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Abstract
CLINICAL MANIFESTATION OF GASTROESOPHAGEAL REFLUX DISEASE ASSOCIATED WITHAUTOIMMUNE THYROIDITIS IN YOUNG PERSONS
Pasiieshvili T., Kovaloyva O.
Background. Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal disorders worldwide, with relevant impact on the quality of life and health care costs. The prevalence of GERD in Western Europe and North America is 30–40 % of the adult population, 10 % of them with daily heartburn as main symptom of GERD. The statistic data of GERD in Ukraine ranges from 11.1 % to 30 %. Purpose. To investigate the clinical features of gastroesophageal reflux disease which associated with autoimmune thyroiditis in young patients. Subjects & Methods. 165 patients have been studied. All patients were divided in two groups: first group consists of 120 patients with GERD associated with autoimmune thyroiditis (AIT), second group included had 45 patients with isolated GERD. Groups were matched in age (21.9 ± 2.7 and 21.2 ± 2.4 years, respectively), sex (77.5 % and 75.5 % women, respectively), education and disease duration. Results. The main clinical symptom of GERD in patients with comorbid pathology and isolated GERD was heartburn, which was recorded in all cases, but its manifestations had different intensity, frequency, time of occurrence and duration. Patients of the group with the combined course of GERD and AIT significantly often noted the appearance of heartburn at night (65 %) in comparison with isolated GERD (31.1 %). Belching was observed in 62 patients (51.7 %) in the group with comorbid pathology and at 6 examined (13.3%) in group with isolated GERD (p<0.05). Conclusions. Patients of the group with the combined course of GERD and AIT significantly more often had the night heartburn at – 65 % versus 31.1 % in the group with isolated GERD (p<0.05). Belching was observed in 52.5 % of patients with comorbid pathology and in 13.3 % of patients with isolated GERD (p<0.05).Assessment of other symptoms of GERD: epigastric discomfort, epigastric pain, dysphagia, nausea, vomiting, belching, satiety after meal, flatulence, hoarseness, cough did not have a significant difference between the groups, but there was a tendency to increase the incidence of symptoms in patients of the GERD group associated with AIT.
Keywords: gastroesophageal reflux disease, autoimmune thyroiditis, clinical characteristics.
Абстракт
КЛІНІЧНА МАНІФЕСТАЦІЯ ГАСТРОЕЗОФАГЕАЛЬНОЇ РЕФЛЮКСНОЇ ХВОРОБИ ТА АВТОІМУННОГОТИРЕОЇДИТУ У ОСІБ МОЛОДОГО ВІКУ
Пасієшвілі Т., Ковальова О.
Вступ. Гастроезофагеальна рефлюксна хвороба (ГЕРХ) є одним з найпоширеніших захворювань травної системи, що негативно впливає на якість життя і витрати на охорону здоров'я. Поширеність ГЕРХ в Західній Європі і Північній Америці становить 30-40 % дорослого населення, 10 % з них мають щоденну печію в якості основного симптому ГЕРХ. Статистичні дані ГЕРБ в Україні коливаються від 11,1 % до 30 %. Мета. Вивчити клінічні особливості ГЕРХ, пов'язаної з аутоімунний тиреоїдит у молодих пацієнтів. Предмети і методи. Було обстежано 165 пацієнтів. Всі пацієнти були розділені на дві групи: перша група складалася з 120 пацієнтів з ГЕРХ, асоційованої з аутоімунний тиреоїдитом (AIT), друга група включала 45 пацієнтів з ізольованою ГЕРХ. Групи були порівнянні за віком (21,9 ± 2,7 і 21,2 ± 2,4 роківвідповідно), статтю (77,5% і 75,5% жінок відповідно), освітою і тривалістю захворювання. Результати. Основним клінічним симптомом ГЕРХ у пацієнтів з коморбідною патологією і ізольованою ГЕРХ була печія, яка реєструвалася у всіх випадках, але її прояви мали різну інтенсивність, частоту, час виникнення і тривалість. Пацієнти з групи з комбінованим перебігом ГЕРХ і АІТ достовірно частіше відзначали появу печії вночі (65 %) у порівнянні з хворими з ГЕРХ (31,1 %). Наявність відрижки відмічали 62 пацієнти (51,7 %) групи з коморбідною патологією та 6 осіб (13,3 %) групи з ізольованим перебігом хвороби (p<0,05). Висновки. У пацієнтів з ГЕРХ та АІТ значно частіше реєстрували печію в нічний час – 65 % проти 31,1% в групі з ізольованою ГЕРХ (р<0,05). Відрижка спостерігалася у 52,5 % пацієнтів з супутньою патологією та у 13,3 % пацієнтів з ізольованою ГЕРХ (р<0,05). Оцінка інших симптомів ГЕРХ: дискомфорт в епігастральній ділянці, біль в епігастральній ділянці, дисфагія, нудота, блювота, відрижка, відчуття насичення після їжі, метеоризм, хрипота, кашель не мали значної різниці між групами, але була тенденція до збільшення частоти виникнення симптомів у пацієнтів з комбінованим плином ГЕРХ та АІТ.
