Clinical Gastroenterological Manifestations as Criteria for the Pathology and Effectiveness of Surgical Correction of Reflux Disease of the Digestive System

All patients with reflux disease (RB) complained of abdominal pain, of which 57% of the pain were diffuse, in 7% of patients the pain was localized in the right iliac region, in 3% in the right hypochondrium, in 2% in the left iliac region, in 4% - in the left and right iliac regions, in 9% - in the right iliac and right hypochondrium regions, in 16% - in the right and left hypochondrium regions, in 2% - in the left hypochondrium and left iliac regions.

In addition to abdominal pain, patients with RB were worried about other complaints typical of gastrointestinal pathology: - 95% of patients noted rumbling in the abdomen, - 79% - bloating, - 71% - constipation, - 65% - diarrhea, - 86% - loosening of the chair, - 88% - feeling of heaviness in the abdomen after eating, - 83% - nausea, - 87% - belching with air, - 95% - bitterness in the mouth, - 79% - bad breath, - 55% - intolerance to milk and other food.

Rapid fatigue occurred in 92% of patients, and in 58% weight loss. In addition to complaints of a gastroenterocolitic nature, 65% of patients noted increased heart rate, 72% - dizziness, 66% - frequent colds (acute respiratory infections, flu, tonsillitis).

Analyzing the clinical manifestations of gastroenterocolitic nature in patients suffering from PUD, PU 12 PK, BA, dermatoses, we can conclude that these complaints are also found in the overwhelming majority of these groups of patients (Table 1).

Thus, patients with NBZ and CNDP, as well as patients with gastric ulcer and duodenal ulcer, bronchial asthma, dermatoses present numerous complaints of the same type of gastroenterocolitic nature, which suggests that this group of patients has a single etiopathogenesis of these pathological manifestations. This category of patients underwent different volumes of operations: bauginoplasty (BP), bauginoplasty in combination with dissection of Treitz's ligament (BP + PCT), bauginoplasty in combination with duodenojejunostya (BP + DES) - Table 2.

Analyzing the clinical manifestations before and after surgery, one can note a sharp regression of gastroenterocolitic complaints (Table 2). The identified set of complaints depends on the condition of the small and large intestine. Improvement of the condition of patients after PD, PD + PCT, PD + DES confirms the main role of PD in the elimination of this symptom complex. The number of patients who stopped noticing these pathological manifestations increased from 2 to 11 times, depending on various symptoms.

Nevertheless, in a significant number of cases, clinical signs of CNDP remain in patients who underwent only bauginoplasty or bauginoplasty with PCT. So, after such volumes of surgical aid, the severity in the abdomen remained in 26% and 25% of patients, respectively, for the indicated operations, nausea - in 18% and 21%, belching - in 35% and 38%, regurgitation - in 13% and 21%, heartburn - 38% and 50%. Surgical aid in the form of bauginoplasty and duodenojejunostomy turned out to be much more adequate in eliminating the clinical manifestations of CPDP. So, the heaviness in the abdomen after eating remained only in 12% of patients, nausea - in 12%, belching - in 12%, regurgitation - in 5%, heartburn - in 12%.

Thus, the presence of numerous gastroenterocolitic complaints in patients with proven NBZ and CNDP and a sharp regression of these complaints after surgical correction of NBZ and CNDP allows us to conclude that the causes of these pathological manifestations are the failure of the Bauginia valve and chronic violation of duodenal patency, and the most adequate bauginoplasty with simultaneous duodenojejunostomy is a surgical tool for eliminating clinical manifestations of reflux disease.