Modern problems of treatment of Helicobacter-associated diseases in children: opportunities of adjuvant therapy

Background. The relevance of research is related to a significant spread of the pathology of the upper digestive tract in children, which in most cases is caused by the pathogenic effect of Helicobacter pylori (Hp). Modern eradication strategies require adjuvant therapy. The aim of the study was to evaluate the clinical effectiveness of the Lactiale symbiotic as an adjuvant therapy for eradication schemes in children of different ages with the pathology of the upper digestive canal. Materials and methods. Seventy children with Hp-associated pathology of the upper digestive tract aged 5 to 18 years were under observation. Patients were divided into 2 groups depending on the use of the symbiotic. The diagnosis was verified using fibrogastroscopy, endoscopic pH-metry, determination of Hp-infection, morphological examination. The results were statistically processed. Results. The results of using Lactiale symbiotic in patients of group 1 as an adjuvant therapy for standard pediatric Hp eradication schemes suggest the expediency and high effectiveness of such treatment. The dynamics of complaints, absence of side effects and good tolerabi-lity of drugs against the background of reception of a symbiotic were positive. The increase in eradication efficiency by 10 % compared with standard schemes corresponds to the results of other studies. The positive influence of the symbiotic on the processes of qualitative healing of ulcers and a significant increase in anti-inflammatory effect in patients of the main subgroup with peptic ulcer of the duodenum was determined. The low result of eradication, obtained in patients with functional disorders, can be considered predictable. This is evidenced by the latest conciliatory conclusions of experts: the effectiveness of eradication in patients with functional dyspepsia does not exceed 15–30 %. Conclusions. The use of the Lactiale symbio-tic as an adjuvant therapy for eradication schemes in children of different ages with Hp-associated pathology of the upper digestive tract is advisable, significantly increases the effectiveness of eradication, improves the tolerability of drugs, adhe-rence of patients to the treatment

Possibilities for the correction of functional disorders of the biliary tract and parasitic infestations in young children using the plant complex Vormil Phyto

Recently, there has been a significant growth in parasitic invasions among young children. At a younger age, parasitic infestations most often occur “under the mask” of gastroenterological pathology. At this age range, according to the domestic and world literature, functional diseases prevail. In May 2016, at the week of American gastroenterology, the Rome criteria IV were adopted. According to the the Rome criteria IV, as well as in the previous editions, it is suggested to prescribe therapy on the basis of the predominant symptom principle, giving preference to so-called complementary and alternative medicine, and, in particular, phytotherapy as additional therapy for the disease, but all also from the standpoint of evidence. The first such combined phytocomplex, which attracted interest from clinical researchers and patients, is Vormil Phyto — a mix of extracts of thirteen plants. The purpose of our research was the improvement of therapeutic approaches to the correction of the combined functional pathology of the biliary tract and parasitic invasion, as well as unassociated pathology of the biliary tract using phytocomplex Vormil Phyto in the main treatment regimens. Sixty children were divided into three groups: the first group with combined functional disorder of the biliary tract and parasitic infestation; the second group with a functional biliary tract disorder, received the phytocomplex Vormil Phyto; the third group with a functional biliary tract disorder, received traditional therapy. In the course of the research, data were obtained that indicate the effectiveness of the phytocomplex Vormil Phyto, which has not only an antihelmintic effect, but also normalizes the kinetics of the biliary tract that improves appetite rapidly and does not induce dyspeptic symptoms at earlier terms

Functional disorders of the biliary tract in children: issues of diagnosis and correction from the position of the Rome IV criteria

More than 80 % of children with digestive system di­seases have various disorders of the hepatobiliary system. Given the fact that in the pediatric population, abnormalities or structural features of the bile ducts and gallbladder are being detected more often, it is recommended to differentiate dyskinesias by functional state of the biliary system — hypomotor (hypokinetic) and hypermotor (hyperkinetic). According to many authors, the most common children’s form is hypermotor (hyperkinetic) dyskinesia. Violations of synchronization in the work of the gastrointestinal tract and sphincter apparatus underlie the functional disorders of the biliary tract (FDBT) and are the cause of clinical symptoms. To date, there are general non-drug and drug-based approaches to the treatment of FDBT and algorithms recommended in Rome IV criteria. Pharmacotherapy should be aimed at relieving smooth muscle spasm and restoring motor activity of the gallbladder, as well as at normali­zing the rheological properties of the bile. Given the above relevance of therapy for FDBT, our attention was attracted by the combined dietary supplement of Viador syrup. The aim of our study was to modify therapeutic approaches to the correction of the functional pathology of the biliary tract and the feasibility of using the combined Viador phytopreparation in the main treatment regimens. This research confirmed the therapeutic efficacy of the combined herbal remedy Viador which has a number of useful qualities differentiating it among other herbal preparations whose effectiveness has been proven by positive clinical dynamics, additional research methods. That allows you to widely use it in the treatment of FDBT

