Voloshyn K. Functional dyspepsia in children: diagnostic and differential diagnostic criteria.

The research work is devoted to the effectiveness increase of diagnostic and differential diagnostic of functional dyspepsia in children. Pecularities of the clinical course, endoscopic and morphological features of gastric mucous membrane in different forms of functional dyspepsia have been determined. Disorders of gastric motility and secretion and H. рylori infection have been studied in children with functional dyspepsia. The level of proinflammatory cytokines TNF-? and IL-1? in blood serum has been determined in patients with functional dyspepsia. It is proved that PDS and EBS have essential distinctions in clinical course, which are induced by gastric motility and secretion disorders and H. рylori infection. Morphological research has revealed changes in gastric mucous membrane state as with endoscopic normal gastric mucosa (peculiar to PDS), also with erythematous gastropathy (peculiar to EBS). The intensity of these changes was various: from minimal (in normal gastric mucosa), to chronic inflammation features (in erythematous gastropathy), which can be considered as chronic gastritis signs. This statement has been confirmed by increased level of TNF-? and IL-1? in blood serum in children with functional dyspepsia, higher in children with EBS. The received results permit to suppose that PDS, with the increasing age of the patients and with absence or unequal treatment, transforms to EBS, which has clinicomorphological features of chronic gastritis. Discovered features of PDS and EBS have been allowed to work out differential diagnostic algorithm of these clinical forms of functional dyspepsia in children.