Effects of the Thyroid Status Correction on the Functional State of Digestive System in Children with Diffuse Nontoxic Goiter

Abstract

Objective: to study the effects of the diffuse non-toxic goiter treatment on the functional state of the digestive system in children. Materials and methods. The screening survey was based on lunior comprehensive schools (695 children aged 5–11 years): questioning of families, anthropometry and examination of children, detection of ioduria, palpation of the thyroid gland. In-depth examination of children with goiter (n = 88): ultrasonography of the thyroid gland and the digestive system, determination of levels of thyroid stimulating hormone, free thyroxine, serotonin, melatonin, vasoactive intestinal peptide. Results. The high incidence of non-toxic diffuse goiter (25.8 %), associated with a reduction in functional activity of the thyroid gland to the minimum thyroid dysfunction (42.0 %) and subclinical hypothyroidism (10.2 %), was detected in school-aged children. The presence of goiter leads to a static increase of the chances for functional gastrointestinal disorders developing (odds ratio 2.33, p = 0.000), mainly due to the hypokinetic conditions. The administration of potassium iodide preparations leads to the decreasing in goiter rate in high compliance up to the 27.3 % and to the normalization of the functional state of the pituitary-thyroid system (thyroid stimulating hormone — 1.66 mIU/L), that is associated with increased level of serotonin (6.14 ng/ml) and vasoactive intestinal peptide (117.86 ng/ml) and decreased melatonin concentration (2.5 pmol/l). In children who consistently for six months received preparations of potassium iodide, along with the normalization of thyroid status we noted the decrease of the frequency of complaints from the digestive system. Conclusions. The treatment of diffuse nontoxic goiter by potassium iodide preparations allows to achieve reduction of thyroid size and to normalize functional activity of thyroid-pituitary system. Increase in the functional activity of the pituitary-thyroid system helps reduce the frequency of gastrointestinal complaints. Optimization of thyroid synthesis is accompanied by increased levels of serotonin and vasoactive intestinal peptide, decreased production of melatonin.

Keywords

• goiter
• pituitary-thyroid system
• functional gastrointestinal disorders
• children