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

Diagnostic algorithm and management of children with liver pathology

The paper deals with the diagnostic algorithm including a comprehensive study, substantiates the necessity to evaluate the results obtained taking into account the age and sex of the child. The article considers the features of management of children with liver pathology and the mechanisms of action of ursodeoxycholic acid on the human body as well as the results of clinical research and observations on the use of the ursodeoxycholic acid for the treatment of children with liver diseases

Screening diagnostics of large intestine diseases in children

Background. Questions of the screening diagnostics of large intestine diseases in children at the prehospital and primary stages of medical care are relevant. Fecal markers of intestinal inflammation testing in children with complaints and clinical manifestations typical to the pathology of the large intestine are proposed as a non-invasive and economically accessible diagnostic method. The purpose of the study was a comparative analysis of the large intestine mucous membrane state with the results of the fecal markers of intestinal inflammation testing. Materials and me­thods. Forty children aged 6–18 years old were examined. The diagnosis was verified by endoscopy in all children. Fecal markers of intestinal inflammation were determined using Calprotectin-Lactoferrin CITO TEST. Results. Comparison of the results of endoscopic studies with that of fecal markers of intestinal inflammation test indicates a significant coincidence (95 %; p < 0.05) of positive results of Cito Test Calprotectin-Lactoferrin with signs of inflammation in the large intestine founded in endoscopy. Conclusions. It has been shown that the proposed method of screening diagnostics for the determination of fecal markers of intestinal inflammation is sufficiently sensitive and can be used at the prehospital and primary diagnostic stages, including the selection of a group of patients for subsequent endoscopic examination

Functional abdominal pain in children

Abdominal pain is one of the most common children’s complaints in the practice of a pediatrician and a family doctor. In most cases, the cause of chronic abdominal pain is non-organic, functional abdominal pain syndrome (FAPS) without objective signs of an underlying organic disorder. At present, among various groups of antispasmodics, selective myotropic antispasmo­dics, namely myocyte cell membrane fast sodium channel blockers (mebeverine), are chosen for the treatment of functional gastrointestinal disorders. In clinical practice, mebeverine hydrochloride (SPARK®, JSC Farmak) is of interest for the treatment of patients with abdominal pain. SPARK® is available in capsules; one capsule contains 200 mg of mebeverine hydrochloride. The pathogenetically justified indication of mebeverine is a relief of chronic abdominal pain in adults and children over 10 years. The drug has no systemic effects. The efficacy of SPARK® (mebeverine) for FAPS in children was studied in the gastroenterological department of the Children’s Clinical Hospital No. 19 in Kharkiv. Forty-four children aged 10 to 18 years with FAPS were examined. The functional pathologies included: functional dyspepsia (FD) — 54.1 %, irritable bowel syndrome (IBS) — 20.8 %, functional biliary disorders (FBD) — 79.2 %; FD + FBD — 34.1 %, FD + IBS — 16 %, FBD + IBS — 8.3 %. The diagnosis was verified according to unified treatment protocols. The patients received a comprehensive pathogenetic therapy and a selective antispasmodic, SPARK®, 1 capsule twice daily for seven days. The pain syndrome was evaluated at admission and every day during the observation period [17]. A numerical pain rating scale was used to assess pain intensity. A tendency towards abdominal pain relief was observed in all patients from the study group; children with mild pain did not report abdominal pain from day 5 of therapy and patients with moderate pain — from day 6. The pain persisted longer, up to 7 days, in children with severe pain. Therefore, abdominal pain is one of the most common and complex problems in medical practice. It mostly occurs in functional gastrointestinal disorders. The use of selective myotropic antispasmodics (mebeverine) to relieve abdominal pain is pathogenetically justified. The results obtained showed the efficacy of SPARK® in the treatment of functional abdominal pain in children. Side effects and allergic reactions to the drug were not observed. Mebeverine (SPARK®) can be the drug of choice and is recommended for abdominal pain in adults and children over 10 years

Gastroesophageal reflux disease in pediatric practice: current topical issues

In recent years, much attention has been paid to the upper digestive tract diseases in children, particularly gastroesophageal reflux disease, as a cause that has an impact on the quality of life, even in children of school age, and thereafter in young adults. Consequently, there are searches for optimization of early detection, new me-thods of non-invasive diagnosis, screening of this pathology in children’s population in order to determine persons with risk factors and to control disease development and complicated course, as well as searches for the formation of preventive activities algorithm. Scientists came to a consensus that all examinations, which are used in pediatric practice, must be maximally available, simple and non-invasive to the extent of child’s condition. The question about advisability of performing esophagogastroduodenoscopy for all patients with complaints of heartburn and with other symptoms of gastroesophageal reflux disease, the question relative to performing ultrasonography of the esophagus in children as an additional method of examination, usage of questionnaire in pediatric practice, formation of disease course prediction algorithm, and identification of preventive measures specific to every patient remain open. In order to explain their application, the developmental mechanisms of this pathology must be well-understood, and individual risk factors that may influence disease severity and disease course prediction, which occur in children in different periods of life, must be taken into account. Therefore, the goal of this research is to provide an overview of modern literature with reference to topical issues of clinical evidence, risk factors, diagnosis, prediction of gastroesophageal reflux disease course in children of different ages (regarding main causative and pathogenic factors, clinical evidence (esophageal and extra-esophageal), diagnostic methods and modern approaches to gastroesophageal reflux disease treatment)