MECHANISMS OF THE FORMATION OF MOTOR-SECRETORY DISORDERS IN PATIENTS WITH GERD WITH CONCOMITANT AIT

OBJECTIVE

The aim: The aim of this work was to study the effect of thyroid hormones on motor-secretory dysfunction in patients with GERD with concomitant AIT.

PATIENTS AND METHODS

Materials and methods: The study involved three groups of patients: with isolated GERD, GERD with AIT at the stage of hypothyroidism and GERD with AIT at the stage of hyperthyroidism. The control group consisted of 15 practically healthy individuals. GERD and AIT were diagnosed on the basis of ICD-10. All patients underwent a comprehensive examination, including ultrasound examination of the motor-evacuation function of the esophagus and stomach. Quality of life of patients was assessed by using the GIQLI questionnaire.

RESULTS

Results: The most expressed complaints and low quality of life are observed among patients with combined pathology. The results of pH-metry indicate more severe course of GERD among patients with concomitant AIT. The most pronounced decrease in the tone of the lower esophageal sphincter and increased regurgitation were observed in the second group.

CONCLUSION

Conclusions: 1. It was found that more reliable motor-secretory disorders were observed among patients with GERD with concomitant AIT. 2. A close correlation was established between the severity of the clinical picture, the level of increased thyroid hormones and the degree of impairment of motor-secretory disorders among patients with GERD with concomitant AIT; 3. The results obtained indicate that changes in the metabolism of thyroid hormones are one of the factors involved in the mechanisms of GERD formation.

PATHOMORPHOLOGICAL FEATURES OF GASTROESOPHAGEAL REFLUX DISEASE REALIZATION IN YOUNG PEOPLE WITH AUTOIMMUNE THYROIDITIS

OBJECTIVE

The aim: To evaluate the pathomorphological features of the esophageal mucous membrane in young people with GERD and autoimmune thyroiditis.

PATIENTS AND METHODS

Materials and methods: 120 patients with GERD and AIT and 45 people with isolated GERD matched for age, gender and social status were examined. Esophagogastroduodenoscopy, histological study and comparative morphometry of the esophageal mucosa were performed.

RESULTS

Results: The frequency of erosive GERD in the examined groups of patients did not statistically differ. At the same time, integral analysis of the structure of erosive forms of GERD revealed statistically significant redistribution of grades of esophagitis towards its enhancement in patients with comorbid pathology. The histological study showed that in patients with GERD and AIT all the morphometric parameters studied had a significantly more severe course and exceeded similar indicators of the group with isolated GERD: epithelium total thickness, epithelium basal layer thickness, connective tissue papillae height, intercellular space. The analysis of morphological changes frequency showed that epithelium basal layer hyperplasia, dystrophic changes and epithelial edema, elongation of papillae and dilation of intercellular space were significantly more frequent in the group with comorbid pathology.

CONCLUSION

Conclusions: GERD and euthyroid AIT comorbidity in the student population is accompanied by a statistically significant redistribution of esophagitis grades towards its aggravation. The presence of concomitant euthyroid AIT in patients with non-erosive GERD leads to statistically more pronounced disorganization of esophageal mucosal epithelium.