Age-related features of gastritis activity in schoolchildren with gastroesophageal reflux disease

Aim. To study age-related features of the association of gastroesophageal reflux disease (GERD) with the activity of the inflammatory process in the gastric mucosa (GM) in schoolchildren. Materials and methods. At the first stage in the Republic of Tuva, we collected data on the presence of gastroenterological complaints in 1535 schoolchildren using a transverse method. At the second stage we performed esophagogastroduodenoscopy with biopsy of the mucous membrane of the antrum and the body of the stomach in two hundred forty six children including 76 cases aged from 7-11 years and 170 patients aged from 12 to 17 years. Morphological assessment of gastritis was carried out according to the Sydney classification after staining biopsy sections with hematoxylin-eosin; diagnostics of Helicobacter pylori - after staining by Giemsa method. The study was approved by the ethical committee and the consent of the surveyed patients was obtained. Results. An increase in the prevalence of GERD was found in the older age group of schoolchildren - 15.6% (7-11 years old - 4.7%; p = 0.0001). GERD schoolchildren showed an insignificant tendency with age to an increase in the activity of the inflammatory process in the mucous membrane of the antrum (p = 0.3408) and the body (p = 0.3346) of the stomach. Among infected GERD schoolchildren in both age groups, gastritis with a high degree (II-III degree) of activity was more often detected than in infected schoolchildren without clinical manifestations of GERD (7-11 years old - p = 0.2551; 12-17 years old - p = 0.0536, respectively) and more often than in those uninfected GERD cases (7-11 years old - p = 0.0082; 12-17 years old - p = 0.0002). The association of highly active forms of gastritis in the body of the stomach in infected schoolchildren with manifestations of GERD has not been established. Conclusion. The presence of GERD in schoolchildren, regardless of age, aggravates the course of the inflammatory process in the antrum. When infected with Helicobacter pylori, GERD and infection in schoolchildren act as factors that mutually aggravate the inflammatory process in the antrum.