PECULIARITIES OF THE COURSE OF GASTROESOPHAGEAL REFLUX DISEASE AND VEGETATIVE DYSFUNCTION IN PATIENTS WITH SPINAL INJURIES OF DEGENERATIVE-DYSTROPHIC AND INFLAMMATORY GENESIS
DOI:
https://doi.org/10.11603/1811-2471.2021.v.i4.12817Keywords:
gastroesophageal reflux disease, osteochondrosis, spondyloarthritis, autonomic dysfunctionAbstract
SUMMARY. Gastroesophageal reflux disease (GERD) is relevant due to the presence of both typical and atypical clinical manifestations that complicate its diagnosis.
The aim – to determine the features of the clinical course of GERD and changes in autonomic dysfunction in patients with spinal lesions of degenerative-dystrophic and inflammatory genesis.
Material and Methods. 126 patients with GERD with various forms of spinal cord injury were examined. Patients with GERD were divided into 2 groups: group I included 46 patients with osteochondrosis (OC) of the cervical and thoracic spine, and group II consisted of 50 patients with spondyloarthritis (SpA) of the spine. All examined patients underwent general clinical studies, as well as evaluation of the state of the autonomic nervous system.
Results. Most of the studied patients of both groups often complained of emotional stress, mood lability, irritability, anxiety, sleep disturbances, headaches, fatigue, palpitations, and heart failure due to negative emotional effects. The analysis of the obtained data indicates the predominant influence of the parasympathetic division of the ANS in both groups of the examined patients, with the most pronounced changes in patients with GERD in combination with SpA. The Kérdö’s Vegetative Index (KVI) values were –14.24 ± -0.86 (p <0.01) in patients of group II and I –11.68 ± -0.55 (p <0.01) in patients of group.
Conclusions. In patients with osteochondrosis of the cervical and thoracic spine GERD is more often manifested by esophageal symptoms, while in patients with spondyloarthritis it has atypical clinical forms: otolaryngological in 43.3 % and dental ‘masks’ in 26.7 %. In patients with degenerative-dystrophic changes of the spine during FEGDS, the degree of esophageal lesions more often corresponds to LA-B, both in patients with esophageal and extraesophageal symptoms, while in patients with spondyloarthritis with atypical GERD, the degree of esophageal lesions more often corresponds to LA-C. (53.3 %). In both groups of examined patients with GERD autonomic dysfunction, namely the predominance of parasympathetic regulation of the nervous system was established.
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