Diagnosis of Functional Gastrointestinal Disorders and Choice of Treatment Regimen in Constipation Patients

Aim. A practical review of functional gastrointestinal disorder diagnosis in constipation patients and the rationale for opting treatment.Key points. Functional constipation commonly afflicts different ages and negatively impacts the quality of life. The current diagnostic algorithm in chronic constipation includes the disease identification according to Rome Criteria IV, red-flag symptom detection and instrumental laboratory examination. Functional constipation is notably often associated with anorectal abnormalities that bear a diagnostic value to elaborate an apt treatment strategy. Anorectal manometry, rectal sensation and balloon expulsion tests are the well-studied and significant probing techniques for objective anorectal zone sensorimotor function assessment in patients with functional constipation. The article reviews modern diagnostic methods in functional defecation disorders.Conclusion. The examination and treatment algorithms presented will help improve diagnosis and apply the most suitable management in a constipation-associated functional digestive pathology

ЭФФЕКТИВНОСТЬ СОПРОВОДИТЕЛЬНОЙ ТЕРАПИИ АДЕМЕТИОНИНОМ (ГЕПТРАЛОМ) ПРИ ПРОВЕДЕНИИ ПРОТИВООПУХОЛЕВОЙ ЛЕКАРСТВЕННОЙ ТЕРАПИИ У БОЛЬНЫХ С ОНКОЛОГИЧЕСКИМИ ЗАБОЛЕВАНИЯМИ РАЗЛИЧНОЙ ЛОКАЛИЗАЦИИ

In the article are described literary given about the frequency, the mechanisms, the factors of the risk of hemotherapy-induced liver injury with conducting of antitumorigenic medicinal therapy for patients with different oncologic diseases. Is represented the substantiation and the clinical experience, which makes it possible to make a conclusion about the high efficiency of the use of ademethionin (Heptral) for overcoming this complication of polychemotherapy. Are represented the results of their own three-stage study, which make it possible to make a conclusion about the high frequency of hemotherapy-induced liver injury with conducting of polychemotherapy, the analysis of the significance of the number of the factors of the risk is carried out. It is proven that the accompanying therapy by ademethionin (Heptral) in the patients with the metastatic forms of cancer with the factors of risk of hemotherapy-induced liver injury contributes to the retention of the level of the syndromes of cholestasis and cytolysis at the levels, which make it possible in the majority of patients to continue the conducted treatment regimen of polychemotherapy.В статье описываются литературные данные о частоте, механизмах, факторах риска гепатотоксичности при проведении противоопухолевой лекарственной терапии у больных различными онкологическими заболеваниями. Представлено обоснование и клинический опыт, позволяющий сделать вывод о высокой эффективности использования адеметионина (Гептрала) для преодоления данного осложнения полихимиотерапии. Представлены результаты собственного трехэтапного исследования, позволяющие сделать вывод о высокой частоте гепатотоксичности при проведении полихимиотерапии; проведен анализ значимости ряда факторов риска. Доказано, что сопроводительная терапия адеметионином (Гептралом) у больных метастатическими формами рака с факторами риска ГТ способствует удержанию уровня синдромов холестаза и цитолиза, позволяющего у большинства больных продолжить проводимую схему полихимиотерапии

Postcholecystectomy syndrome

There are a lot of different views on the definition of postcholecystectomy syndrome. 4 major causes of complications after cholecystectomy are distinguished. Pathogenesis of digestive disorders associated with postcholecystectomy syndrome is proved to be a complex and multicomponent process, consisting of a number of interlinked and closely related pathogenic "rings". In case of absence of indications for surgical correction of the syndrome, prescription of combination of pancreatine in enterosoluble mini-microspheres and selective myotropic anti-spasmatic mebeverine is recommended as the optimal way of breaking the "vicious circle" described above

Prospects for the use of herbal medicine for liver diseases

Liver disease today is the number one digestive disease. According to WHO, there are more than 2 billion people with liver disease in the world, while in the CIS countries the registered number of people suffering from liver disease varies from 500 thousand to 1 million annually. Liver diseases with concomitant somatic, toxicological and surgical pathologies, along with viral hepatitis, are increasingly dominating the morbidity pattern

New Prospects of Cytoprotection in the Treatment and Prevention of Gastric and Intestinal Diseases (Resolution of an Expert Council and Literature Review)

Aim. To generalize up-to-date information on the possibilities of cytoprotection in the treatment and prevention of gastric and intestinal diseases, as well as to present the materials of an Expert Council meeting held on February 8, 2020 in Moscow under the support of the Alium company.General provisions. The conducted Expert Council meeting was aimed at discussing the importance of improving the cytoprotective properties of the gastric and intestinal mucous membrane in the treatment of its lesions. It was shown that Rebamipide exhibits positive effects on various parts of the protective barrier of the gastrointestinal tract (GIT), primarily due to its stimulating action on the production of prostaglandins playing a key role in maintaining the cytoprotective properties of the gastrointestinal mucosa. The possibilities of applying Rebamipide for the treatment and prevention of erosive and ulcerative gastrointestinal lesions caused by non-steroidal anti-inflammatory (NSAIDs) and antithrombotic drugs were demonstrated. In the treatment of gastroesophageal reflux disease, Rebamipide is recommended for patients refractory to therapy with proton pump inhibitors (PPIs) and for those with non-acid reflux. The efficacy of Rebamipide in the treatment of Helicobacter pylori (H. pylori) infection, as well as functional dyspepsia and chronic gastritis, was confirmed.Conclusions. Rebamipid is a highly effective drug positively affecting various cytoprotection links, thus being suitable for the treatment and prevention of erosive and ulcerative lesions of the gastrointestinal tract, as well as gastroenterological diseases of various etiologies.Conflict of interest: The Expert Council meeting was supported by the Alium company