Ключові слова: гастроезофагеальна рефлюксна хвороба, автоімунний тиреоїдит, клінічна характеристика.
Абстракт
КЛИНИЧЕСКАЯ МАНИФЕСТАЦИЯ ГАСТРОЭЗОФАГЕАЛЬНОЙ РЕФЛЮКСНОЙ БОЛЕЗНИ И АУТОИММУННОГО ТИРЕОИДИТА У ЛИЦ МОЛОДОГО ВОЗРАСТА
Пасиешвили Т., Ковалева О.
Вступление. Гастроэзофагеальная рефлюксная болезнь (ГЭРБ) является одним из самых распространенных заболеваний пищеварительной системы, что оказывает существенное влияние на качество жизни и расходы на здравоохранение. Распространенность ГЭРБ в Западной Европе и Северной Америке составляет 30–40 % взрослого населения, 10 % из них с ежедневной изжогой в качестве основного симптома ГЭРБ. Статистические данные ГЭРБ в Украине колеблются от 11,1 % до 30 %. Цель. Изучить клинические особенности гастроэзофагеальной рефлюксной болезни, связанной с аутоиммунным тиреоидитом у молодых пациентов. Материал и методы. Были обследованы 165 пациентов. Все пациенты были разделены на две группы: первая группа состояла из 120 пациентов с ГЭРБ, ассоциированной с аутоиммунным тиреоидитом (AIT), вторая группа включала 45 пациентов с изолированной ГЭРБ. Группы были сопоставимы по возрасту (21,9 ± 2,7 и 21,2 ± 2,4 года соответственно), полу (77,5% и 75,5% женщин соответственно), образованию и продолжительности заболевания.
Результаты. Основным клиническим симптомом ГЭРБ у пациентов с коморбидной патологией и изолированной ГЭРБ была изжога, которая регистрировалась во всех случаях, но ее проявления имели различную интенсивность, частоту, время возникновения и продолжительность. Пациенты из группы с комбинированным течением ГЭРБ и АИТ достоверно чаще отмечали появление изжоги ночью (65 %) по сравнению с больными с ГЭРБ (31,1 %). Наличие отрыжки отмечали 62 пациента (51,7 %) в группе с коморбиднлй патологией и 6 человек (13,3 %) в группе с изолированным течением заболеванимя (p<0,05).
Выводы. У пациентов с комбинированным течением ГЭРБ и АИТ значительно чаще регистрировали изжогу в ночное время – 65 % против 31,1 % в группе с изолированной ГЭРБ (р<0,05). Отрыжка наблюдалась у 52,5 % пациентов с сопутствующей патологией и у 13,3 % пациентов с изолированной ГЭРБ (р<0,05). Оценка других симптомов ГЭРБ: дискомфорт в эпигастральной области, боль в эпигастральной области, дисфагия, тошнота, рвота, отрыжка, чувство насыщения после еды, метеоризм, хрипота, кашель не имели значительной разницы между группами, но была тенденция к увеличению частоты возникновения симптомов у пациентов с комбинированным течением ГЭРБ и АИТ.
Ключевые слова: гастроэзофагеальная рефлюксная болезнь, аутоиммунный тиреоидит, клиническая характеристика.
References
REFERENCES
Fakhre Yaseri H. (2017). Gender is a risk factor in patients with gastroesophageal reflux disease. Medical journal of the Islamic Republic of Iran, 31, 58. doi:10.14196/mjiri.31.58
El-Serag HB, Sweet S, Winchester CC, Dent J. (2014). Update on the epidemiology of gastro-oesophageal reflux disease: A systematic review Article. Literature Review in Gut 63(6):871-880 doi: 10.1136/gutjnl-2012-304269.
Gyawali, C. P., Kahrilas, P. J., Savarino, E., Zerbib, F., Mion, F., Smout, A., … Roman, S. (2018). Modern diagnosis of GERD: the Lyon Consensus. Gut, 67(7), 1351–1362. doi:10.1136/gutjnl-2017-314722
Klenzak, S., Danelisen, I., Brannan, G. D., Holland, M. A., & van Tilburg, M. A. (2018). Management of gastroesophageal reflux disease: Patient and physician communication challenges and shared decision making. World journal of clinical cases, 6(15), 892–900. doi:10.12998/wjcc.v6.i15.892
Harrison C, Henderson J, Miller G, Britt H. (2017). The prevalence of diagnosed chronic conditions and multimorbidity in Australia: a method for estimating population prevalence from general practice patient encounter data. PLoS One. 12(3):e0172935. doi: 10.1371/journal.pone.0172935.
