Kossak I. The improvement of diagnosis and treatment of chronic gastroduodenitis associated with Helicobacter pylori in children.

The thesis is denoted to the contemporary pediatric problem - to improve the diagnostic and treatment procedures of chronic gastroduodenitis, associated with Hp infection. The thesis represents the results of clinical, laboratory and instrumental investigations which were carried out on 137 patients with chronic gastroduodenitis: in 81 patients chronic gastroduodenitis was associated with Hp and in 56 children chronic gastroduodenitis was not associated with Hp. The specific features of clinical manifestations with disease clinical-endoscopic variances were studied considering serum levels of pepsinogen I and gastrin, stomach motor disturbances and acid-production failure. The detection of Hp antigens in stool specimens was proven as a non-invasive method for rapid, sensitive and accurate Hp diagnosis and for estimation of efficiency after Hp eradication. Eradication therapy preponderance was proved in chronic gastroduodenitis, associated with Hp in children having latent iron deficiency and children previously treated by iron without effect, in particular cases with elevated pepsinogen I and gastrin levels but neither duodenogastric nor gastroesophageal reflux identified; reconciliation of eradication therapy and iron supplementation caused cessation of sideropenia as well as anemic manifestations in children with iron deficiency anemia.