Principles of rehabilitation of children with digestive pathology

Chronic diseases of the digestive system in children are one of the most prevalent diseases in pediatric pathology structure. It often causes temporary disability and invalidity in adults. Proper pathogenetic therapy at different stages of treatment is the only way to recover, prevent relapses and transformation it to pathology in adult age. This task can only be carried out in compliance with fundamental stages of rehabilitation (clinical, sanatorium, adaptative) using not only drugs, but also a wide spectrum of non-pharmacological methods of treatment

Using GerdQ as a screening diagnostic method in children with gastroduodenal diseases

Background. Problem of screening for esophageal diseases in primary stages of diagnosis in children with gastroduodenal pathology is widespread. As non-invasive and economically available method, a modified Gastroesophageal Reflux Disease Questionnaire (GerdQ) is proposed for children aged 12–18 years. The purpose of the study is comparative analysis of the state of esophageal, gastric and duodenal mucosa and endoscopic pH values of the esophagus with the results of GerdQ use in children with gastroduodenal patho­logy. Materials and methods. Sixty seven children aged 12–18 years were examined. All patients underwent endoscopic study of the esophagus, stomach and duodenum with endoscopic pH measuring. The GerdQ was filled out by the children surveyed. Results. The data obtained indicate a significantly higher incidence of catarrhal and erosive esophagitis in children with destructive and catarrhal changes in the gastric mucosa and duodenum. The degree of gastroesophageal reflux and a decrease in pH values in the esophagus and stomach progressed in the presence of significant changes in the gastric mucosa. GerdQ results indicated GERD in patients with score ≥ 8. Endoscopy findings in this group were mostly catarrhal and destructive changes of esophageal mucosa with high acidity. Patients with score < 8 had mostly motility disorders (gastroesophageal reflux) and moderate increase of acidity. The results of GerdQ comparison with the data of the endoscopic study and the pH-measuring shows a significant (95 %; p < 0.05) coincidence of positive GerdQ results with pronounced endoscopic changes in the esophageal mucosa and a decrease in pH < 4 in the esophagus and < 1.2 in the stomach. Conclusions. The study shows that the sensitivity of the questionnaire is quite high and allows its use at the primary stage of diagnosis in children of middle and senior school age

The role of adsorbents in the management of diarrhea syndrome in children

This article deals with the pathological conditions with diarrhea syndrome in children. Pathogenetic mechanisms of diarrhea development, peculiarities of clinical and laboratory manifestations in various diseases are considered. The main methods to control diarrhea are presented, mechanisms of sorption therapy action are considered. The classification of enterosorbents used in clinical pediatric practice is given. The characteristics of Apsorbin sachet which is registered in Ukraine as dietary supplement with enterosorption action is given. The results are presented on using Apsorbin sachet in comprehensive therapy of children with irritable bowel syndrome (type with diarrhea) and convalescent children after gastrointestinal infections

Optimization of treatment of irritable bowel syndrome in children

Background. Factors that trigger several pathophysiological mechanisms may simultaneously be involved in the occurrence of irritable bowel syndrome (IBS). Disorders of the intestinal microbiota play a significant role in the pathogenesis of the disease in children, given the characteristics of the child’s body. Changes in the composition of the intestinal microflora may be accompanied by movement disorders and impaired sensory sensitivity of the intestines, which form the basis for the formation of pain, dyspeptic manifestations and stool disorders. The lack of effect from the treatment of IBS may be due to the presence of violations of the intestinal biocenosis in the child; therefore, in accordance with the recommendations of the Rome IV criteria, it is necessary to correct the intestinal microflora. The purpose is to study the effectiveness of synbiotic Optilact® in the treatment of irritable bowel syndrome in children. Materials and methods. Thirty-three children aged 8 to 14 years with irritable bowel syndrome (variant with constipation) were examined. The diagnosis was made on the basis of clinical, paraclinical, laboratory and instrumental studies. The dietary supplement Optilact® was prescribed in order to relieve the main complaints — constipation, flatulence, to reduce pain symptoms and improve the general condition of the patient. The effectiveness of therapy was evaluated on the basis of the clinical dynamics of pain and dyspeptic complaints, reduction of constipation. The dyna­mics of coprological data was assessed by the end of the course of dietary supplement administration. Results. The findings indicate the feasibility and effectiveness of synbiotic Optilact® in children with irritable bowel syndrome (variant with constipation). The positive dynamics of pain and dyspeptic manifestations, the absence of side effects make it possible to use it in children. Conclusions. The use of the dietary supplement Optilact® in the comprehensive therapy of patients with IBS (variant with constipation) reduces pain and dyspeptic manifestations of the disease, eliminates constipation

Experience of using ursodeoxycholic acid in the therapy of biliary sludge in children

Background. The article presents the causes, diagnostic criteria and peculiarities of pathogenetic therapy of biliary sludge (BS). The results of the study on the effectiveness of Ukrliv (ursodeoxycholic acid) are described in the correction of sludge syndrome in children. Materials and methods. Open comparative study included 60 patients with BS (42 girls, 18 boys) aged 4 months to 8 years. BS diagnosis in each child was established during ultrasound examination of the abdominal cavity. After this, two groups of 30 persons were formed by means of random sampling: study group — Ukrliv was used at a dose of 10 mg/kg body weight once a day in the evening for a month on the background of standard therapy; comparison group — children received only standard therapy. Before treatment and after it, we have evaluated clinical manifestations of the disease, the data of ultrasound examination of the abdominal cavity, the results of the biochemical study of the liver function. Results. In the study group, on the background of Ukrliv administration, BS was resolved or decreased in all children, while only 8 of the 30 children in the comparison group had spontaneous disappearance of BS. In the comparison group, the results of the biochemical study of the liver function were a little different from baseline and significantly different from indicators of the study group, where normalization of the biochemical liver functions occurred. Conclusions. Ukrliv administration contributed to the rapid resolution of BS according to ultrasound research. On the background of drug intake, there was a rapid normalization of liver function. Ukrliv did not cause side effects that would require drug withdrawal, and was well tolerated by sick children. Inclusion of Ukrliv (ursodeoxycholic acid) in the comprehensive therapy of children with BS is pathogenetically grounded