Kyian T. Optimization of diagnostics and prevention of gastroduodenal zone diseases in adolescents with food hypersensitivity

The dissertation is devoted to the problems of increasing the efficiency of diagnostics and prevention of chronic gastritis and chronic duodenitis in adolescents with food hypersensitivity by studying the clinical and morphological features of their development, mucosal homeostasis of the gastric mucosa and duodenum. In this dissertation work it was found that food hypersensitivity worsens the course of chronic duodenitis. It was determined that adolescents with chronic gastritis and duodenitis with food hypersensitivity significantly more often had an impaired heredity for chronic diseases of the gastroduodenal zone and allergic diseases. Adolescents with chronic gastritis and duodenitis on the background of food hypersensitivity had erosions of duodenal mucosa, hypoacid level of gastric pH and motor-evacuation disorders in the form of a combination of gastroesophageal and duodenogastric refluxes. It was found that duodenal mucosa prevailed in children with chronic gastritis and duodenitis with food hypersensitivity, and was morphologically characterized by atrophy of duodenal mucosa, shortening of duodenal mucosa villi by 0.5 mm, microerosions and fibrosis of the duodenal mucosa. It was determined that 50.0% of children with body weight deficit had atrophy of duodenal mucosa. It was found that patients with chronic duodenitis and food hypersensitivity had a decrease in the cytoprotective potential of duodenal mucosa, which was represented by the absence of TFF-2 expression in the mucous membrane of 63.0% of these patients. The diagnostic criteria for the affected duodenal mucosa and predictors of atrophic changes of duodenal mucosa were determined. The algorithm of management of patients with chronic gastritis and chronic duodenitis with food hypersensitivity was developed. Keywords: food hypersensitivity, adolescents, chronic diseases of the gastroduodenal zone, TFF-2 expression.