SOVREMENNAYA PEDIATRIYA.2016.8(80):111-115; doi 10.15574/SP.2016.80.111 

Therapeutic intervention in children with gallbladder and sphincter of oddi dysfunction combined with iron deficiency

Marushko U. V., Nagorna K. I.

Bogomolets National Medical University, Kiev, Ukraine

Background. The significant prevalence rate of gallbladder and sphincter of Oddi dysfunction (GSOD) as well as latent iron deficiency (LID) in children in Ukraine, and undeveloped therapeutic tactics in combination of these conditions makes them an actual problem of modern pediatrics. Objectives: to study the efficiency of complex treatment including singlet-oxygen therapy (SOT) with choleretic herbs and combined iron supplementation a prospective study was conducted in 91 children of 9–17 years age with GSOD exacerbation and LID. Among them, 31 in addition to the conventional treatment used medical complex under study, 30 received combined iron supplementation, and 30 received conventional treatment. Methods the study of anamnesis, clinical examination, CBC, serum iron, TIBC indexes, percent transferrin saturation calculation, dynamic ultrasound cholecystography, follow-up for period of 12 months.

Results: the study found that the medical complex under study was the most effective in children with GSOD and LID as compared to using a combined ironsupplementation and traditional therapy. It provided a rapid regression of clinical symptoms, a normalization of biliary tract motor function, and a long-term clinical remission of GSOD.

Conclusion. Use of complex therapy including a combined iron supplementation, and SOT with choleretic herbs in children with GSOD and LID contributes to a rapid regression of disease acute phase clinical manifestations, a bile ducts motor-evacuation function normalization in 82.4%–87.75% of patients and reduces the frequency of relapse within a year at 65%.

Key words: children, gallbladder and sphincter of Oddi dysfunction, latent iron deficiency, singlet.oxygen therapy.

References

1. Bablyuk LA. 2010. Complex treatment chronic non-stone cholecystitis by extract of an artichoke and singletn-oxygen therapy: extended abstract of Cand. Scidissert. Ivano-frankivsk: 20.

2. Loranskaya ID. 2013. Functional disorders of the biliary tract. Moskow, Forte print: 92.

3. Unified clinical protocols of primary, secondary (specialized) medical care in iron deficiency anemia. Order of MOH Ukraine №709 of 02.11.2015: 46.

4. Unified clinical protocols of medical care for children with diseases of the digestive system. Order of MOH Ukraine №59 of 29.01.2013:196.

5. Shadrin OG, Hayduchyk GA. 2016. Problems of nutrition of infants and solutions. Ukrainian Medical Journal. 2(112); III/IV: 68-69.

6. De Andrade Cairo RC, Rodrigues Silva L, Carneiro Bustani N, Ferreira Marques CD. 2014, Jun 1. Iron deficiency anemia in adolescents; a literature review.Nutr Hosp. 29(6): 1240-9. doi 10.3305/nh.2014.29.6.7245. PMID: 24972460.

7. Queiroz DM Harris PR, Sanderson IR et al. 2013, Jul 4. Iron status and Helicobacter pylori infection in symptomatic children: an international multi-centered study. PLoS One. 8(7): e68833. doi 10.1371/ journal.pone.0068833. Print 2013.

8. Oral Iron for Anemia: A Review of the Clinical Effectiveness, Cost-effectiveness and Guidelines Rapid Response Report: Summary with Critical Appraisal [online].Canadian Agency for Drugs and Technologies in Health. 2016. https://www.cadth.ca/sites/default/files/pdf/htis/jan-2016/RC0735%20Oral%20Iron%20Final.pdf

9.Yokusoglu M, Nevruz O., Baysan O. 2007, Aug. The altered autonomic nervous system activity in iron deficiency anemia. Tohoku J Exp Med. 212(4): 397-402.https://doi.org/10.1620/tjem.212.397; PMid:17660705

10. Zariwala MG, Somavarapu S, Farnaud S. 2013, Dec. Comparison Study of Oral Iron Preparations Using a Human Intestinal Model. Sci Pharm. 81(4): 1123–1139.https://doi.org/10.3797/scipharm.1304-03; PMid:24482777 PMCid:PMC3867244