American Journal of Technology and Applied Sciences ISSN (E): 2832-1766 Volume 22, March - 2024 P a g e | 7 www.americanjournal.org FEATURES OF THE ACID-FORMING FUNCTION OF THE STOMACH IN DUODENAL ULCER IN CHILDREN Ibatova Sh. M. Ruzikulov N. E. Samarkand State Medical University, Samarkand, Republic of Uzbekistan A B S T R A C T K E Y W O R D S According to the materials of foreign and domestic statistical studies, duodenal ulcer (duodenal ulcer) in children accounts for 81% of all cases of the disease, gastric ulcer is observed in 13% of cases, and combined localization - in 6% of cases. 30 children with duodenal ulcer aged 7-15 years were examined. The examined children were divided into two main groups: group 1 included 12 patients with duodenal ulcer during an exacerbation, group 2 included 8 patients with duodenal ulcer without exacerbation, and the control group included 10 children hospitalized with functional dyspepsia. An increase in acid-forming function was observed in two main groups, while it was significantly higher in the group of children with duodenal ulcer during the exacerbation period. Patients, duodenal ulcer, Helicobacter pylori, acid-forming function of the stomach. Introduction It is known that the development of gastric diseases of the stomach and duodenum in 40-60% of adults begins in childhood. The peak incidence occurs at the age of 10-16, boys and girls get sick with approximately the same frequency, and after the age of 10, boys get sick much more often. Despite the successes achieved in the study of the pathology of the digestive organs in children's practice, interest in it does not fade, due to the high prevalence, frequent complications and early disability, leading to a decrease in the quality of life of children [4,8,14,16,18]. According to the materials of foreign and domestic statistical studies, duodenal ulcer (duodenal ulcer) in children accounts for 81% of all cases of the disease, gastric ulcer is observed in 13% of cases, and combined localization - in 6% of cases [2,13,17]. In childhood, the pathology of the gastroduodenal zone has its own peculiarities of course, the disease is asymptomatic for a long time, this is often due to the fact that children usually do not pay attention to their health, and therefore complications often turn out to be the first clinical manifestation of the disease [11]. Violent acute attacks, rapid course and progression end in severe traumatic operations [1,5,7,9,11]. The role of hereditary burden is one of the main risk factors for the occurrence of duodenal ulcer; the disease is transmitted in an autosomal dominant or autosomal recessive manner, not linked to sex [3,6,10,15]. American Journal of Technology and Applied Sciences Volume 22, March - 2024 P a g e | 8 www.americanjournal.org In recent years there is no doubt about the etiological and pathogenetic role of Helicobacter pylori in the development of the ulcerative process, which contributed to the introduction of eradication therapy regimens and the widespread use of modern antisecretory drugs. Despite this, it has not yet been possible to resolve the issue of a complete cure of the ulcerative process. Most relapses and complications leading to chronization require careful study of the role of pepsin in various parts of the gastric tract and periods of acid formation, as this determines an individual approach to the treatment of such patients. The frequent use of nonsteroidal anti-inflammatory drugs prescribed by doctors for the treatment of various diseases is the most common cause of ulceration [12]. In connection with the above, we decided to determine the features of the acid-forming functions of the stomach in children with gastrointestinal pathology. THE PURPOSE OF THE STUDY To identify the features of the acid-forming function of the stomach in children with duodenal ulcer using intragastric pH-metry. MATERIALS AND METHODS OF RESEARCH 30 children with gastrointestinal tract pathology aged 7-15 years were studied at the Regional Children's Multidisciplinary Center in Samarkand. After analyzing the clinical data, the children were divided into two main groups: Group 1 included 12 patients with duodenal ulcer during exacerbation, group 2 included 8 children with duodenal ulcer outside exacerbation and the control group included 10 children hospitalized with functional dyspepsia who had the organic pathology of the gastroduodenal zone is excluded. In addition to routine examination methods, fibroesophagogastroduodenoscopy was determined in all children before treatment and after a course of eradication therapy. Diagnosis of Helicobacter pylori was determined in blood serum using the IgG test for Helicobacter pylori. The acid-forming function was studied by intragastric pH-metry, probes using