Chronic pathology of the gastroduodenal zone belongs to the multifactorial disorders with contributing role of both genetic and environmental factors, thus, realization of the genetic predisposition requires certain unfavourable external influences.

The aim of present study was to assess the role of the genetics and environmental factors in the development of various gastroduodenal disorders in children.

This clinical genealogic study included 83 families with children 6-11 years of age with chronic gastroduodenal disorders. Functional dyspepsia was diagnosed in 21 (25,3 %), gastritis and gastroduodenitis – in 43 (51,8 %) of children, destructive gastroduodenal disorders in 19 (22,9 %) of patients. The group of general population control included children from 45 families without any somatic diseases. In total, 524 relatives of children from the general population control and 1054 relatives from the children with gastroduodenal disorders were evaluated.

Among children with gastroduodenal disorders positive family history for the diseases of stomach and duodenum was reported in 55 cases (66,3 %). It is interesting that children with functional disorders predominantly had positive family history from the fathers’ side, while those with organic pathology – from the mother or both sides. In 14 families of children with functional dyspepsia (66,7 %) high prevalence of other functional disorders (except dyspepsia) such as irritable bowel syndrome, syndrome of autonomic dysfunction, syndrome of biliary dyskinesia, which is suggestive about the propensity for somatization. Somatoform autonomic disorder was diagnosed in 11 children with gastroduodenal disorders – in 5 children (23.8 %) with functional dyspepsia, 6 (14,0 %) with gastritis/gastroduodenitis and in none of the children with mucosal destruction. The coefficient of the inheritance for predisposition to the pathology of gastroduodenal zone (h2) in the study group for the first degree relatives was 22.4 % and 22.6 % for the relatives of the second degree. The highest predisposition inheritance coefficient was demonstrated for destructive gastroduodenal disorders, which is consistent with the D.S. Falconer model, stating that relatives of patients with more severe disease course are at higher risk. The inheritance coefficient among siblings was lower for all studied diseases of the gastroduodenal zone, which is suggestive about the threshold mechanisms for the realization of genetic predisposition for these diseases. To assess the contribution of genetic and environmental factors for the development of chronic gastroduodenal disorders in children the J.H. Edwards model was used. It was found that genetic factor contribute 57,4 % to the development of this pathology in children. The rest 42.6 % are attributed to environmental factors. The genetic factors play the most important role in the destructive diseases of stomach and duodenum (66,0 %), while in functional disorders the percentage of genetic factors is lower (46,8 %).

The most significant is the contribution of genetic factors in the formation of destructive forms of gastroduodenal diseases. In functional disorders dominated by environmental factors. The inheritance of predisposition to gastroduodenal pathology occurs through the threshold mechanism. That explains the increase of the frequency of this pathology in the lower generations, clinic polymorphism, the availability of various severity, course, prognosis of diseases in one family.

Keywords: gastroduodenal disorders, children, genetic and environmental factors

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