Vegetative accompaniment of the combined course of gastroesophageal reflux disease in young patients with autoimmune thyroiditis
Journal Title: Сучасна гастроентерологія - Year 2019, Vol 0, Issue 3
Abstract
Objective — to establish the presence of autonomic dysfunction and to assess the frequency and severity of its manifestations in patients with autoimmune thyroiditis (AIT) and gastroesophageal reflux disease (GERD) with the use of the A. M. Vein questionnaire. Materials and methods. The examinations involved 83 students aged (22.1 ± 2.11) years with comorbidity of GERD and AIT. Women consisted the majority, 73.5 % (61 person), of patients with GERD with history from «newly diagnosed» to three-years’ duration; and AIT from «newly diagnosed» up to 2.5 years’ duration. The GERD verification of was performed by endoscopic method, which allowed to establish the non-erosive disease form in 74 (87.8 %) cases, and erosive form in 9 cases (12.2 %). The AIT presence was confirmed in clinical, instrumental and immunological studies: antibodies to the thyroid gland exceeded the normal values; the serum of thyroid-stimulating hormone, FT3 and FT4 level corresponded to the euthyroid state. Autonomic dysfunction was assessed with A. M. Vein questionnaire (11 questionings). The statistical processing included the calculation of the χ2 criterion with the Yates amendment. Results. The assessment of results of A. M. Vein questioning showed that the most often manifestations of the autonomic dysfunction were: changes in the colour of the skin during agitation (92.8 %), excessive sweating (88 %), heartbeat (68.7 %), the appearance of lower dyspeptic syndrome (69.9 %), headaches (51.8 %), decreased performance and rapid fatigue (97.6 %). At the same time, a number of autonomic dysfunction manifestations were less common. So, numbness and coldness of the extremities were characteristic for 37.3 % respondents; difficulty breathing — for 32.5 %, fainting — 10.8 %, which was explained by the young age of the patients and a small history of nosological forms. In total, 78.3 % of the surveyed subjects had manifestations of autonomic dysfunction, and disease duration, gender and form of the esophageal mucosa damage did not matter. As a result of two-month observation on these patients, the presence of a «vegetative tail» has been revealed in 51.8 % of cases in a form of asthenic syndrome: general weakness, decreased performance, rapid fatigue, palpitations, pulse lability and pressure; and 37.3 % of individuals had some of its manifestations within 4 — 5 weeks after discharge from the hospital. Conclusions. The combined course of GERD and AIT in most cases (78.3 %) was accompanied by vegetative dysfunction, the manifestations of which aggravated the disease course. The «vegetative tail» in a form of asthenic syndrome, the manifestations of which have a negative impact on the quality of life of patients with GERD and AIT for 1 — 2 months after clinical remission of diseases can be observed.
Authors and Affiliations
T. M. Pasiieshvili
Keywords
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- EP ID EP615613
- DOI 10.30978/MG-2019-3-26
- Views 122
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