scholarly journals Clinical features of gastroesophageal reflux disease in children with different genotypes of C825T polymorphic loci of GNB3 gene

2017 ◽  
Vol 86 (3) ◽  
pp. 207
Author(s):  
Marta Dats-Opoka ◽  
Halyna Makukh

Introduction. Considering the steady growth of the gastroesophageal reflux disease (GERD) in children in recent decades, the difficulty of GERD diagnosing in children, the variety of GERD clinical and morphological features as well as the factors that cause it, including genetic predisposition, a detailed analysis of each of them remains relevant.Aim. To analyze the peculiarities of nutritional status in children with GERD and its correlation with the different genotypes of C825T polymorphic loci of GNB3 gene as well as its association with different GERD clinical manifestations.Material and Methods. The analysis of GERD clinical features was carried out and the nutritional status in 100 children of school age was estimated. Molecular and genetic research of C825T loci of GNB3 gene using PCR method (rs5443) was carried out in the studied group (100 children) and in 40 healthy children that formed the control group.Results. The distribution of the genotypes of C825T polymorphic loci of the GNB3 gene in children with GERD and healthy children in the control group did not have any statistically significant difference (χ2 = 0.27, р = 0.87). Among more than a half of the children in both groups, the GNB3 825ST heterozygous genotype were detected (54.0% of the experimental group and 57.5% of the control group), according to de Vries et al. data is a factor of GERD increased risk. The association between the genotype of C825T locus of GNB3 gene and the data of intragastric endoscopy with pH monitoring was found: in patients with hyperacidic GERD the genotype 825CT was predominantly revealed, and in children with normal and hypoacidic GERD a higher frequency of the 825TT genotype was found. In children with GERD having a lack of the nutritional status (61%), the genotype 825CT (61.82%, p = 0.013) and 825TT (100%, p = 0.005) of the GNB3 gene were detected significantly more often.Conclusions. The distribution of the genotypes of C825T polymorphic loci of the GNB3 gene in children with GERD was determined. Differences in GERD development depending on the different GNB3 genotypes were not detected. The distribution of the genotypes of C825T loci of the GNB3 gene remained unchanged at different GERD clinical manifestations. The presence of 825CT and 825TT genotypes of GNB3 gene in patients with GERD is associated with a decrease in physical development signs. The association between genotype of C825T loci of GNB3 gene and pH intragastric endoscopy data was identified: in patients with hyperacidity GERD 825CC genotype was usually found, and in children with normal- and hypoacidity GERD 825TT genotype was usually found.

2020 ◽  
Vol 22 (7) ◽  
Author(s):  
Mehdi Ahmadi ◽  
Mohsen Amiri ◽  
Tahere Rezaeian ◽  
Amir Mansour Rezadoost ◽  
Enayatollah Bakhshi ◽  
...  

Background: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal disorders that can disturb patients’ respiratory indices. Proton pump inhibitors (PPIs) such as omeprazole are currently the most common treatment in the patients. PPI-refractory GERD is a clinical problem constituting around 30% of patients with GERD. Objectives: The aim of this study was to investigate the effects of diaphragmatic breathing (DB) and omeprazole on respiratory indices (RI) and diaphragmatic excursion (DEX) in patients with GERD. Methods: This is a clinical trial conducted for eight weeks among 40 patients with severe GERD in Tehran in 2018. The block randomization method was designed to randomize 40 patients into two groups (DB and control) that resulted in equal sample sizes. The control group received omeprazole 20 mg once daily, and the DB group, in addition to omeprazole, performed DB. Respiratory indices, including (Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), Peak Expiratory Flow (PEF)), and DEX were evaluated before, immediately, and six weeks after the end of intervention by spirometry and ultrasonography; respectively. Results: There was no significant difference in the RI and DEX before the intervention between groups. FVC (P = 0.04) and PEF (P = 0.02) significantly changed in the control group, but FEV1 (P = 0.001), FVC (P = 0.002), PEF (P = 0.001) and DEX (0.001) significantly changed after DB. There was a significant difference in terms of RI between before and followed up in DB. Conclusions: Diaphragmatic breathing with omeprazole had more effects on RI and DEX than omeprazole alone. The positive effects of DB remain at least six weeks after the end of the intervention.


2019 ◽  
Vol 10 (3) ◽  
pp. 40-48
Author(s):  
T. S. Petrenko ◽  
K. Yu. Retyunskiy ◽  
M. D. Borovskikh ◽  
D. R. Devyatkina ◽  
A. V. Pereshitova ◽  
...  

