Some pathogenetic relationships in gastroesophageal reflux disease in children

Objective. To study the relationship of the upper gastrointestinal tract acidity index and collagen metabolites and proteoglycans in children with GERD. Materials and methods. 62 children with GERD were observed. The control group included 32 children. All children underwent esophagogastroduodenoscopy with parietal endoscopic pH-metry. The content of free hydroxyproline (FHOP), peptide-bonded hydroxyproline (PSHOP), glycosaminoglycans (GAG), as well as a-mannosidase activity in gastric juice were studied. Results. The hyperacidity of the pH in the esophagus, the gastric “lake” and the body of the stomach in children with GERD was revealed. A relationship between hyperacidity and the breakdown of collagen in the mucous membrane of the gastroesophageal area demonstrated by high levels of GAG, FHOP, and PSНOP a-mannosidase in the gastric juice has been shown. Conclusions. In children with GERD, the dynamic balance of aggressive-protective factors in the gastroduodenal area is disturbed. As a result of it, degradation of collagen in the mucous and submucous layer of the esophagus and stomach is observed.