I.B. ROMASH1, V.H. MISHCHUK2, I.R. ROMASH3

1Department Propaedeutics of Internal Medicine, Ivano-Frankivsk National Medical University, Ukraine
2Department of General Practice (Family Medicine), Physical Rehabilitation and Sport Medicine, Ivano-Frankivsk National Medical University, Ukraine
3Department of Psychiatry, Narcology and Medical Psychology, Ivano-Frankivsk National Medical University, Ukraine.

SUMMARY
Introduction. According to the scientific data, UCTD is a premorbid background for the development of many pathological conditions and chronic diseases. The gastrointestinal tract is one of the systems that are exposed to it most often, and about 80% of the total number of this system diseases belong to the esophagus pathology, and, in particular, to gastroesophageal reflux disease (GERD).
Objectives. To study the changes of prostaglandins E2 and F2α levels in the blood serum of the patients with GERD associated with UCTD and in case of GERD only and their relation to the number, duration and frequency of esophagogastroduodenal refluxes.
Materials and methods. The Study included 120 patients underwent inpatient treatment of GERD. GERD developed on the background of UCTD syndrome in 75 patients (Group II) and no signs of connective tissue disease in case of GERD were noted in 45 patients (Group I). Each patient underwent a targeted search for visceral and phenotypic signs of UCTD syndrome. They were evaluated according to the criteria recommended by M. Moska et al, A. Doria et al, the criteria of T.I. Kadurina, L.N. Abakumova in the modification of T. Milkovska-Dimitrova, the scale by T.Yu. Smolnova, Beighton criteria. PGF2a and PGE2 indices were determined in all patients in the blood serum by enzyme immunoassay method.
Results. Functional disorders of esophagus have increasingly manifested in case of UCTD which was confirmed by our studies, according to which dysphagia was diagnosed more often by 24.8%, Raynaud’s phenomenon by 24.4%, and proximal muscle weakness by 21.8% in the patients with combined pathology. Acid refluxes were recorded more often by 33.4% and the mixed ones were noted by 21.6% more frequently in the examined patients with GERD and UCTD, and their duration was longer by 20 minutes. The obtained data on the level of prostaglandins in the blood indicated an increase in PG E2 level by 1.3 times in the patients with GERD and by 2.46 times in case of its combination with UCTD. At the same time, we observed a decrease in PG F2a level by 35.30% and 23.3%, respectively, and it decrease weakened the tone of LES.
Conclusions. Thus, GERD development associated with UCTD was manifested by more frequent GER, some manifestations of the latter (Raynaud’s phenomenon, proximal muscle weakness, etc.) complicating timely diagnosis, and the increase in the frequency and duration of acid and mixed reflux with combined pathology required the search for new methods of treatment. Changes in the level of prostaglandins capable of affecting the tone of the smooth muscles of the esophageal sphincter, enhancing or reducing the tolerance of its mucous membrane to damaging factors and affecting connective tissue metabolism, can be considered as one of the pathological links of the combined pathology development.
Keywords: gastroesophageal reflux disease; undifferentiated connective tissue disease; prostaglandin E2; prostaglandin F2α.

Lek obz (Med Horizon), 2020, 69 (2): 44 – 50