated GERD. Patients with positive Helicobacter pylori status received antihelicobacter therapy. Patients in group 1 were divided into subgroups: 1a (n = 34) – COPD in combination with esophageal manifestations of GERD and 1b (n = 26) – COPD in combination with extraesophageal manifestations of GERD. Group 1a received complex therapy, which consisted of basic therapy of COPD in combination with antireflux and with rebapimide, group 1b – only basic therapy of COPD in combination with antireflux. Results: After treatment, the clinical signs of GERD significantly decreased in all patients receiving complex therapy, improved the course of respiratory symptoms of COPD. After treatment, patients showed a clinically significant reduction in systemic inflammation, which is best seen in the group with the use of rabipimide. Conclusions: Comprehensive treatment of combined pathology with the use of antireflux therapy has a positive effect not only on the clinical symptoms of the disease, but also on the indicators of external respiratory function in patients with combined COPD and GERD.

Awareness and Prevalence of Oral Manifestation of Gerd in Population of Ludhiana

Awareness and Prevalence of Oral Manifestation of Gerd in Population of Ludhiana

Non-medicine Methods of Treatment of Gastroesophageal Reflux Disease

Few decades away a problem of throwing of acidic gastric content into an esophagus was reduced to the concept of reflux-esophagitis. In-depth study of pathogenesis of a disease resulted in “gastroesophageal reflux disease” (GERD) term which is acknowledged as leading disease of digestive system in terms of frequency and dangerous complications. GERD formation is determined by influence of numerous factors, however, it is generally accepted, that it is mainly related to insufficiency of lower esophageal sphincter (LES). Also, role of vasoactive intestinal peptide (VIP) in regulation of functional state of LES is determined. In spite of success in field of pharmacology, number of GERD patients has no downward trend which mainstreams search for non-medicine treatment methods. Physical factors affecting pathological processes by influencing regulatory processes are among these methods. Goal of this study is elaboration, scientific justification and clinical implementation of natural and preformed physical factors and acupuncture in treatment of patients with gastroesophageal reflux disease. Materials and Investigation methods: Randomized placebo-controlled study included 137 patients with gastroesophageal reflux disease, 63 (46%) men and 74 (54%) women, at the age of 18 to 65. Investigation included patients with no contraindications for physiotherapy. Patients with Barrett’s esophagus, stricture of esophagus, esophagus ulcer have also been excluded from investigation. Patients were divided into 3 groups: Ist group – 40 GERD patients, including high-frequency electromagnetic field effect and general iodine bromine bathes. II nd group - 67 GERD patients passing acupuncture treatment course. Control group was comprised of 30 GERD patients, receiving placebo MEF therapy. Treatment was carried out without medicines. Therapeutic effectiveness of complex influence of microwave electromagnetic field therapy (MEF-therapy) applied to collar area alternated with general iodine-bromine bathes on clinical manifestations of GERD is determined. Treatment course contributed to reliable decrease of increased count of VIP – a neurotransmitter, regulating LES tonus. In term, it contributed to improve of functional state of LES, reliable decrease of reflux index, and, as a result, improvement of clinical and functional indicators. Estimation of clinical manifestations of a disease among patients of 2nd group displayed positive dynamics of clinical and functional indicators. Round-clock pH-monitoring of stomach and esophageal content shows reliable decreaseof transitory relaxations of LES during single acupuncture procedure and increase of pH of gastric content. Acupuncture course also resulted in decrease of elevated VIP numbers.

Frequency of Pulmonary Manifestations of in Patients with Gastroesophageal Reflux Disease

Introduction: Pulmonary manifestations of GERD are attracting increasing attention. The physiological link between GERD and pulmonary disease has been extensively studied in chronic cough and asthma. The gastric contents can cause throat irritation, postnasal drip and hoarseness also recurrent cough. Objectives: This study is to determine frequency of pulmonary manifestations in patients with Gastroesophageal Reflux Disease. Settings: This cross-sectional study was conducted in Aeer ud din Medical college during June 2019 to December 2019. All patients with heartburn, both males and females of 20-70 years of age. Results: Out of 150 patients’ laryngeal symptoms were 10% have dry cough 8% have hoarseness and dry cough hoarseness both in 10% in patients with heartburn. 34% patients with GERD were found to be asthmatic. Nasal symptoms were infrequent 2%. Out of 150 patients 36% do not have any pulmonary manifestations. Conclusion: There is high prevalence of pulmonary manifestations in patients with GERD.

