One of violations of motor function of the stomach and duodenum are retrograde casts of gastric contents into the esophagus and intestinal contents into the stomach - reflux: gastroesophageal, duodenal and duodenobulbarny.Refluxes often associated gastroduodenal pathology.So, according to our clinic, duodenal reflux with gastroduodenitis and duodenal ulcer exacerbation occurs in 66-69%, gastritis exacerbation - in 56%, functional disorders of the stomach - in 44%.
combination with gastroduodenal pathology duodenogastric reflux significantly worsens the underlying disease, shortens the remission and requires targeted treatment.Currently, some authors recommend the use of adult Cerucalum for nor.malizatsii motility of the stomach and duodenum.In the pediatric literature on the effectiveness of communications Cerucalum with duodenal reflux, associated gastroduodenal pathology, no.
In this regard, the aim of this work was to study the effect of Cerucalum on the motor activity of the upper gastrointestinal
tract in children.We observed 115 children with various gastroduodenal pathology in combination with motor disorders of the stomach and duodenum.Of the 115 children were girls 86, boys 29. Children under 11 years of age - 52, from 11 to 14 years - 63.
Depending on the primary clinical diagnosis, all patients were divided into groups.The clinical diagnosis was made on the basis of complaints, anamnesis, physical examination, laboratory tests.All children to confirm the clinical diagnosis performed fibrogastroduodenoscopy, in cases of doubt - morphological study.
pronounced clinical manifestations could not be detected duodenal reflux.However, it should be noted that in patients with gastroduodenal pathology combined with duodenogastric reflux of the complaints are dominated dyspeptic symptoms like belching, nausea in the morning and on an empty stomach.In addition to pain, which characterizes the underlying disease, observed non-localized pain cramping in nature, without a distinct connection with the meal.With continuous fractional study of gastric contents in these children was revealed admixture of bile in all portions with an increase in its fractions stimulated.When fibrogastroduodenoskopicheskom study, along with the basic gastric mucosal changes and duodenum inherent in the underlying disease, determined by endoscopic features that characterize duodenal reflux: staining mucous lakes in yellow, the presence on the walls of the stomach, especially in the antrum, lumps of mucus greenish motoractivities gatekeeper was often slowing.During diastole, or permanently (if the pyloric sphincter deficiency), there was a regurgitation of bile into the stomach.
All patients depending on the underlying diagnosis receive appropriate therapy, including individual diet, vitamins, sedative therapy (a decoction of valerian root), on the testimony of antacids (vikalin, Almagelum), cholagogue preparations (allohol, immortelle, corn silk, oksafenamid), antispasmodic(no-spa, papaverine), physiotherapy - electrophoresis solution of magnesium sulfate on the right hypochondrium.
45 children (group 1 patients) of 115, along with the above treatment gave an additional course of treatment in a hospital tserukalom.As is known, the drug mainly affects chemosensitivity zone medulla and to a lesser extent to other parts of the central nervous system.In this regard, it is increasingly used in pediatric practice.Reglan enhances gastric motility, accelerates the emptying does not affect gastric secretion, is well combined with antacids and drugs holinoliticheskimi.Appointed 3 times a day before meals in the age dosages for 10- 14 days.The second group included 70 patients with gastroduodenal pathology, did not receive during the treatment Reglan.
Our observations have shown (Table 2) that the 45 children who received Reglan, there came more rapid improvement of health, appetite, disappearance of dyspeptic symptoms by the end of the first week.Pain was stopped at the end of the first week in 39 children, 6 children - in the second week.
In the second group of patients not treated with Reglan, dyspeptic symptoms were more pronounced and long-wearing character (up to three weeks).Pain was stopped for 1 week only in 9 of 70 patients (including 6 patients with functional disorders of the stomach), for 3-4 week - in 37 children failed to get 22 children from the effects of the therapy.
15 patients who received treatment tserukalom, one month was carried out re fibrogastroduodenoscopy, which revealed a significant improvement in cardiac motility and pyloric sphincter, reducing the inflammatory changes of the gastric mucosa, especially the antrum.Bile regurgitation were noted in 14 of 15 patients examined.One child with two ulcers duodenal bulb duodenal reflux was maintained.
Only two of the 45 children observed side effect from taking Cerucalum.In the analysis of medical records, it was found that a history of these children have neurological disorders (neurasthenia, enuresis) and one child chronic pyelonephritis in remission.
Cerucalum Side effects manifested in the deterioration of general condition - weakness, dizziness, giperkinetodistonicheskih occurrence of phenomena in the muscles of the neck, the head, the upper limbs.Introduction of caffeine quickly eliminate these phenomena.
Thus, our observations provide an opportunity to recommend Cerucalum in children with gastroduodenal pathology in combination with motor disorders of the stomach and duodenum.