Zhuravel O. Clinical and pathogenetic mechanisms of developing of extraesophageal (respiratory) manifestations of gastroesophageal reflux disease in adolescents and ways to their rehabilitation

The dissertation is devoted to increase of efficiency of rehabilitation actions at children of pubertal age with frequent episodes of respiratory diseases affected by GERD by timely diagnostics and correction of oxidative stress, disturbances of immunity, D-vitamin maintenance. In the dissertation it is established that gastroesophageal reflux disease worsens the course and leads to an increase in the incidence of respiratory diseases in adolescents. Assessment of morphological changes of the mucous membrane of the distal esophagus in children with frequent recurrent RH on the background of GERD II degree should take into account the following signs: the presence of erosions, thinning, alternation of areas of thinning and thickening, epithelial dystrophy, elongation of papillaev, the presence of inflammatory infiltration, basal layer hyperplasia, vascular congestion; evaluation of dystrophic changes of keratocytes in the superficial parts of the multilayered squamous epithelium and the proliferative activity of its cells, determined using monoclonal Ki-67 and polyclonal Nstric Oxide Synthase, endothelial (eNOS) antibodies. In order to improve health, normalize cellular non-specific immune protection, local immunity of mucous membranes, increase the level of vitamin D3 in the body and prevent the development of extraesophageal complications of GERD in adolescents, a rehabilitation and prevention complex has been developed. Key words: gastroesophageal reflux disease, adolescents, recurrent respiratory diseases.