Testing and validation of the Russian version of quality of life questionnaire in patients with GERD - GERD-HRQL

This study aimed to test the Russian version of GERD-HRQL in the focus group of patients with GERD, as well as to evaluate its psychometric properties reliability, validity and sensitivity. The total of 57 patients with GERD (mean age 45.812.4 years, 72% women, 68% patients with not erosive reflux disease, 84% had esophageal manifestations of GERD) were enrolled into the study. All the patients filled out the Russian version of GERD-HRQL and generic quality of life questionnaire RAND SF-36 during the routine visit to the gastroenterologist. According to the results of testing of GERD-HRQL, it was clear and easy to complete for patients and reflected the main concerns specific for GERD patients. The most frequent and bothersome symptoms/problems which interfered with quality of life in GERD patients were heartburn (100% of patients) and bloating (84% of patients). During the validation procedure, the high reliability and validity of the Russian version of GERD-HRQL were demonstrated. It was shown that the tool was sensitive both to changes over time and to clinically determined differences in patients status. The Total GERD-HRQL Score was significantly higher (worse quality of life) in the following groups: a) patients who had esophageal manifestations of GERB vs those without esophageal manifestations of GERB; b) patients with GERD complications vs those without GERD complications, c) patients with comorbidities of upper gastrointestinal tract vs without those comorbidities; d) patients with erosive esophagitis vs with non-erosive reflux disease (p0.05). The developed Russian version of the GERD-HRQL questionnaire proved to have high psychometric properties and may be used in the Russian population of GERD patients both in research studies and in a real clinical practice.

The Oral Mucosa Status and the Correlation between the Functional Parameters and the Level of Nitric Oxide Metabolites in Saliva among Patients with GERD.

The study involved 91 patients (48 women and 43 men), aged from 18 to 70 years with GERD. All patients underwent the clinical dental examination according to a single scheme including general clinical manifestations (nausea, single vomiting, belching, heartburn, pain in the epigastrium and around the navel, and poor appetite) and dental manifestations of GERD. The objective assessment of the dental status of the examined patients included the measurement of the functional parameters of the mixed saliva, buffer capacity (BC) of saliva, and the detection of the nitric oxide metabolites (NOx) content in saliva from the right parotid salivary gland (“SRPSG”) and in blood serum using the indirect method based on the determination of the stable metabolites: nitrates and nitrites using the Griess reaction. It was established that salivation rate among patients with GERD with the prevailing of ACR and SACR was at the lower limit of normal values (0.32 + 0.19 ml/min), and the salivation rate among patients with the prevailing of SALCR was low (0.10 + 0.04 ml/min). The BC of saliva among patients with the prevailing of ACR and SACR was high (9.07 + 1.23 mmol eq/l and 9.40 + 1.71 mmol eq/l, respectively) and was reduced among patients with the prevailing of SALCR (7.63 + 0.18 mmol eq/l). The NOx level in SRPSG among patients with GERD was increased (especially in Group 3 (20.93 + 11.23 umol/l)). The direct correlation between the indicators of sialometry, the level of the BC of saliva, and the NOx level in SRPSG were established during the study.

The Role of Helicobacter Pylori in The Causation of Laryngopharyngeal Disorder in Specialized Allergic Center /Kirkuk-Iraq

Laryngopharyngeal reflux disease is a common manifestation of GERD, about 10% of cases presented to ENT department. Out of 56 cases tested for H.pylori ,36 were positive for serum test and 20 cases were positive for both serum and stool.75% of cases responded to treatment of GERD with no recurrence

DIAGNOSTIC VALUE OF MORPHOLOGICAL CHANGES IN GASTROESOPHAGEAL REFLUX DISEASE IN BIOPSY MATERIAL OF THE DISTAL ESOPHAGUS IN ADOLESCENTS SICKLY WITH ACUTE RESPIRATORY DISEASES

