## 4 Discussion  
Regarding the hematological parameters, we point out the fact that the hemoglobin value is significantly lower in the GERD group as compared to in the control group (\(p=0.017\)). Our study indicates that at least two erythrocyte indices values are significantly affected, namely the mean corpuscular hemoglobin concentration and the mean corpuscular volume, which can indicate a tendency towards iron deficiency anemia. The MCHC's behavior is similar to that of the hematocrit, with the same decreasing tendency, even if the decrease is not statistically significant. In children diagnosed with GERD, anemia can be explained both by the bleeding occurring in peptic esophaggitis and nutritional deficiencies, as well as by the toxicity induced by the aluminum content of the antacid medication [16; 17]. In this case, the biological profile facilitates the diagnosis of a complicated evolution. Anemia can also be associated with the long-term administration of proton pump inhibitors, which represent the first-line therapy for GERD [18]. The study group included children diagnosed with GERD and no other conditions; therefore, the anemia was considered to be secondary to this disease. The white cell values are slightly higher in the GERD patients, yet this increase is not statistically significant, whereas the eosinophils have statistically significant higher values in the GERD patients as compared to in the control group. The literature in the field speaks about the association between GERD and cow's milk protein allergy (CMPA), especially because there are clinical characteristics common to both disorders, such as regurgitation and vomiting. Up to 56% of the children diagnosed with GERD can also present CMPA symptoms, while the prevalence of food allergies in GERD children can reach 43% [19; 20]. In this context, the higher eosinophil values indicated by our study can suggest an allergic component. At the same time, higher numbers of eosinophils can also represent a marker of eosinophil esophaggitis, especially when associated with other biomarkers, as suggested by relevant literature data [21; 22]. To what extent the symptoms of GERD are determined by eosinophilic esophaggitis is yet unknown. This is an \begin{table}
\begin{tabular}{c c c c c c c c c c} \hline  & **Mean** & **Std. Deviation** & **Std. Error Mean** & \(p\) **T0-3 m** & \(p\) **T0-6 m** & \(p\) **T0-9 m** & \(p\) **3-6 m** & \(p\) **3-9 m** & \(p\) **6-9 m** \\ \hline MCH & & & & 0.048 \({}^{*}\) & 0.219 & 0.000 \({}^{*}\) & 0.006 \({}^{*}\) & 0.001 \({}^{*}\) & 0.032 \({}^{*}\) \\ \hline T0 & 19.4100 & 2.27533 & 0.80445 & & & & & & \\
3 months & 17.0638 & 2.87639 & 1.01696 & & & & & & \\
6 months & 21.0600 & 4.17713 & 1.47684 & & & & & & \\
9 months & 25.2250 & 3.37229 & 1.19229 & & & & & & \\ \hline MCHC & & & & 0.009 \({}^{*}\) & 0.221 & 0.000 \({}^{*}\) & 0.021 \({}^{*}\) & 0.001 \({}^{*}\) & 0.000 \({}^{*}\) \\ \hline T0 & 28.9513 & 1.96599 & 0.69508 & & & & & & \\
3 months & 26.4838 & 3.80581 & 1.34556 & & & & & & \\
6 months & 29.8875 & 1.91047 & 0.67545 & & & & & & \\
9 months & 33.6313 & 0.89571 & 0.31668 & & & & & & \\ \hline Hb & & & & 0.033 \({}^{*}\) & 0.727 & 0.001 \({}^{*}\) & 0.059 & 0.001 \({}^{*}\) & 0.000 \({}^{*}\) \\ \hline T0 & 10.2613 & 0.66288 & 0.23436 & & & & & & \\
3 months & 9.6138 & 1.04352 & 0.36894 & & & & & & \\
6 months & 10.3588 & 0.69279 & 0.24494 & & & & & & \\
9 months & 12.0813 & 0.70070 & 0.24774 & & & & & & \\ \hline Ht & & & & 0.032 \({}^{*}\) & 0.135 & 0.000 \({}^{*}\) & 0.011 \({}^{*}\) & 0.000 \({}^{*}\) & 0.000 \({}^{*}\) \\ \hline T0 & 26.6763 & 2.14520 & 0.75844 & & & & & & \\
3 months & 25.4375 & 1.97425 & 0.69800 & & & & & & \\
6 months & 28.3263 & 1.38587 & 0.48998 & & & & & & \\
9 months & 32.6425 & 1.41130 & 0.49897 & & & & & & \\ \hline ESR, erythrocyte sedimentation rate; Ig, immunoglobulins; MCH, mean corpuscular hemoglobin; MCHC, mean corpuscular hemoglobin concentration; Hb, hemoglobin; Ht, hematocrit. & & & & & & \\ \end{tabular}
\end{table}