Gastroenterology

(Probiotics in the treatment of irritable bowel syndrome: a tribute to tradition or a necessity?)

Targeted action and prolongation of the course of therapy to 8–12 weeks are considered as the main principles for prescribing probiotics for IBS, which allows increasing the effectiveness of therapy for patients. From this standpoint, the probiotic strain Bifidobacterium longum 35624® (Symbiosis Alflorex) with high proven efficacy and safety in the treatment of patients with IBS is of particular interest.

(The use of natural mineral water “Donat” for functional constipation and constipation in comorbid patients)

A comparison of the effectiveness of the three mineral waters studied showed that Donat mineral water is the most effective. The results of a randomized clinical trial of Donat mineral water in the treatment of functional constipation, as well as the experience of its use in domestic studies that demonstrated the effectiveness and safety of Donat medicinal mineral water in pediatric practice and in adult patients with functional constipation are discussed in detail. The characteristics of natural mineral water Donat allow to consider it as the first choice for the treatment of constipation in certain categories of comorbid patients. The rationale for the use of Donat mineral water for the treatment of constipation in patients with concomitant periodontal diseases and for the treatment of drug-induced constipation caused by the use of proton pump inhibitors is presented.

(The role of glutamine in the treatment of severe acute pancreatitis)

In later stages, the cause of mortality is sepsis following parapancreatic infection, intestinal barrier damage and translocation of pathogenic microbes and their toxins through the intestinal wall into the blood and lymph. Glutamine restores function of enterocytes and gastrointestinal tract, as well as reduces manifestations of systemic inflammatory response, incidence of infectious complications and risk of mortality in patients with severe acute pancreatitis.

(Baby colic: sides of the problem)

It elaborates on the causative factors for infantile colic, as well as a number of refined pathogenetic mechanisms. Special attention is given to therapeutic strategies, both traditionally accepted and those based on the principles of evidence-based medicine. The experience of using prebiotics and probiotics, as well as special formulas with modified protein, carbohydrate and fat composition, enriched with galacto- and fructo-oligosaccharides, is reviewed in detail.

(Chronic colonic stasis: some aspects diagnosis and treatment)

It has been established that in the diagnosis of chronic colonic stasis there are a number of diffi culties, for the solution of which it is necessary to use a complex of various methods of instrumental diagnostics. The views on conservative treatment and approaches to the choice of surgical treatment option for CCS are highlighted. Literature data indicate that the most accurate indications for the use of conservative or surgical methods of treatment have not yet been established, and criteria for selecting patients have not been established.

(Role of increased intestinal permeability in the development and progression of liver diseases)

At the same time, more and more information is accumulating on the effect of “leaky gut” on the occurrence and progression of liver diseases. This article presents a literature review of recent materials on the relationship between the intestine and the liver through the phenomenon of “leaky gut” and new potential points for therapeutic intervention.

(The spectrum of antral phenotype metaplasia of stomach body mucosa: what do we know so far? (literature review))

This review of the literature is devoted to a comprehensive review of pyloric, pseudopyloric metaplasia, as well as metaplasia with expression of antispasmodic polypeptide from the point of view of biological role, pathogenesis, diagnosis and prognostic aspect. Pyloric metaplasia is positioned as a probable precursor of incomplete intestinal metaplasia, and is realised through several development mechanisms, depending on which the probability of developing intestinal cancer varies.

(Modern methods of assessing the viability of the intestinal wall (literature review))

Results: despite recent advances in scientific methods and technologies, currently the visual method remains the most popular for assessing the viability of the intestinal wall, which includes parameters such as color of the intestinal wall, peristalsis, and arterial pulsation.

Conclusion: it would be fair to conclude that such methods as hyperspectral imaging, multimodal coherent tomography provide greater flexibility and details on the intestinal viability. However, further research is needed to determine their value in clinical practice. To the date, the most studied and applied method is fluorescent angiography, which allows to assess the viability of the intestine for most of its length.