The article dedicated to the problem of the diagnostic value of morphological changes in gastroesophageal reflux disease in the biopsy of the distal esophagus in pubertal children of childbearing age. Aim of the research is to investigate the diagnostic value of morphological changes in gastroesophageal reflux disease in esophageal biopsy material in adolescents sickly with acute respiratory diseases. Methodology. The objective of the study was achieved through examination of 90 adolescents (10 to 16 years old, average age 13.1±3.54 years) kept under observation at the Children’s Clinical Hospital No. 9 of Kyiv and on the basis of the Department of Pediatrics No. 1 Center of Primary Health Care No. 4 of the Desnianskyi district of Kyiv. All adolescents belonged to the group of sickly with a number of respiratory diseases averaging 6-8 times a year, lasting from 8 to 18 days (on average 12.8±5.41 days). All children have undergone endoscopic examination of the esophagus, stomach and duodenum with the esophagus mucosa biopsy using the OLYMPUS GIF-P3 flexible fiberscope. Results. It was found that the least valuable diagnostic feature in the morphological examination of the mucous membrane of the distal esophagus in the pain-causing children with GERD was thickening of the epithelium with a sensitivity of 13,0 %, a specificity of 96.0 %, and total value of 65.0 %. It has been proved that hyperplasia of cells of the basal layer of the mucous membrane of the distal esophagus at the GERD in the infected children is 46.7 % (specificity – 93.3 %, the total value is 75.6 %). Increase in the number of papillae and their prolongation in 33.3 % cases (sensitivity – 33.3 %, specificity – 93.3 %, overall diagnostic value – 70.8 %). Conclusion. The peculiarity of the morphological manifestations of GERD in childbearing children is dystrophic changes in keratocytes in the superficial parts of the multilayer squamous epithelium, which are detected at 100.0 % of patients (specificity is 93.3 %, total value is 96.8 %), with parakeratosis centers at 13.3 % of cases. It has been shown that a frequent and diagnostically valuable indication is inflammatory infiltration of the esophageal mucosa, which are verified in all cases (100.0 %, with dilatation and hyperemia in 46.7 % of patients (specificity – 40.0 %, total value – 81.3 %).

Effect of Gastroesophageal Reflux Disease on Pulmonary Function Tests

Background Gastroesophageal reflux disease (GERD) is a condition in which the esophagus becomes irritated or inflamed because of acid backing up from the stomach. Heartburn and regurgitation are the typical symptoms of GERD. GERD can cause esophageal and extra-esophageal syndromes. Respiratory manifestations of GERD represent one of the most prevalent and challenging of these extra-esophageal syndromes. It is known to be associated with many forms of respiratory diseases, including asthma, pulmonary fibrosis, cystic fibrosis, and obstructive sleep apnea syndrome. The following study is taken up to know the extent to which the GERD affects the lung functions so that it can be diagnosed and treated at the earliest in order to prevent irreversible damage to the lungs. Objectives To assess the lung function tests in individuals suffering from Gastroesophageal Reflux disease. Materials and Method The study included 30 patients suffering from GERD as cases and 30 subjects not suffering from GERD as controls. Pulmonary function tests of each subject were recorded using Helios 401 spirometer. The results were compiled and statistically analyzed for significant differences. Results It was found that the following PFT Parameters FVC, FEV1, PEFR, FEV1/FVC, FEF25–75% were significantly reduced in GERD patients in comparison with controls. Conclusion The results of the study conclude that GERD patients have a significantly lower Pulmonary function in comparison with controls.

Laryngopharyngeal Reflux Disease - LPRD.

Introduction:Laryngopharyngeal reflux disease (LPRD) referes to an inflammatory reaction of the mucous membrane of pharynx, larynx and other associated respiratory organs, caused by a reflux of stomach contents into the esophagus. LPRD is considered to be a relatively new clinical entity with a vast number of clinical manifestations which are treated through different fields of medicine, often without a proper diagnosis. In gastroenterology it is still considered to be a manifestation of GERD, which stands for gastroesophageal reflux disease. Patients suffering from LPRD communicate firstly with their primary physicians, and since further treatment might ask for a multidisciplinary approach, it is important to have a unified approach among experts when treating these patients.Goal:This paper is written with the intention to assess the frequency of symptoms of LPR in family medicine, possible diagnostics and adequate treatment in primary health care.Materials and methods:This is a prospective, descriptive cohort study. Authors used „The Reflux Symptom Index” (RSI) questionnaire. Examinees were all patients who reported to their family medicine office in Gracanica for the first time with new symptoms during a period of one year. Patients with positive results for LPR (over 13 points) were treated in accordance with the suggested algorithm and were monitored during the next year.Results:Out of 2123 examinees who showed symptoms of LPR, 390 tested positive according to the questionnaire. This group of examinees were treated in accordance with all suggested protocols and algorithms. 82% showed signs of improvement as a response to basic treatment provided by their physicians.Conclusion:Almost every fifth patient who reports to their family medicine physician shows symptoms of LPR. On primary health care levels it is possible to establish some form of prevention, diagnostics and therapy for LPR in accordance with suggested algorithms. Only a small number of patients requires procedures which fall under other clinical fields.