CLINICAL COURSE OF EROSIVE GASTROESOPHAGEAL REFLUX DISEASE IN SCHOOL-AGE CHILDREN: CURRENT PERSPECTIVES

Introduction. In children, the manifestations of gastroesophageal reflux disease (GERD) can vary from an asymptomatic course or nonspecific symptoms, such as irritability in infants, refusal to eat, anorexia, cough, to more specific ones, such as heartburn, regurgitation, abdominal pain in older children, which significantly complicates the diagnosis. Symptoms in a child may indicate the need for examination or treatment of GERD, but the reliability of these clinical manifestations is not always clear, which can lead to unjustified diagnostic interventions and excessive or insufficient therapy. Objective. To study the features of the clinical course of the erosive form of gastroesophageal reflux disease in school-age children. Materials and Methods. Included 98 school-age children with erosive GERD, aged 7 to 18 years old, (mean age 11.4±2.1 years, of which boys – 71, girls – 27). The main inclusion criteria were: primary visit with symptoms of dyspepsia; the presence of erosive changes in the esophagus according to fibrogastroduodenoscopy. The comparison group consisted of 30 children with non-reperfusion GERD (mean age 12.7±1.8 years, boys – 11, girls – 19). The main inclusion criteria were: the presence of heartburn at least once a week over the last 3 months; the absence of erosive changes in the esophagus according to fibrogastroscopy. A comparative evaluation of the clinical manifestations of the disease was carried out. Results. Only 33.6% of children with erosive GERD complain of heartburn. Heartburn is more often observed in older (45.4%) than in younger (23.6%) schoolchildren. Abdominal pain is observed in 96.9%, belching in 43.8%, and nausea in 37.7% of the examined. In 11.2% of the children, periodic episodes of vomiting are observed and in 7.1%, halitosis. The clinical manifestations of the disease do not depend on the severity of erosive changes in the esophagus. The overlap with diarrhea-IBS was detected in 16.3%, and IBS with constipation /functional constipation in 10.2%, in addition, the overlap with postprandial distress syndrome is observed in 5.1% of children.