Objective: to study the clinical neuropsychiatric and neuropsychological features of children suffering from systemic somatovegetative disorders.Materials and methods: the study involved children from 5 to 12 years old with an established diagnosis of bronchial asthma — 108 children; atopic dermatitis — 105 children; gastroesophageal reflux disease — 112 children; the control group consisted of 60 same age healthy children. All children underwent clinical-anamnestic, neurological, psychopathological and neuropsychological research.Results: the children with systemic somatovegetative disorders have a significantly high incidence of pathogenic factors of central nervous system damage in early stages of ontogenesis (pathology of pregnancy and childbirth). Early sensory and motor deprivation due to somatic suffering aggravates neuropsychiatric deficiency. Neuropsychological disorders were predominantly represented by a violation of the perception of their body, lack of kinesthetic and motor functions, spatial and quasi-spatial representations.Conclusion: the clinical dynamics of neuropsychiatric disorders in children with systemic somatovegetative disorders corresponds to the dynamics of residual cerebral organic impairment with a stage-age changes of syndromes. The revealed neuropsychological disorders correspond to preferential damage to the first (energy) functional block of the brain.


2018 ◽  
Vol 6 (3) ◽  
Author(s):  
Qian Liu

<p class="18">Abstract: Objective: To observe the clinical effect of “Chaihu Shugan Powder Zuojin Pill” in the treatment of non-erosive gastroesophageal reflux disease. Methods: Sixty patients with non-erosive gastroesophageal reflux disease were randomly divided into treatment group and control group (30 cases in each group). The patients were treated with “Zaohu Shugan Powder” and “Zangjin Pills” and omeprazole respectively. For 8 weeks, the clinical efficacy and changes in clinical symptoms were observed. Results: The total effective rate was 93.3% in the treatment group and 80.0% in the control group. There was significant difference between the two groups before and after treatment (P &lt;0.05). Conclusion: “Chaihu Shugan Powder Zuojin Pill” can effectively improve the clinical symptoms of non-erosive gastroesophageal reflux disease.</p>


2014 ◽  
Vol 87 (4) ◽  
pp. 269-276
Author(s):  
Aurelia Spinei ◽  
Alina Monica Picos ◽  
Ina Romanciuc ◽  
Antonela Berar ◽  
Ana Maria Mihailescu

Background and aim. Patients with disabilities have a higher prevalence of caries and dental erosions than general population. This particularity may be assessed by the study of microcrystallization of saliva. We investigated the oral liquid microcrystallization in children with gastroesophageal reflux disease (GERD), a condition associated with dental erosions. Material and methods. 54 children have been clinically examined: 27 children suffering from GERD with ages between 13 and 15, were included in the study group, and 27 healthy children - the control group. The study of crystallographic changes of the oral liquid was performed using the method developed by Shatohina, Razumov SN, Shabalin VN (2006) with the scanning electron microscope VEGA TESCAN TS 5130 MM. Results. The degree of microcrystalization of the oral liquid in children with GERD was considerably reduced, (1.73±0.11 points) and was lower than in children in the control group (3.22±0.16 points) (p<0.01, RR=2). The degree of micro-crystallization of oral liquid in children with GERD was 1.86 times lower than in healthy children. This was correlated with the duration of gastroesophageal reflux. Conclusion. The study of structural particularities of dehydrated droplet of oral liquid in children with GERD has elucidated a number of markers of the changes produced in the oral cavity. These can be used in the screening research in prevention of caries and dental erosions. 


2020 ◽  
Vol 49 (4) ◽  
pp. 73-77
Author(s):  
T. M. Pasiieshvili

Aim: to establish the content and role of Klotho protein in the pathogenesis of gastroesophageal reflux disease, which occurs against the background of autoimmune inflammation in young people. Materials and methods. Three groups of patients were involved in the study: with the gastroesophageal reflux disease (GERD ) and autoimmune thyroiditis (AIT ) (120 persons), isolated GERD (45) and AIT (42) aged 18 to 25 years, of the same sex and duration of the disease. The content of Klotho protein was determined in the serum by ELISA, Elabscience reagents (ELISA, USA). Results. Significant increase in Klotho protein was detected in patients with GERD and especially in its combination with AIT relative to the control. Content of Klotho protein did not correlate with the morphological form of the disease and its duration. In patients with isolated AIT , Klotho protein level did not have a significant difference with control group. Conclusion. The GERD and its combination with AIT in young people are accompanied by an increase in Klotho protein content, as a result of the presence of an active inflammatory process in the esophagus mucosa and its stimulating effect on antioxidant defense processes.


