The significance of correction of gut flora for maintenance of remission in children with chronic gastroduodenitis
The objective. To study the effect of the probiotic preparation Bifiform on metabolic processes, the state of gut flora, psychoemotional specificities and the quality of life in children with CGD in the phase of remission. Patients and methods. The examination included 60 children in the phase of exacerbation of CGD associated with helicobacter infection, and 52 children in the phase of remission. The control group comprised 22 children - adolescents from a comprehensive school. For diagnosing helicobacter infection, along with histological examination, we used the rapid urease test and H.pylori breath test. The quality of life (QL) of children was studied by the SF-36 questionnaire. In the phase of remission, _| taking into account the obtained findings, children received a course of the probiotic (Bifiform) 1 capsule 2 times daily after meals for 1 month. All parameters were examined dynamically: in the phase of exacerbation, 6 months after eradication therapy and 1 month after the course of treatment with the probiotic. Results. In the phase of exacerbation, clinical signs of CGD in children were manifested by abdominal pain syndrome with predominant localization of pains in the upper abdomen (100% of children), symptoms of gastric dyspepsia in the form of nausea (30%), heartburn (41.6%), sensation of heaviness in the epigastric area (51.6%), practically in 100% of cases there were complaints characteristic for asthenic autonomic syndrome. Six months after eradication therapy in the absence of complaints on the upper GIT there were signs of intestinal dyspepsia (95% CI: 38.4-51.59, p = 0.0012) significantly more often than in the phase of exacerbation (in 45%/27 cases). In children with CGD in the phase of exacerbation and in the phase of remission we found a reduction of the volume of obligatory flora (bifidobacteria, lactobacilli) and increased amounts of conditionally pathogenic flora in 100% of cases. The severity of disorders of gut flora was reliably (p < 0.05) associated with increased anxiety and worsening of the QL parameters. After a month course of treatment with the probiotic, the state of microbiota restored with an increase of the amounts of bifidobacteria and lactobacilli by 1.5 and 1.2 times, respectively, as compared with baseline values, there was reduction of the amounts of CPF comparable after treatment with the values in the control group. Against this background, the patients' psychoemotional status improved with a decrease of the levels of reactive and personal anxiety, normalization of mood. Conclusion. The use of the probiotic Bifiform enhances the clinical effectiveness of treatment of CGD from the positions of complex action on various pathogenetic links, contributes to correction of the endoecosystem of a macroorganism, normalization of the psychoemotional status and improvement of QL of patients, opens up new perspectives for optimization of treatment of children with CGD.