Gastroesophageal reflux disease and risk factors in schoolchildren

Aim. To study the association between family predisposition to gastrointestinal diseases with gastroesophageal reflux disease (GERD) in schoolchildren in ethnic populations of Tuva.

Material and methods. A total of one thousand seventy nine children (761 Mongoloid-Tuvinian and 318 Caucasian) aged of 7–17 years in the Republic of Tyva were examined. Anamnestic data and information on gastrointestinal complaints in schoolchildren were obtained. The diagnostic criterion for GERD was complaints of weekly heartburn. Statistical analysis was performed using the Pearson chi-square test.

Results. GERD children more often had anamnestic data on gastritis (p = 0.025), gastric ulcer (p = 0.039) and oncological diseases of the gastrointestinal tract (p = 0.052) in parents. At the same time, schoolchildren of the indigenous population with GERD manifestations had greater unfavourable conditions for a number of diseases in parents: gastritis (p = 0.01), gastric ulcer (p = 0.012). Whereas in Caucasians, a similar association was not established. The association between GERD in schoolchildren and gastrointestinal pathology in grandparents (2^nd degree of kinship) also concerned only Tuvans in the presence of gastritis (p = 0.023). Summary data on family history of gastrointestinal diseases (1^st and 2^nd generation relatives) in GERD children, as expected, prevailed in Tuvans (gastritis (p = 0.004), peptic ulcer (p = 0.033) and specifically gastric ulcer (p = 0.02)). A more negative association between GERD in Tuvan children and a family predisposition to gastrointestinal diseases, in contrast to Caucasians, may be due to a higher prevalence of a number of gastrointestinal diseases in adults and is related with the functional features of the system, formed under the influence of the features of traditional life and nutrition.

Conclusion. In the Republic of Tyva, GERD in native schoolchildren is associated with a wide range of gastrointestinal diseases in relatives.

Contribution:
Polivanova T.V. — concept and design of the study, writing the text;
Polivanova T.V., Vshivkov V.A., Ahmetshin T.N. — data collection and processing;
Vshivkov V.A., Ahmetshin T.N. — statistical processing of the data;
Polivanova T.V., Vshivkov V.A. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: September 11, 2024
Accepted: October 08, 2024
Published: November 12, 2024

1. Maret-Ouda J., Markar S.R., Lagergren J. Gastroesophageal reflux disease: a review. JAMA. 2020; 324(24): 2536–47. https://doi.org/10.1001/jama.2020.21360

2. Nirwan J.S., Hasan S.S., Babar Z.U., Conway B.R., Ghori M.U. Global prevalence and risk factors of gastro-oesophageal reflux disease (GORD): systematic review with meta-analysis. Sci. Rep. 2020; 10(1): 5814. https://doi.org/10.1038/s41598-020-62795-1

3. Mousa H., Hassan M. Gastroesophageal reflux disease. Pediatr. Clin. North Am. 2017; 64(3): 487–505. https://doi.org/10.1016/j.pcl.2017.01.003

4. Polivanova T.V., Kasparov E.V., Vshivkov V.A. Age-related features of gastritis activity in schoolchildren with gastroesophageal reflux disease. Rossiyskiy pediatricheskiy zhurnal. 2022; 25(2): 116–20. https://doi.org/10.46563/1560-9561-2022-25-2-116-120 https://elibrary.ru/cmqpxj (in Russian)

5. Sintusek P., Mutalib M., Thapar N. Gastroesophageal reflux disease in children: what’s new right now? World J. Gastrointest. Endosc. 2023; 15(3): 84–102. https://doi.org/10.4253/wjge.v15.i3.84

6. Singendonk M., Goudswaard E., Langendam M., van Wijk M., van Etten-Jamaludin F., Benninga M., et al. Prevalence of gastroesophageal reflux disease symptoms in infants and children: a systematic review. J. Pediatr. Gastroenterol. Nutr. 2019; 68(6): 811–7. https://doi.org/10.1097/MPG.0000000000002280

7. Tack J., Pandolfino J.E. Pathophysiology of gastroesophageal reflux disease. Gastroenterology. 2018; 154(2): 277–88. https://doi.org/10.1053/j.gastro.2017.09.047

8. Axel E.M. Gastrointestinal cancer statistics. Sibirskiy onkologicheskiy zhurnal. 2017; 16(3): 5–11. https://doi.org/10.21294/1814-4861-2017-3-5-11 https://elibrary.ru/wofabw (in Russian)

9. Uhlenhopp D.J., Then E.O., Sunkara T., Gaduputi V. Epidemiology of esophageal cancer: update in global trends, etiology and risk factors. Clin. J. Gastroenterol. 2020; 13(6): 1010–21. https://doi.org/10.1007/s12328-020-01237-x

10. Tack J., Pandolfino J.E. Pathophysiology of gastroesophageal reflux disease. Gastroenterology. 2018; 154(2): 277–88. https://doi.org/10.1053/j.gastro.2017.09.047

11. Sherman P.M., Hassall E., Fagundes-Neto U., Gold B.D., Kato S., Koletzko S., et al. A global, evidence-based consensus on the definition of gastroesophageal reflux disease in the pediatric population. Am. J. Gastroenterol. 2009; 104(5): 1278–95. https://doi.org/10.1038/ajg.2009.129