2010 ◽  
Vol 47 (1) ◽  
pp. 66-71 ◽  
Author(s):  
Yu Kar Ling Koda ◽  
Marcos J Ozaki ◽  
Kelly Murasca ◽  
Eliana Vidolin

CONTEXT: In infants, it is not always easy to distinguish between pathological and physiological gastroesophageal reflux based only on clinical criteria. In Brazil, studies about gastroesophageal reflux disease in infants are few and are even rare those that used prolonged esophageal pH monitoring for its evaluation. OBJECTIVE: To describe the clinical features of gastroesophageal reflux disease and to determine its prevalence in infants with gastroesophageal reflux attending a tertiary Pediatric Gastroenterology Service and submitted to esophageal pH monitoring for investigation. METHODS: Descriptive study in 307 infants in whom esophageal pH monitoring (Mark III Digitrapper, Synectics Medical AB, Sweden) was performed during the period December, 1998-December, 2008. The clinical features studied were age group (1-12 months and 13-24 months), and clinical manifestations that motivated the indication of pH monitoring. RESULTS: One hundred twenty-four (40.4%) were female and 183 (59.6%) male with mean age 12.2 ± 6.2 months (1-23 months). The prevalence of gastroesophageal reflux disease was 18.2% (56/307). One hundred forty-eight (48.2%) were 1-12 months old and 159 (51.8%), 13-24 months. No significant difference was found between the prevalence of these two age groups (P = 0.3006). Gastroesophageal reflux disease was more frequent in those with digestive manifestations (24.2%), crisis of cyanosis/apnea (23.8%) and mixed manifestations (21.5%). Respiratory manifestations were the most frequent indication (39.1%) of pH monitoring. However, the prevalence of gastroesophageal reflux disease was lower (12.5%) in this group compared with in those with digestive manifestations (P = 0.0574), crisis of cyanosis/apnea (P = 0.0882) and mixed manifestations (P = 0.1377). All infants that presented clinical manifestations as crisis of cyanosis/apnea and abnormal pH-metry were < 3 months of age. CONCLUSIONS: In our Service, the prevalence of gastroesophageal reflux disease associated with acid reflux in infants revealed elevated. Infants with crisis of cyanosis/apnea constitute risk population for gastroesophageal reflux disease in which diagnostic investigation needs to be considered.


2021 ◽  
Author(s):  
Zhi-tong Li ◽  
Rui Zhang ◽  
Xin-wei Han ◽  
Chun-xia Li ◽  
Li Wang ◽  
...  

Abstract Hiatus hernia (HH) is a common benign disease of the digestive tract, which weaks the function of the anti-reflux barrier and causes gastroesophageal reflux disease (GERD). Laparoscopic HH repair and fundoplication is a classic surgical treatment for GERD patients with HH; however, some patients may complain of dysphagia and gas-bloating after the operation. For reducing complications of fundoplication, we adopted a new type of anti-reflux surgery for GERD treatment. We analysed our database of 40 patients with GERD plus HH who had LDF or a new anti-reflux surgery. At 12 months after surgery, the total score(Sc), DeMeester score, numbers of reflux detected by impedance monitoring all decreased in two groups postoperatively, and there was no significant difference between the two groups after surgery. The minimum respiratory value increased after the operation in the control group, but there was no significant difference between the two groups. The mean respiratory value both increased in two groups postoperatively, and there was no significant difference between the two groups. The dysphagia in the experimental group was less common than that in the control group from early to 12 months after surgery. There was no significant difference in gas-bloating between the two groups in the early postoperative period but it was significantly lower in the experimental group than that in the control group in the late postoperative period. The short-term efficacy of the new anti-reflux surgery is the same as that of the LDP in the treatment of GERD with HH; however, the operation time, intraoperative blood loss, and the surgical complication rate are lower than that of the LDF, therefore, it is more commonly recommended.


2020 ◽  
Vol 10 (12) ◽  
pp. 4368
Author(s):  
Gabriela Ghiga ◽  
Nicoleta Gimiga ◽  
Daniel Vasile Timofte ◽  
Oana Maria Rosu ◽  
Vladimir Poroch ◽  
...  

