Clinical and sonographic parallels of gastroesophageal reflux disease and comorbid gastrointestinal pathology

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. 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. 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. 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. 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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