Ye, B. X., Jiang, L. Q., Lin, L., Wang, Y., & Wang, M. (2017). Reflux episodes and esophageal impedance levels in patients with typical and atypical symptoms of gastroesophageal reflux disease. Medicine, 96(37), 79-78. doi:10.1097/MD.0000000000007978
Yamasaki, T., Hemond, C., Eisa, M., Ganocy, S., & Fass, R. (2018). The Changing Epidemiology of Gastroesophageal Reflux Disease: Are Patients Getting Younger?. Journal of neurogastroenterology and motility, 24(4), 559–569. doi:10.5056/jnm18140
Galos F, Boboc C, Balgradean M (2016). Gas Reflux in Children with Normal Acid Exposure of the Oesofagus. Maedica (Buchar), Vol. 11, Issue 4. – P. 345–348
Eiko Okimoto, Norihisa Ishimura, Yoshiya Morito, Hironobu Mikami, Shino Shimura, Goichi Uno, Yuji Tamagawa, Masahito Aimi, Naoki Oshima, Kousaku Kawashima, et al. (2015). Prevalence of gastroesophageal reflux disease in children, adults, and elderly in the same community. J Gastroenterol Hepatol., 30(7): 1140–1146. doi: 10.1111/jgh.12899
Leung, A. K., & Hon, K. L. (2019). Gastroesophageal reflux in children: an updated review. Drugs in context, 8, 212591. doi:10.7573/dic.212591
Fadieienko, H.D., Halchinska, V.Yu., Kushnir, I.E. (2016). Porushennia funktsionalnoho stanu endoteliiu ta yoho rol u patohenezi hastroezofahelnoi refliuksnoi khvoroby v poiednanni z ishemichnoiu khvoroboiu sertsia [Violation of the functional state of the endothelium and its role in the pathogenesis of gastroesophageal reflux disease combined with coronary heart disease]. Suchasna gastroyenterologіya – Modern Gastroenterology, 5 (91), 9-14 [in Ukrainian].
Monroy, M., Ruiz, M. A., Rejas, J., & Soto, J. (2018). Mapping of the Gastrointestinal Short Form Questionnaire (GSF-Q) into EQ-5D-3L and SF-6D in patients with gastroesophageal reflux disease. Health and quality of life outcomes, 16(1), 177. doi:10.1186/s12955-018-1003-y
Ebrahimi-Mameghani, M., Sabour, S., Khoshbaten, M., Arefhosseini, S. R., & Saghafi-Asl, M. (2017). Total diet, individual meals, and their association with gastroesophageal reflux disease. Health promotion perspectives, 7(3), 155–162. doi:10.15171/hpp.2017.28
Kiel S, Ittermann T, Völzke H, Chenot JF, Angelow A (2019). Prevalence of thyroid abnormality: a comparison of ambulatory claims data with data from a population-based study. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 62(8):1004-1012. doi: 10.1007/s00103-019-02983-1.
Pyzik, A., Grywalska, E., Matyjaszek-Matuszek, B., & Roliński, J. (2015). Immune disorders in Hashimoto's thyroiditis: what do we know so far?. Journal of immunology research, 2015, 979167. doi:10.1155/2015/979167
Bliddal, S., Nielsen, C. H., & Feldt-Rasmussen, U. (2017). Recent advances in understanding autoimmune thyroid disease: the tallest tree in the forest of polyautoimmunity. F1000Research, 6, 1776. doi:10.12688/f1000research.11535.1
Martinucci, I., Natilli, M., Lorenzoni, V., Pappalardo, L., Monreale, A., Turchetti, G., … de Bortoli, N. (2018). Gastroesophageal reflux symptoms among Italian university students: epidemiology and dietary correlates using automatically recorded transactions. BMC gastroenterology, 18(1), 116. doi:10.1186/s12876-018-0832-9
Alrashed, A. A., Aljammaz, K. I., Pathan, A., Mandili, A. A., Almatrafi, S. A., Almotire, M. H., & Bahkali, S. M. (2019). Prevalence and risk factors of gastroesophageal reflux disease among Shaqra University students, Saudi Arabia. Journal of family medicine and primary care, 8(2), 462–467. doi:10.4103/jfmpc.jfmpc_443_18
Cellini, M., Santaguida, M. G., Virili, C., Capriello, S., Brusca, N., Gargano, L., & Centanni, M. (2017). Hashimoto's Thyroiditis and Autoimmune Gastritis. Frontiers in endocrinology, 8, 92. doi:10.3389/fendo.2017.00092
Liu, L., Li, S., Zhu, K., Yu, W., Wang, H., Guo, J., & Gao, H. (2019). Relationship between esophageal motility and severity of gastroesophageal reflux disease according to the Los Angeles classification. Medicine, 98(19), e15543. doi:10.1097/MD.0000000000015543
Rajaie S, Ebrahimpour-Koujan S, Hassanzadeh Keshteli A, Esmaillzadeh A, Saneei P, Daghaghzadeh, Feinle-Bisset, Adibi. (2019). Spicy Food Consumption and Risk of Uninvestigated Heartburn in Isfahani Adults. Dig Dis. 30:1-10. doi: 10.1159/000502542.
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