33 research outputs found

    Phenotypes of Non-Alcoholic Fatty Liver Disease in Different Regions of the Russian Federation, Diagnostic and Therapeutic Approach in Clinical Practice

    Get PDF
    Aim: to present data on the prevalence of various phenotypes of non-alcoholic fatty liver disease (NAFLD), the features of its diagnosis and treatment in various regions of the Russian Federation following a meeting of chief gastroenterologists.Key points. Non-alcoholic fatty liver disease (NAFLD) holds the leading position among non-infectious liver diseases in the Russian Federation, its prevalence is 37.3 % and does not tend to decrease.To get information on various aspects of NAFLD diagnosis and treatment, opinion of 18 chief external regional gastroenterologists and leading specialists in the field of liver diseases was studied by analyzing the responses to questions specially formulated for them. Information on the situation in the Ural, Privolzhsky, Southern, Central and North-western Federal Districts was obtained. Regional statistics on the prevalence of NAFLD and its certain phenotypes (steatosis, steatohepatitis, cirrhosis), diagnostic instruments and treatment approaches which are used in clinical practice, as well as on the most common associated conditions was presented.Conclusions. The collected information allows to improve both administrative and treatment and diagnostic-related activities in managing patients suffering from this disease

    Phenotypes of Non-Alcoholic Fatty Liver Disease in Different Regions of the Russian Federation, Diagnostic and Therapeutic Approach in Clinical Practice

    Get PDF
    Аim: to present data on the prevalence of various phenotypes of non-alcoholic fatty liver disease (NAFLD), the features of its diagnosis and treatment in various regions of the Russian Federation following a meeting of chief gastroenterologists.Key points. Non-alcoholic fatty liver disease (NAFLD) holds the leading position among non-infectious liver diseases in the Russian Federation, its prevalence is 37.3 % and does not tend to decrease.To get information on various aspects of NAFLD diagnosis and treatment, opinion of 18 chief external regional gastroenterologists and leading specialists in the field of liver diseases was studied by analyzing the responses to questions specially formulated for them. Information on the situation in the Ural, Privolzhsky, Southern, Central and Northwestern Federal Districts was obtained. Regional statistics on the prevalence of NAFLD and its certain phenotypes (steatosis, steatohepatitis, cirrhosis), diagnostic instruments and treatment approaches which are used in clinical practice, as well as on the most common associated conditions was presented.Conclusions. The collected information allows to improve both administrative and treatment and diagnostic-related activities in managing patients suffering from this disease

    Digestive Disease Mortality Dynamics During New Coronavirus Infection Pandemic in Different Subjects of Russian Federation

    Get PDF
    Aim. An analysis of digestive disease mortality dynamics in different subjects of the Russian Federation in course of the new coronavirus infection pandemic.Key points. In most subjects of the Russian Federation, the first half of 2021 enduring the COVID-19 pandemic has witnessed a higher overall mortality from digestive diseases and from peptic ulcer, liver and pancreatic illnesses compared to the same period in 2020. This situation may have roots in both the adverse impact of coronavirus infection on pre-existing digestive diseases and shortages in providing specialty medical aid to gastroenterological patients during the pandemic. Improved outpatient care and remote counselling, as well as successful educational measures, may reduce gastroenterological disease-associated mortality.Conclusion. Most regions of Russia have registered a growing mortality from digestive diseases at the new coronavirus infection pandemic due to the SARS-CoV-2 adverse impact on illness progression, as well as imposed difficulties in providing specialty medical aid

    Determination of Probiotics Prescription Indications in Patients with Irritable Bowel Syndrome (Materials of the Expert Council and Literature Review)

    Get PDF
    Aim. To review the main indications for probiotics prescription in patients with irritable bowel syndrome and to present the materials of an Expert Council, which was held on 18 March 2022 in Moscow.Key points. Gut microbiota disturbance is an integral part of irritable bowel syndrome (IBS) pathogenesis. Changes of colonic microbiota composition are associated with its functional potential modification, which leads to an increasing of the pro-inflammatory immune response, as well as to an exacerbation of the disease symptoms and quality of life decreasing in patients with IBS. The novel coronavirus infection (COVID-19) is an independent risk factor for both exacerbation and onset of IBS, which predispose to increase IBS incidence. Correction of gut microbiota composition with probiotics seems to be a promising therapeutic target for IBS treatment optimizing. The optimal probiotic should be effective, safe, strain-specific, and its dose and duration of administration should be confirmed by the results of clinical studies. Some of the probiotics with proven efficacy in IBS are Alflorex® and Enterol®.Conclusion. Prescription of certain probiotics in IBS is advisable to normalize the frequency and consistency of stools, relieve abdominal pain and bloating, as well as improve patients’ quality of life

    Practical Recommendation of the Scientific Сommunity for Human Microbiome Research (CHMR) and the Russian Gastroenterological Association (RGA) on Small Intestinal Bacterial Overgrowth in Adults

