Mazurenko N.N.*, Zablodsky A.N.*, Tovstashov A.L.**, Matyushchеnko O.V.**
Duodenogastral reflux and Helicobacter pylori: morphological evaluation in children
*Public Health Establishment «Vitebsk Regional Children’s Clinical Centre», Vitebsk, Republic of Belarus
**Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University», Vitebsk, Republic of Belarus
Vestnik VGMU. 2016;15(4):55-64.
Objectives. To study the changes of gastric mucosa under the influence of duodenogastral reflux (DGR) and Helicobacter pylori (H. pylori).
Material and methods. A total of 65 children treated at the in-patient department of Vitebsk Children’s Clinical Centre from February 2015 to February 2016 – 34 girls, 31 boys with complaints concerning the gastrointestinal tract – nausea, vomiting, a burning sensation in the epigastrium, vague abdominal pain principally localized in the epigastrium have been examined. The age group of children was from 5 to 17 years. The average age made up 13-15 years. The analysis of their medical history, ultrasound investigation of the abdominal cavity organs, videogastroduodenoscopy, visual assessment of gastric contents, taking 4 biopsies from the antrum and fundus of the stomach were conducted, followed by morphological evaluation. The histological changes of gastric mucosa under the influence of the bile reflux and H. pylori were studied in detail. The control group consisted of 30 persons from related departments (cardiology, neurology, allergy, pulmonary departments, who complained of discomfort behind the breast bone, shortness of breath, recurrent cough) without any complaints from the side of the gastrointestinal tract, without DGR and H. pylori and marked histological changes in the biopsies.
Results. As a result of the conducted studies in patients with duodenogastral reflux inflammatory changes have been revealed, and the presence of H. pylori leads to the increased activity and expressiveness of inflammation, the number of the lymphoid follicles. The major symptom in the clinical picture is pain, proportion of asymptomatic course is also high.
Conclusions. Bile reflux results in changes in the gastric mucosa as inflammation, fibroproliferation, foveolar hyperplasia, branching toruli, expressed manifestations of pain, and in the presence of Helicobacter pylori infection the picture changes toward the increase in the activity and expressiveness of inflammation, expressiveness of foveolar and lymphoid hyperplasia.
Key words: duodenogastral reflux, bile reflux, stomach morphology.
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Information about authors:
Mazurenko N.N. – endoscopist, Public Health Establishment «Vitebsk Regional Children’s Clinical Centre»;
Zablodsky A.N. – Doctor of Medical Sciences, head of the endoscopic department, Public Health Establishment «Vitebsk Regional Children’s Clinical Centre»;
Tovstashov A.L. – senior teacher of the Chair of Pathologic Anatomy, Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University»;
Matyushchеnko O.V. – Candidate of Medical Sciences, associate professor of the Chair of Pediatrics, Educational Establishment «Vitebsk State Order of Peoples’ Friendship Medical University».