Authors: Yu.V. Marushko, A.O. Asonov, Bogomolets National Medical University, Kyiv
One of the relevant problems of modern pediatrics is damage to the esophagus during gastroesophageal reflux disease. Purpose of work: study of the efficacy and safety of pantoprazole (Uselapan) and combined synbiotic (Opefera) in the complex therapy of GERD with reflux esophagitis in children with chronic gastroduodenitis (СGD).
Materials and methods
60 children with chronic gastroduodenitis and gastroesophageal reflux disease accompanied by gastroesophageal reflux and esophagitis at the age from 12 to 17 years old who were in hospital were examined. Depending on the infection with H. pylori patients, two surveillance groups were formed: I – 20 children with a diagnosis of GERD with reflux esophagitis and CGD not associated with H. pylori; II – 40 children with GERD with reflux esophagitis and CGD associated with H. pylori. Children from both groups received pantoprazole 40 mg as antisecretory therapy (Ulsepan). To prevent antibiotic-associated diarrhea in children from the 2nd group of observations, we used a pre-and probiotic complex (synbiotic) Opefera.
Results and discussion
Based on the results of the evaluation of the dynamics of the disappearance of GERD symptoms against the background of Upsepan PPI (pantoprazole), it was found that in a month of treatment in 90.0% of patients with GERD with reflux esophagitis and CGD non-associated with H. pylori no symptoms of GERD were present, and in the group children of patients with GERD with reflux esophagitis and CHD associated with H. pylori, the absence of GERD symptoms was recorded in 87.5% of patients, statistically significantly less than before the initiation of therapy. It was established that the manifestations of antibiotic-associated diarrhea in children who received synbiotic Opefera from the first day of antibacterial treatment occurred in 5.0% of patients. In the group of children who received the synbiotic after the abolition of the antibiotic, clinical manifestations of antibiotic-associated diarrhea were detected in statistically significant (p <0.05) of a larger numberof patients (20.0%).
Gastroesophageal reflux disease is an actual pediatric problem, occupying one of the leading places in the structure of gastroenterological diseases in children. The use of pantoprazole (Ulsepan) in the complex therapy of children with gastroesophageal reflux disease with reflux esophagitis and chronic gastroduodenitis in patients over 12 years of age provides a pronounced positive clinical effect. The use of the synbiotic complex Opefera from the first days of H. pylori eradication therapy with antibacterial drugs significantly reduces the manifestations of antibiotic-associated diarrhea in children.
Key words: gastroesophageal reflux disease, children, Ulsepan, Opefera