Rum'yanzeva M. Clinical and pathogenic features and tactics of differentiated treatment of functional dyspepsia in children.

It is carried out a clinical study of 127 sick children with functional dyspepsia (FD) and 45 healthy children. It is shown that the development of FD in children contributes to female gender and age of 7-12 years, and the role of these factors is aggravated by the presence of co-morbidity, burdened heredity, pathology of antenatal period, especially the feeding during the first year of life. It is found that FD in children is associated with certain types of temperament, character accentuation, ambi- and intraversion, moderate or high levels of anxiety and stressful situations. Among children with FD, patients with epigastric pain syndrome-(EPS) infected with H. pylori, and suffering more than 3 years dominated. The remaining cases occur in postprandial syndrome (PPS) and mixed forms. It is shown that EPS is combined with a tendency to hyperacidity and PPS and mixed form - with normacidity, and the presence of H. pylori correlates with the acidity of gastric contents. It is proved that the axis 'gastrin-melatonin' plays a significant role in the pathogenesis of childhood FD. Based on clinic outcomes, gastro-pH-monitoring as well as gastrin and melatonin levels, it is shown that the main antisecretory drugs for correcting of gastric acid production in children with EPS should be H2 histamine blocker famotidine that effectively reduces clinical symptoms, normalizes the acidity without causing of hypoacidity and hypergastrinemia, with smaller increase in melatonin level as compared with proton pump inhibitor lansoprazole.