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Evaluation and diagnosis of the environmentally induced gastroduodenal disorders at children

Author: Adela Horodişteanu-Banuh
Degree:doctor of medicine
Speciality: 14.00.09 - Pediatrics
Scientific adviser: Ion Mihu
doctor habilitat, professor, Public Medical Sanitary Intitution Scientific Research Institute of Mother and Child Health Care
Scientific council:


The thesis was presented on the 26 December, 2006
Approved by NCAA on the 1 March, 2007


Adobe PDF document0.18 Mb / in romanian


CZU [616.33-002+616.33-002.44+616.342-002]-053.2-07:574

Adobe PDF document 1.69 Mb / in romanian
156 pages


drinking water, nitrates, levels of minerals, gastroduodenal pathology, Helicobacter pylori


The study presents the results of examination of 150 children from three rural localities from the Republic of Moldova (villages Copciac, Cotul-Morii and Valcinet), that differ by indices of the drinking water quality as measured by the minerals load, nitrates, microbial and other ecotoxins pollution degrees. The morbidity by gastroduodenal disorders have been correlated with the strength of water pollution indices, also the study revealed clinical and laboratory features of the gastroduodenal disease evolution in children from ecologically unfavourable areas.

The results of investigation revealed a significant percentage of gastroduodenal disorders among children who entered the study - 62,2% from the total of investigation. The analysis of the state of children’s health showed increased morbidity by gastric and duodenal pathologies at children in localities with high minerals and man-made pollutants load in the drinking water - 750‰, as compared to control locality – 562,4‰ (p< 0,05, t=2,08). Distribution of the morphological changes in the context of the gastroduodenal morbidity showed that inflammatory hyperplastic and erosive processes predominated in children from highly polluted regions, as compared to area with minimal level of drinking water pollution, where the leading position was hold by erythematous inflammation mainly at the gastric mucosa level (p<0,05, t=2,26).

Electronic microscopy of the gastric mucosa biopsy materials in cases gastroduodenal lesions revealed evident ultrastructural changes of the cellular elements in gastric and duodenal walls, manifested predominantly by degenerative processes. The interrelation between the Helicobacter pylori infection and certain clinical determinants of the gastroduodenal diseases and increased microbiological indices of the drinking water was demonstrated.

Evaluation of the SIgA in biologic secretions and of the sialic acids fractions emphasized the decrease in gastric mucus protective properties and unbalanced regulatory mechanisms of the secretion process. The mode and the intensity of micro- and macroelements (calcium, sodium, potassium, iron and magnesium) response for negative action of hydroecological factors vary largely, and each biological parameter taken separately reflects the adaptation capacity or metabolic adaptation failure of the child organism.

Relative and attributive risks of environmental and biological factors in development of gastrointestinal disorders were determined, which allow to make prognosis of morbidity level and to put intu the practice a preventive strategy.