Juvenile polyposis syndrome (literature review))

Only in 40-60% of cases, pathogenic variants of the SMAD4 and BMPR1A genes can be identified, each of which is characterized with its own clinical manifestations. Treatment options for patients with JPS include endoscopic and surgical; however, the decision-making algorithm, as well as the timing of postoperative follow-up, are not evaluated in Russian clinical guidelines. The rare occurrence of this syndrome, difficulties in endoscopic diagnosis and morphological verification, as well as limitations in determining the molecular genetics cause of the disease demonstrate the need for further research.

(Physical exercises as an effective adjuvant therapy of IBD in remission (literature review))

In this regard, a search is underway for additional tools to increase the frequency of achieving and maintaining remission. There is recent evidence that exercise induces a cascade of anti-inflammatory cytokines, specifically triggered by an exponential increase in muscle interleukin 6, and with regular exercise during remission may reduce basal levels of circulating inflammatory markers and potentially reduce chronic inflammation in IBD. Doctor’s recommendations for physical activity during remission can be effective as an additional component of anti-relapse treatment.

(Functional heartburn: problems of diagnosis and treatment)/strong>

The disease is often associated with anxiety and depressive disorders, the growth of which has been noted recently, which requires timely diagnosis and correction of these conditions. Visceral hypersensitivity is a key part of the pathophysiology of functional heartburn, and psychosocial factors influence interactions between the gastrointestinal nervous system and the brain, which determines the severity of symptoms in patients. Doctors are recommended to tell patients in detail about the essence of the diagnosis, directions in possible effective treatment, for better adherence to therapy, the use of antidepressants, cognitive behavioral therapy, hypnotherapy and relaxation methods is recommended.

At the moment, the standard for the diagnosis of functional heartburn is pH-impedance measurement, with the primary exception of organic pathology during endoscopic examination of the esophagus with biopsy and histological examination, and the exclusion of esophageal motility disorders during manometry. Non-invasive, affordable and cost-effective diagnostic tools are needed to avoid overdiagnosis of gastroesophageal reflux disease and improper use of proton pump inhibitors, saliva pepsin examination and dental examination are promising. Objective. The purpose of the review is to summarize the existing research data on the prevalence of functional heartburn, the influence of psychological factors on its course, and current methods of diagnosis and treatment of this pathology. In order to identify studies on the problems of diagnosis and treatment of functional heartburn, a literature search was conducted in the PubMed and eLibrary databases until November 2023, original articles, meta-analyses and relevant reviews were reviewed.

(Modern approaches to surgical treatment of mechanical injuries of the esophagus)

In the practice of surgery for esophageal injuries, minimally invasive technologies are becoming increasingly common, including endovideosurgical and oral endoscopic interventions. A special place in this is occupied by endoscopic vacuum therapy, which results have been sufficiently studied in the treatment of complications of gastrointestinal surgery. At the same time, the use of this technology in patients with mechanical damage to the esophagus is limited to small series of observations, which requires further study.

(The effect of SARS-CoV-2 on the gut and its microbiome: what we know and what we would like to know)

(The use of melatonin in the treatment of irritable bowel syndrome: a systematic review of randomized placebo-controlled clinical trials)

Results. The inclusion criteria were met by four randomized placebo-controlled trials, totaling 155 participants, and these trials were included in the subsequent analysis. All investigations revealed a considerable reduction in the frequency and severity of bloating, as well as a tendency for other intestinal symptoms to regress. Two trials reported an improvement in patients’ quality of life, albeit one of the studies did not find these changes to be statistically significant, and the other did not assess them. This review demonstrates that melatonin is effective in treating IBS by lowering the frequency and severity of the condition’s symptoms in the vast majority of published RCTs. The poor number and sample size of clinical trials, along with their inadequate methodological quality, prevent us from drawing any firm conclusions about the contribution of melatonin to the improvement of IBS patients’ quality of life. To confirm melatonin’s significance in the treatment of IBS patients, larger studies are required to assess its efficacy and safety when used in various doses.

(Chronic kidney disease and non-alcoholic fatty liver disease – new pathogenetic links)

(Neurogenic-genetic theory of etiology peptic ulcer disease)

(Refractory non-erosive reflux disease: characteristics of pathogenesis, diagnosis and treatment)

(Dietary aspects in the treatment of inflammatory bowel disease)