Diagnosis and Treatment of Peptic Ulcer in Adults (Clinical Guidelines of the Russian Gastroenterological Association, Russian Society of Colorectal Surgeons and the Russian Endoscopic Society)

Aim. These clinical recommendations present up-to-date methods for the diagnosis and treatment of peptic ulcer. The recommendations are intended for gastroenterologists and general practitioners.General provisions. Peptic ulcer (PU) represents a chronic relapsing disease occurring with alternating periods of exacerbation and remission. The main manifestation of the disease is the formation of a defect (ulcer) in the wall of the stomach and duodenum. Most cases of peptic ulcer are pathogenetically associated with the infection of H. pylori. PU can be an independent disease or represent symptomatic ulcers of the stomach and duodenum (medicinal, as a result of stress or endocrine pathologies, associated with chronic diseases of internal organs). In the absence of contraindications, esophagogastroduodenoscopy is recommended for all patients with suspected ulcer with the purpose of confirming the diagnosis. In order to determine indications for eradication therapy, all ulcer patients should be tested for the presence of H. pylori using a 13C-breath test or a stool antigen test. In the case of simultaneous endoscopy, rapid urease test can be used. For the prevention of subsequent relapses of ulcer, all PU patients with confirmed H. pylori should undergo eradication therapy. In addition, in order to achieve ulcer healing, 4–6 week antisecretory therapy with proton pump inhibitors is recommended. Clinical recommendations contain criteria for assessing the quality of medical care, an algorithm of the doctor’s actions, as well as information for patients.Conclusions. These clinical recommendations present modern ideas about the etiology and pathogenesis of peptic ulcer disease, its clinical manifestations, methods of laboratory and instrumental diagnostics and basic approaches to conservative and surgical treatment

НЕКОТОРЫЕ ИННОВАЦИОННЫЕ ПОДХОДЫ К ПОДДЕРЖАНИЮ АДАПТИВНОГО ОТВЕТА ОРГАНИЗМА ПРИ СТРЕССОВЫХ НАГРУЗКАХ

The paper presents data on the development of complex means, which increase the power of the adaptive response of the organism under stress and pathological conditions. This complex includes dietary supplements based on natural metabolites with pronounced antihypoxic activity, perfluorocarbon drugs for improving the oxygen regime of tissues, and effective immunomodulators based on sodium aminodihydrophthalazinedione and the neurotransmitter oligopeptide with increased stability. Their application is promising in the healthcare and in the military medicine. They provide an increase in efficiency, acceleration of recovery processes, increasing the body’s resistance to extreme loads, intoxications, infections, various types of tissue damage.В работе представлен материал по разработке комплекса средств, увеличивающих силу адаптивного ответа организма при стрессовых и патологических воздействиях. В этот комплекс входят БАД на основе естественных метаболитов, обладающих выраженной противогипоксической активностью, перфторуглеродные лекарственные средства для улучшения кислородного режима тканей и эффективные иммуномодуляторы с повышенной стабильностью на основе аминодигидрофталазиндион натрия и нейромедиаторного олигопептида. Использование представляемых средств перспективно в здравоохранении, и военной медицине для повышения работоспособности, ускорения восстановительных процессов, повышения устойчивости к экстремальным нагрузкам, интоксикациям, инфекциям, различным видам повреждений тканей.</p