    Get PDF
    Aim. To optimize the choice of treatment strategies by physicians and gastroenterologists to improve treatment and prevention of small intestinal bacterial overgrowth (SIBO) in adults.Key points. SIBO is a condition characterized by an increased amount and/or abnormal composition of the microbiota in the small intestine. Clinically, the syndrome is manifested by nonspecific gastroenterological complaints and the development of malabsorption syndrome. Most often, SIBO is associated with various chronic non- infectious diseases (both diseases of the gastrointestinal tract, and the cardiovascular system and the neuromuscular apparatus) and can affect the severity of their symptoms. Specific methods for diagnosing SIBO are the culture method and breath tests. The main approaches to the treatment of SIBO include the elimination of the underlying cause of its occurrence, the use of antibacterial drugs and adherence to dietary recommendations (elemental diet).Conclusion. Small intestinal bacterial overgrowth is common in patients with various diseases, but has non-specific manifestations, so proper diagnosis of this condition is required. SIBO therapy involves prescription of antibacterial agents, the most studied of which is the non-absorbable antibiotic rifaximin-α

    Clinical Recommendations of Russian Gastroenterological Association and RENDO Endoscopic Society on Diagnosis and Treatment of Gastritis and Duodenitis

    Get PDF
    Aim. The clinical guidelines are intended to supplement specialty decision-making for improved aid quality in patients with gastritis and duodenitis though acknowledging the latest clinical evidence and principles of evidencebased medicine.Key points. Gastritis is an inflammatory disease of stomach mucosa, with a separate definition of acute and chronic gastritis. Chronic gastritis is a cohort of chronic diseases uniting a typical morphology of persistent inflammatory infiltration, impaired cellular renewal with emergent intestinal metaplasia, atrophy and epithelial dysplasia of gastric mucosa. Oesophagogastroduodenoscopy (OGDS) or high-resolution OGDS with magnified or non-magnified virtual chromoendoscopy, including targeted biopsy for atrophy and intestinal metaplasia grading and neoplasia detection, are recommended to verify gastritis and duodenitis, precancer states and/or gastric mucosal changes. All chronic gastritis patients positive for H. рylori should undergo eradication therapy as aetiological and subsidiary for gastric cancer prevention. Chronic gastritis patients with symptoms of dyspepsia (epigastric pain, burning and congestion, early satiety), also combined with functional dyspepsia, are recommended proton pump inhibitors, prokinetics, rebamipide and bismuth tripotassium dicitrate in symptomatic treatment. With focal restricted intestinal metaplasia, follow-up is not required in most cases, mainly when advanced atrophic gastritis is ruled out in high-quality endoscopy with biopsy. However, a familial history of gastric cancer, incomplete intestinal metaplasia and persistent H. pylori infection render endoscopy monitoring with chromoendoscopy and targeted biopsy desirable once in three years. Patients with advanced atrophic gastritis should have high-quality endoscopy every 3 years, and once in 1–2 years if complicated with a familial history of gastric cancer.Conclusion. The recommendations condense current knowledge on the aetiology and pathogenesis of gastritis and duodenitis, as well as laboratory and instrumental diagnostic techniques, main approaches to aetiological H. pylori eradication and treatment of dyspeptic states

    Small Intestinal Bacterial Overgrowth in Various Specialties of Medical Practice (Literature Review and Expert Council Resolution)

    Get PDF
    Aim: to discuss current views on the clinical significance, diagnostic opportunities, and therapeutic approaches in the treatment of small intestinal bacterial overgrowth (SIBO) as an important component in the gut microbiota function assessment, to assess the awareness of physicians and the opportunities in the diagnosis and treatment of this disease in patients in the Federal districts of the Russian Federation, as well as to present the proceedings of the Expert Council held on December 16, 2023 in Moscow.Key points. SIBO is a common syndrome often associated with irritable bowel syndrome, liver cirrhosis, asthma, and congestive heart failure, being also a predictor of early death in the elderly. Today, in many regions of the Russian Federation, there are limitations for instrumental diagnosis of this disease — lack of awareness among doctors, unavailability of gas analyzers for diagnosing SIBO, lack of information about the need to diagnose SIBO in the standards of compulsory health insurance. Rifaximin is the first-line treatment due to the highest therapeutic efficacy. One of the ways to increase the efficacy of SIBO treatment is to include strain-specific probiotics in the treatment regimen. Saccharomyces boulardii CNCM I-745 is thought to be the most studied, promising probiotic. The review also presents statistical data on the issues in the diagnosis and treatment of SIBO in the regions of the Russian Federation.Conclusion. Optimization of approaches to the diagnosis and treatment of SIBO, the development of domestic gas analyzers, increasing the awareness of physicians in all regions of the Russian Federation, as well as the development and optimization of clinical recommendations appear to be necessary measures to increase the effectiveness of medical care, the duration and quality of life of the Russian population. These goals can be achieved within the framework of Federal programs under the supervision of specialized reference centers of the Ministry of Health of the Russian Federation
    corecore