medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-7-36-43medsovet-6858Research ArticleЗаболевания пищевода и желудкаDiseases of the esophagus and stomachКлинико-сонографические параллели гастроэзофагеальной рефлюксной болезни и коморбидной гастроинтестинальной патологииClinical and sonographic parallels of gastroesophageal reflux disease and comorbid gastrointestinal pathologyhttps://orcid.org/0000-0001-8665-6796ГорбаньВ. В.GorbanV. V.

Горбань Виталий Васильевич - доктор медицинских наук, заведующий кафедрой поликлинической терапии с курсом общей врачебной практики (семейной медицины) факультета повышения квалификации и профессиональной переподготовки специалистов.

350063, Краснодар, ул. Митрофана Седина, д. 4.

Vitaly V. Gorban - Dr. Sci. (Med.) - Head of the Department of Polyclinic Therapy with Course of General Medical Practice (Family Medicine) of the Faculty of Advanced Training and Professional Retraining of Specialists, Kuban State Medical University.

4, Mitrofan Sedin St., Krasnodar, 350063.

gorbanvv@mail.ruhttps://orcid.org/0000-0002-1585-8814МатвееваЭ. В.MatveevaE. V.

Матвеева Элеонора Викторовна - аспирант кафедры поликлинической терапии с курсом общей врачебной практики (семейной медицины) факультета повышения квалификации и профессиональной переподготовки специалистов, КубГМУ; врач ультразвуковой диагностики, клиника «Евромед» ООО «Современные диагностические технологии».

350063, Краснодар, ул. Митрофана Седина, д. 4; 350004, Краснодар, ул. Калинина, д. 201.

Eleanorа V. Matveeva - Postgraduate Student of the Department of Polyclinic Therapy with Course of General Medical Practice (Family Medicine) of the Faculty of Advanced Training and Professional Retraining of Specialists, Kuban State Medical University; Doctor of Ultrasound Diagnostics, Euromed Clinic by Modern diagnostic technologies LLC.

4, Mitrofan Sedin St., Krasnodar, 350063; 201, Kalinin St., Krasnodar, 350004.

evmatveeva74@mail.ruhttps://orcid.org/0000-0002-5026-5053ГорбаньЕ. В.GorbanE. V.

Горбань Елена Витальевна - кандидат медицинских наук, ассистент кафедры поликлинической терапии с курсом общей врачебной практики (семейной медицины) факультета повышения квалификации и профессиональной переподготовки специалистов, КубГМУ; врач ультразвуковой  диагностики, ККБ № 2.

350063, Краснодар, ул. Митрофана Седина, д. 4; 350012, Краснодар, ул. Красных партизан, д. 6/2.

Elena V. Gorban - Cand. Sci. (Med.), Assistant of the Department of Polyclinic Therapy with Course of General Medical Practice (Family Medicine) of the Faculty of Advanced Training and Professional Retraining of Specialists, Kuban State Medical University; Doctor of Ultrasound Diagnostics, Regional Clinical Hospital No. 2.

4, Mitrofan Sedin St., Krasnodar, 350063; 6/2, Krasnykh partisan St., Krasnodar, 350012.

msgorban@mail.ruКубанский государственный медицинский университетРоссияKuban State Medical UniversityRussian FederationКубанский государственный медицинский университет; Клиника «Евромед» ООО «Современные диагностические технологии»РоссияKuban State Medical University; Euromed Clinic by Modern diagnostic technologies LLCRussian FederationКубанский государственный медицинский университет; Краевая клиническая больница №2РоссияKuban State Medical University; Regional Clinical Hospital No. 2Russian Federation202213052022073643Copyright © Горбань В.В., Матвеева Э.В., Горбань Е.В., 20222022Горбань В.В., Матвеева Э.В., Горбань Е.В.Gorban V.V., Matveeva E.V., Gorban E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6858Введение

Введение. Рост сочетанных с гастроэзофагеальной рефлюксной болезнью (ГЭРБ) заболеваний диктует необходимость разработки методических подходов для ранней амбулаторной диагностики коморбидных гастроинтестинальных состояний общедоступными методами, включая трансабдоминальное ультразвуковое исследование (УЗИ).

