Добовий рН-моніторинг стравоходу у пацієнтів із гастроезофагеальною рефлюксною хворобою та спондилоартритом хребта

Abstract

Introduction. Conducting research aimed at studying the features of the clinical course and diagnosis of gastroesophageal reflux disease (GERD) in patients with spondyloarthritis (SA) of the cervical or thoracic spine is an urgent task of modern medicine. The aim of the study. To study the features of daily pH monitoring of the esophagus in patients with GERD and SA of the spine. Materials and methods. At the clinical base of the Department of Propaedeutics of Internal Medicine, 52 patients with GERD and SA of the cervical or thoracic spine were examined. Patients were divided into two subgroups depending on the presence or absence of Helicobacter pylori (HP) infection, namely: group I consisted of 30 patients infected HP; the II group included 22 HP-negative patients with GERD and SA of the spine. Results of the study. In patients with GERD in combination with SA of the spine infected HP during endoscopic examination more often reflux esophagitis corresponding to the LA-C degree was detected (in 43.3% of the examined - p<0.05), while in patients of the II group more often, the degree of damage to the esophagus corresponding to LA-B was established (in 45.5% of patients, respectively - p < 0.05). In HP-infected patients with GERD in combination with SA of the spine the number of gastroesophageal reflux (GER) with pH < 4 was significantly more often diagnosed than in patients of the II group (HP-negative patients) - p<0.05.Gastroesophageal reflux, which lasted more than 5 minutes, was also more often found in the examined subjectsof the group I. Conclusions. 57.7% of patients with GERD in combination with SA of the spine were diagnosed a HP infection. Pronounced changes in the mucous membrane of the esophagus corresponding to LA-C (43.3%), as well as signs of candidal esophagitis and duodenogastric reflux were more often found in HP-infected patients with GERD and SA of the spine. The amount of GER longer than 5 minutes and the longest GER according to daily pH-monitoring of the esophagus in patients with GERD and SA is associated with the persistence of HP infection (r=0.80; р<0.01; r=0.84; р<0 .01 respectively).