Gastroesophageal reflux disease (GERD) is a common digestive condition, representing one of the most frequent reasons for medical examination, especially in pediatric gastroenterology departments. GERD could be associated with biochemical alterations representing either its systemic manifestations or markers of complications. The aim of our paper was to evaluate biochemical parameters secondary to GERD in children. Two hundred and sixty-seven children of both genders aged between 1 month and 18 years who displayed suggestive symptoms for this condition were included in the study and were monitored for a period of 5 years. Depending on the range of symptoms and technical possibilities, the following procedures/investigations were performed: esophageal pH monitoring and imagistic or endoscopic examination, besides specific biochemical investigations. The cohort was sub-divided into two groups: one that included 213 children with confirmed GERD who represented the study group and 54 healthy children where GERD had been excluded, the control group. Out of all the investigated children, 39.0% displayed low hemoglobin values, 43.7% displayed low values of erythrocyte indices (MCH), and 68.5% had increased erythrocyte sedimentation rate (ESR) values, while increased eosinophil levels were recorded in 46.9% of the cases. Such parameters were proven to be a biomarker of suspected eosinophilic esophagitis, whereas 32.9% of the cases displayed high blood glucose values that could be correlated with gastroesophageal reflux symptoms. Other measured parameters (such as magnesium, aminotransferases and proteins) remained within the normal limits, without statistically significant differences compared to in the control group. This condition is diagnosed based on invasive investigations, which are often difficult to accept by the patients’ parents. The biochemical modifications correlated to the clinical manifestations can anticipate the progression of the disease, thus limiting the necessity of performing invasive diagnosis tests.


2017 ◽  
Vol 3 ◽  
pp. 10-17
Author(s):  
Marta Dats-Opoka ◽  
Halyna Makukh ◽  
Oleg Hnateyko

Gastroesophageal disease (GERD) is the one of most spread diseases that injures an esophagus. Taking into account the large number of factors that can cause GERD development already in child age, including genetic predisposition, it is necessary to analyze each of them in detail. Aim of this work was to analyze a frequency and possible association type of р. Leu72Met mutation of GHRL gene in children with gastroesophageal reflux disease. The analysis of clinical parameters and course of disease in the group of 100 schoolchildren with GERD was carried out. The molecular-genetic study of c.214C>A locus of GHRL gene by CPR method (rs696217) was carried out in patients with GERD and 40 healthy children from the control group. In 82% of children with GERD was revealed a GHRL 214СС (Leu/Leu) homozygous genotype, at 58% among children from the control group. GHRL 214СА (Leu/ Met) genotype was registered three times more seldom in children of the studied group comparing with ones from the control group: 15,0% and 42,5%, respectively. It was established, that GHRL 214CС genotype presence conditions the increase of GERD development risk in 3,4 times. On the contrary, GHRL 214CА genotype manifests a reliable protective effect that is essentially decreased GERD development risk in a child at such genotype – 0,24 comparing with a conventional unit. There was established alleles and genotypes distribution of c.214C>A (р.Leu72Met) locus of GHRL gene in children with GERD. GHRL 214CС genotype is associated with threefold increase of GERD risk development. Gender differences as to GERD development risk at different genotypes of ghrelin gene were established. At GHRL 214СС (Leu/Leu) genotype the relative GERD risk for boys increased in more than 6 times. There were not established any differences in alleles and genotypes distribution depending on erosive or surface inflammatory changes of a gastrointestinal tract mucosa.


Author(s):  
Alberto Aiolfi ◽  
Mario Nosotti ◽  
Kazuhide Matsushima ◽  
Carolina Perali ◽  
Cristina Ogliari ◽  
...  

Abstract Introduction Gastroesophageal reflux disease (GERD) is frequently seen in patients with systemic sclerosis (SSc). Long-standing GERD may cause esophagitis, long-segment strictures, and Barrett’s esophagus and may worsen pre-existing pulmonary fibrosis with an increased risk of end-stage lung disease. Surgical treatment of recalcitrant GERD remains controversial. The purpose of this systematic review was to summarize the current data on surgical treatment of recalcitrant GERD in SSc patients. Materials and methods A systematic literature review according to PRISMA and MOOSE guidelines. PubMed, EMBASE, and Web of Science databases were consulted. Results A total of 101 patients were included from 7 studies. The age ranged from 34 to 61 years and the majority were females (73.5%). Commonly reported symptoms were heartburn (92%), regurgitation (77%), and dysphagia (74%). Concurrent pulmonary disease was diagnosed in 58% of patients. Overall, 63 patients (62.4%) underwent open fundoplication, 17 (16.8%) laparoscopic fundoplication, 15 (14.9%) Roux en-Y gastric bypass (RYGB), and 6 (5.9%) esophagectomy. The postoperative follow-up ranged from 12 to 65 months. Recurrent symptoms were described in up to 70% and 30% of patients undergoing fundoplication and RYGB, respectively. Various symptoms were reported postoperatively depending on the type of surgical procedures, anatomy of the valve, need for esophageal lengthening, and follow-up. Conclusions The treatment of recalcitrant GERD in SSc patients is challenging. Esophagectomy should be reserved to selected patients. Minimally invasive RYGB appears feasible and safe with promising preliminary short-term results. Current evidence is scarce while a definitive indication about the most appropriate surgical treatment is lacking.


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