Preventive measures in school-age children with gastoroenterological pathology


  • D.V. Melnyk Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine,



виразкова хвороба дванадцятипалої кишки в дітей, первинна профілактика, лікар загальної практики — сімейний лікар


Background. The prevalence of peptic ulcer is 1.7–16 % in the structure of the digestive pathology. The prevalence of peptic ulcer among the children in Ukraine is 0.4–4.3 %. The peak time of morbidity is 9–11 years of age for girls and 12–14 years for boys. A hereditary predisposition for peptic ulcer occurs in 45–75 % of patients. The purpose of the study is to determine the need to implement a reduced morbidity strategy, taking into account the occurrence of risk factors and adverse course of duodenal ulcer in children. Materials and methods. The methods of systemic analysis, comparison, organizational experiment, ma­thematical and descriptive modeling were used to develop a targeted program for the prevention of duodenal ulcer disease in school-age children at the primary health care level. Results. The study investigated the main risk factors for duodenal ulcer in school-age children, namely: sex, age, blood type, Helicobacter pylori presence; concomitant pathology; psychoemotional di­sorders; inefficient nutrition with a regime violation; burdened heredity; tobacco smoking; self-treatment, etc. The innovative elements of improved primary prevention of duodenal ulcer in school-age children, first of all, were: the involvement of general practitioners — family doctors to timely identify risk factors and adverse course of the disease (in particular, diagnosis of Helicobacter pylori). General practitioners — family doctors involvement acquires special significance in the surveillance system of the population with risk factors. Stratification is carried out to the groups of dynamic monitoring of the risks system and their monitoring, that is, the expansion and improvement of prevention tasks is envi­saged, and modern trends in the systemic approach for preven­ting duodenal ulcer and its negative consequences are provided. Development, improvement and compliance with local protocols for managing school-age children with a duodenal ulcer are important at all levels. At the same time, the special attention is paid to the set of primary prevention measures, including a wide range of medical and social influence at the population level. Conclusions. The conceptually proposed model for the prevention of duodenal ulcer in school-age children is focused, first of all, on the practice of a general practitioner — family doctor, in close cooperation with gastroenterologist, primary care physician on the principles of family medicine, provides a comprehensive, holistic, continuous and accessible medical care for children, and includes the priority of preventive principles and coordination of efforts of all the concerned parties in the health care system.


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General practice - family medicine