Цель – определить значимые сонографические параметры поражения толстой кишки у больных с полиморбидной ГЭРБ, ассоциированные с сопутствующими клиническими и метаболическими изменениями, для улучшения транссиндромной диагностики на амбулаторном приеме.

Материалы и методы

Материалы и методы. Были обследованы 150 амбулаторных больных с ГЭРБ (60 мужчин и 90 женщин) со средним возрастом 40,2 ± 3,1 года. Всем пациентам проведены клинико-лабораторное обследование, эзофагогастродуоденоскопия, колоноскопия, УЗИ желудочного-кишечного тракта с расчетом объема гастроэзофагеального (ГЭ) рефлюктата.

Результаты и обсуждение

Результаты и обсуждение. У больных ГЭРБ критерии, отражающие патологические состояния толстой кишки по данным колоноскопии и УЗИ, имели прямую корреляцию. Показаны статистически значимые взаимосвязи УЗ-признаков  поражения различных сегментов толстой кишки с  полом, возрастом  больных, индексом  массы  тела, эрозивной  рефлюксной  болезнью и объемом ГЭ-рефлюктата, а также с недостаточностью лактазы и витамина D, наличием дрожжеподобных грибков и повышением уровня фекального кальпротектина.

Выводы

Выводы. Практическая значимость работы заключается в возможности у больных ГЭРБ с коморбидной гастроинтестинальной патологией диагностировать морфофункциональные нарушения толстой кишки,  ассоциированные  не  только  с  основным, но и с сопутствующими заболеваниями, УЗ-методом в месте оказания медицинской помощи. Тюнинг гастроинтестинальной сонографии, направленный на немедленную интеграцию УЗ-изображений в план ведения пациентов, предполагает расширение транссиндромной диагностики и обоснование терапевтической тактики на амбулаторном приеме.

Introduction

Introduction. The growth of gastrointestinal diseases associated with gastroesophageal reflux disease (GERD) dictates the need to develop methodological approaches for early outpatient diagnosis of comorbid gastrointestinal conditions using generally available methods, including transabdominal ultrasound (USR).

Aim

Aim. To determine significant sonographic parameters of colon lesions in patients with polymorbid GERD, associated with clinical and metabolic concomitant changes, in order to improve transsyndromic diagnosis at an outpatient appointment.

Materials and methods

Materials and methods. The study included 150  outpatients  with  GERD  (60  men  and  90  women)  with  an  average  age of 40.2 ± 3.1 years old. All patients underwent clinical and laboratory examination, esophagogastroduodenoscopy, colonoscopy, ultrasound of the gastrointestinal tract with the calculation of the volume of gastroesophageal (GE) refluctate.

Results  and discussion

Results  and discussion. In patients with GERD, the criteria reflecting the pathological conditions  of the colon  according  to  the data of colonoscopy and ultrasound had a direct correlation. Statistically significant relationships between ultrasound signs of lesions of various segments of the colon with gender, age of patients, body mass index, erosive reflex disease and the volume of GE refluctate, as well as with lactase and vitamin D deficiency, the presence of yeast-like fungi and an increase in the level of fecal calprotectin are shown.

Conclusions

Conclusions. The practical significance of the work lies in the possibility of diagnosing morphofunctional disorders of the colon in GERD patients with comorbid gastrointestinal pathology, associated not only with the main, but also with concomitant diseases by the ultrasound technique at the place of medical care. Tuning of gastrointestinal sonography, aimed at the immediate integration of ultrasound images into the patient management plan, involves the expansion of transsyndromic diagnostics and the substantiation of therapeutic tactic at an outpatient appointment.

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The authors declare that there are no conflicts of interest present.