Daily pH-monitoring for diagnosis of gastroesophageal reflux disease in children
The daily pH monitoring of the esophagus and stomach is the gold standard for diagnosis of gastroesophageal reflux disease. The daily pH monitoring of patients with reflux esophagitis and Hp-induced chronic gastroduodenitis revealed hyperacidity state in the stomach in 93.6 % of the patients. Gastroesophageal reflux (GER) exceeded the normal limit in 16 %. The alkaline reflux, indicating duodenogastric reflux (DGR), was observed in 29 % of the examined patients. With pathological GER, in accordance with the DеМееster criteria, the acidification time of the esophagus with a pH of less than 4.0 exceeds 4.5 % of the total time of pH monitoring, and the amount of acid casts throughout a day reaches 46. In this case, the reflux has a damaging effect on the mucous membrane of the esophagus. In addition, the microbial flora that is not typical of the overlying parts gets there, which can also contribute to the development of infectious and inflammatory processes. Under the generalized esophageal mucosal injury index, DeMeester index was above the normal in 71 % of the patients. 100 % of the patients with erosive esophagitis, Hp-induced chronic gastroduodenitis, reflux esophagitis and duodenal ulcer suffered from hyperacidity of gastric contents. The clinical value of pH monitoring of the upper digestive tract is the best diagnosis of functional disorders in acid-dependent diseases of the gastrointestinal tract, which allows in all cases, especially in combined pathologies, to develop adequate treatment tactics and control the course of treatment.