the Gastroscan-AGM apparatus. At the same time, the average pH level in different parts of the stomach was evaluated, and the effectiveness of the acid-inhibiting effect of therapeutic drugs was determined, which is important in developing an optimal treatment course [3,4]. THE RESULTS AND THEIR DISCUSSIONS Burdened heredity both in acid-dependent diseases and in the general morbidity of the digestive system was found with the same frequency in children of 1-2 groups, in the control group - hereditary gastrointestinal burden was more common on the maternal side. When distributed by gender, there were 7 (39%) boys and 5 (41.6%) girls in the 1st group, 6 (33.3%) and 4 (33.4%) in the 2nd comparison group, respectively, and 5 in the control group (27.7%) boys and 3 (25%) girls. The average age of the surveyed was 12.5±3.8 years. It should be noted that the age-related shift in children with with duodenal ulcer was noted towards the older age of 12-15 years and more often in boys. According to the results of the severity of clinical symptoms, differences in pain and dyspeptic syndromes were not revealed in children with duodenal ulcer during and after exacerbation, 15.0 and American Journal of Technology and Applied Sciences Volume 22, March - 2024 P a g e | 9 www.americanjournal.org 65.0% of cases, respectively, and in children of the second group - 11.8 and 41.2% of cases, unlike the control group, where the brightness of symptoms was less pronounced. The results of fibrogastroduodenoscopy showed that the mucous membrane of the stomach and duodenum in the examined patients differed significantly, since visualization of the duodenum during fibrogastroduodenoscopy revealed significant changes in the 1st group of children in the form of erasive and ulcerative bulbitis in 83.3% of cases and in the 2nd group in 75%, in children of the control group no organic pathology of the gastroduodenal zone was revealed. According to our data, the average size of the ulcerative defect was 4.2±0.22 mm (from 1 to 1.5 mm), while single ulcers occurred on average in 80% of cases, and multiple ulcers in 35%. The duration of the ulcerative anamnesis was 2 times less in group 2, which indirectly indicates a more aggressive course in the first group. Helicobacter pylori was detected in 85% of patients in groups 1 and 2 and 20% in the control group. The secretory function of the stomach was impaired in 85% of patients with It should be noted that the age-related shift in children with with duodenal ulcer was noted towards the older age of 12-15 years and more often in boys and 30% in patients of the control group. An increase in acid-forming function was observed in two main groups, while it was significantly higher in the group of children with duodenal ulcer during the exacerbation period in 75% of cases. Clinical manifestations of hyperacidity were noted in children with duodenal ulcer during the exacerbation period (heartburn 25%, acid belching was in 41.6%, burning in the throat and chest was felt by 33.4% of children, in 25% of children with duodenal ulcer outside the exacerbation, these symptoms were less pronounced. However, in children with functional dyspepsia, this symptom was noted similarly to group 1, but less pronounced (heartburn 10%, acid belching was in 20%). When studying gastric acid, it was revealed that the level of gastric acidification in all patients had their own individual characteristics, which were to some extent related to circadian rhythms and eating habits. The secretion of gastric contents in patients with duodenal ulcer during the exacerbation period, compared with patients outside the exacerbation, was at a lower pH level from 0.9 to 1.6. CONCLUSIONS Our studies indicate that in patients with duodenal ulcer, regardless of the clinical variant of the disease, there is a violation of the acid-forming function of the stomach, the cause of which is such features as a family history of duodenal ulcer, carriage of Helicobacter pylori, prolonged asymptomatic course of the disease. Thus, the research results indicate that patients with pathology of the gastrointestinal tract, regardless of the clinical variant of the disease, They are characterized by a violation of the acid-forming function of the stomach, the cause of which is such features as a family history of gastric and duodenal ulcer and the carriage of Helicobacter pylori, prolonged asymptomatic course, non-compliance with the regime and improper nutrition of children. REFERENCES 1. Baranov A.A. Clinical and functional features of chronic gastroduodenitis in children from high- risk groups for the development of duodenal ulcer. Author's abstract. dis cand. honey. Sci. Perm 2006. P. 25. American Journal of Technology and Applied Sciences Volume 22, March - 2024 P a g e | 10 www.americanjournal.org 2. Belousov A.S., Shulga N.I. Peptic ulcer disease in children. Current issues in pediatrics and childhood surgery. Jubilee materials. scientific-practical conf. M 2002. pp. 7-9. 