Optimization of eradication treatment for chronic gastroduodenitis associated with Helicobacter pylori in children using spore recombinant probiotic based on Bacillus subtilis

Background. The relevance is associated with a significant spread of Helicobacter pylori (Hp) in children in Ukraine. Chronic gastroduodenitis is the main nosology in children associated with Hp, which requires comprehensive treatment, first of all eradication one. To optimize the effective use of eradication schemes, current international recommendations provide for the possibility of prescribing probiotics. The purpose of the study was to evaluate the influence of Subalin probiotic on eradication efficacy and tolerability of anti-Helicobacter therapy in children aged 12–18 years with Hp-positive chronic gastroduodenitis. Materials and methods. Design: a single-center open comparative study. The study included 50 children with Hp-associated chronic gastroduodenitis aged 12 to 18 years. Patients are divided into 2 groups depending on the probiotic administration. The diagnosis was verified using fibrogastroscopy, endoscopic pH-metry, determination of Hp infection. The results were recorded in a specially developed individual patient’s chart and statistically processed. Results. The results of using Subalin probiotic in patients of the main group concomitantly with the standard first-line pediatric schemes of Hp eradication in children and adolescents with Hp-positive forms of chronic gastroduodenitis indicate the advisability, effectiveness and prospects of such treatment. This is confirmed by the positive dynamics of complaints, the absence of side effects (including antibiotic-associated diarrhea), and good tolerability of drugs in triple or quadruple therapy regimens against the background of recei­ving spore recombinant probiotic in the vast majority of patients. Patients from the comparison group also had a positive dynamics in the main complaints, but less pronounced. However, the worsening of tolerability and side effects from standard eradication schemes were significantly more frequent (on average 35–40 %) compared with main group. In addition, administration of Subalin increases by 5 % the efficiency of eradication of standard first-line anti-Hp regimens. Conclusions. The use of spore recombinant probiotic Subalin together with standard eradication schemes in children from 12 years of age is advisable, since it allows increasing the eradication efficiency by 5 %, improving the tolerability of anti-Hp drugs and, accordingly, the adherence of patients to the treatment and recommendations. The possibi­lity of using Bacillus subtilis already at the first stage of treatment helps to optimize therapeutic measures in older children with Hp-positive variants of chronic gastroduodenitis

Diarrhea in young children: clinical picture, diagnosis, principles of therapy

Many diseases in infants and young children are accompanied by the development of diarrheal syndrome. As a result, there are organic lesions and functional disorders in the intestine. It is well known fact that 1.4 billion children under 5 years in the world suffer from acute diarrhea, and 123 million of them are forced to seek medical help urgently, 9 million require inpatient care, and 1.8 million children die from dehydration. In this connection, the choice of therapeutic regimen remains urgent. Medications that slow intestinal motility (loperamide) are contraindicated in acute diarrhea in children, since the risk of side effects including ileus, drowsiness, nausea (mortality to 1 %) is high. Probiotics are living microbial drugs commonly used to prevent acute diarrhea. A large number of researches have been conducted, and results of meta-analyzes have been published that have revealed the effect of Escherichia coli strain Nissle 1917 (Mutaflor) in reducing the duration of diarrhea in children with acute gastroenteritis. Escherichia coli strain Nissle 1917 is one of the three bacteria in the world, which is better characterized at the molecular-biological level, the most investigated non-pathogenic and genetically stable strain in the world with 100-year history, having a genetic map, the genome of which is completely sequenced, genetic loci are deterministic. The product is included into the German Collection of Microorganisms and Cell Cultures (DSMZ). The purpose of our study was to improve the therapeutic approaches to the correction of diarrheal syndrome using Escherichia coli strain Nissle 1917 (Mutaflor) in the main treatment regimens. Seventy four children were examined and divided into two groups: the first group — children with diarrheal syndrome, who additionally received Mutaflor from the first day, the second group — children with diarrheal syndrome, who received traditional therapy. As a result of the study, the data were obtained proving the effectiveness of Escherichia coli strain Nissle 1917 (Mutaflor) in the treatment of diarrhea in young children, its beneficial effect not only on intestinal microflora and normalization of intestinal kinetics, but also on faster improvement of clinical symptoms, which allows recommending it to children from the first months of life