3. Islamova D.S., Gaffarov U.B., Ibatova Sh.M. Assessment of the nature of acid formation in children with duodenal ulcer and primary chronic gastroduodenitis using intragastric pH-metry // Problems of pediatric and pediatric surgery in the XXI century. Beshkek. –2014. P. 53. 4. Islamova D.S., Shadieva Kh.N., Togaev I.U., Ibatova Sh.M., Mamatkulova F.Kh. Complicated course of duodenal ulcer in children of senior school age: causes, diagnostic criteria. // Problems of biology and medicine, 2017, No2 (94) pp. 51-53. 5. Sh.M. Ibatova, F.Kh. Mamatkulova, N.B. Abdukadirova, H.M. Oblokulov, F.A. Achilova. The effectiveness of apricot oil in children with rickets. // Scientific and practical journal "Questions of science and education", Moscow, 2019, No. 27 (76), -Р.40-46. 6. Ibatova Sh. M., Mamatkulova F. Kh., Ruzikulov N.Y.The Clinical Picture of Acute Obstructive Bronchitis in Children and the Rationale for Immunomodulatory Therapy. International Journal of Current Research and Review. Vol 12 Issue 17. September 2020. - P.152-155. 7. Ibatova Sh. M., F. Kh. Mamatkulova, N. B. Abdukadirova, Yu. A. Rakhmonov, M. M. Kodirova. Risk Factors for Development of Broncho-Ostructive Syndrome in ISSN: 2776-0979, Volume 4, Issue 11, November, 2023 294 Children. International Journal of Current Research and Review. Vol 12. Issue 23 December 2020. -P. 3-6. 8. Ibatova Sh.M., Mamatkulova F.Kh., Rakhmonov Y.A., Shukurova D.B., Kodirova M.M. Assessment of the Effectiveness of Treatment of Rachit in Children by GasLiquid Chromatography. International Journal of Current Research and Review. Vol 13, Issue 06, 20 March 2021. -P.64-66. 9. Sh.M. Ibatova, F.Kh. Mamatkulova, D.S. Islamova. Efficiency of combined application of apricot oil and aevit as a regulator of lipase activity of blood serum in children with vitamin D-deficiency rickets. Journal of Сritical Reviews. // ISSN2394-5125. VOL 7, ISSUE 11, 2020. P.1266-1274. 10. Ibatova Sh.M., D.T.Rabbimova, E.S.Mamutova, N.B.Abdukadirova, M.M.Kadirova. Gas- chromatographic appraisal of aplication of apricot oil and aevit in complex therapy of vitamin D- deficiency rickets in children. International Scientific Journal Theoretical &Applied Science, 24.04.2019 , Philadelphia, USA, Р.333-336. 11. Sh.M. Ibatova, N.Q. Muhamadiev, Sh.O. Axmedov, S.N. Muhamadieva Improvement of Vitamin D-deficient rachitis treatment in children International Journal of Medicine & Health Research. - 2015. - V.1. - N 1. - P. 1-5. 12. Ibatova Sh. et al. (2018). Correction of some lipid metabolism in children with rickets by the combined use of apricot oil and aevita. " Proceedings of the XXXIV International Scientific and Practical Internet Conference "Trends and Prospects for the Development of Science and Education in the Context of Globalization". Collection of scientific papers Pereyaslav-Khmelnitsky, 2018. -Р.589- 593. 13. Ibatova Sh. M., Mamatkulova F. Kh., Ruzikulov N.Y.The Clinical Picture of Acute Obstructive Bronchitis in Children and the Rationale for Immunomodulatory Therapy. International Journal of Current Research and Review. Vol 12 Issue 17. September 2020. - P.152-155. 14. Ibatova Sh. M., F. Kh. Mamatkulova, N. B. Abdukadirova, Yu. A. Rakhmonov, M. M. Kodirova. Risk Factors for Development of Broncho-Ostructive Syndrome in Children. International Journal of Current Research and Review. Vol 12. Issue 23 December 2020.-P. 3-6. American Journal of Technology and Applied Sciences Volume 22, March - 2024 P a g e | 11 www.americanjournal.org 15. Ibatova Sh.M., Mamatkulova F.Kh., Rakhmonov Y.A., Shukurova D.B., Kodirova M.M. Assessment of the Effectiveness of Treatment of Rachit in Children by GasLiquid Chromatography. International Journal of Current Research and Review. Vol 13, Issue 06, 20 March 2021. P.64-66. 16. Sh.M. Ibatova, F.Kh. Mamatkulova, D.S. Islamova. Efficiency of combined application of apricot oil and aevit as a regulator of lipase activity of blood serum ISSN: 2776-0979, Volume 4, Issue 11, November, 2023 295 in children with vitamin D-deficiency rickets. Journal of Сritical Reviews. // ISSN2394-5125. VOL 7, ISSUE 11, 2020. P.1266-1274. 17. Ibatova Sh.M., Baratova R.Sh., Mamatkulova F.Kh., Ergashev A.Kh. State of immunity in chronic obstructive pulmonary disease in children. Asian Journal of Multidimensional Research (AJMR). Vol.10, Issue 3, March, 2021. P. 132-136. 18. Sh.M. Ibatova, F.Kh. Mamatkulova, N.Y. Ruzikulov, Yu.A. Rakhmonov. Bronchoo structive syndrome in children: prevalence and difficulties of differential diagnostics. ACADEMICIA: An International Multidisciplinary Research Journal 2021, P. 87-92.