GASTROESOPHAGEAL REFLUX DISEASE IN PATIENTS WITH FUNCTIONAL DYSPEPSIA AND CONSTIPATION PREDOMINANT IRRITABLE BOWEL SYNDROME: CLINICAL FEATURES AND EFFICACY OF LACTULOSE AND ITOPRIDE HYDROCHLORIDE

Background: The frequent coexistence of gastroesophageal reflux disease (GERD) with functional dyspepsia (FD) and an irritable bowel syndrome (IBS) has been described in the literature. Aim: To study the specific features of GERD clinical course and diagnosis in patients with GERD in combination with FD and constipation predominant IBS (IBS-C) in comparison to patients with isolated GERD; to assess the efficacy of lactulose and itopride hydrochloride. Materials and methods: A total of 60 patients with GERD, FD (Rome criteria III), and IBS-C (Rome criteria III) and 29 patients with isolated GERD were examined. GERD diagnosis was based on clinical, endoscopic, and pH-metric criteria. For 4 weeks 10 patients with combination of non-erosive reflux disease (NERD), FD and IBS-C received lactulose monotherapy and other 10 patients received combination of lactulose with itopride hydrochloride. Clinical symptoms and pH-metric parameters were assessed before and 4 weeks after treatment. Results: Combination of GERD, FD and IBS-C was noted more frequently in women under 40 with normal body mass index (р<0.05). Classic GERD symptoms were absent in 43.4% of patients with gastrointestinal comorbidity and in 10.3% of patients with isolated GERD (р=0.004). A higher prevalence of belching and nausea was found in patients, suffering from GERD, FD and IBS-C, than in those with isolated GERD (р<0.05). After 4-week lactulose and itopride hydrochloride treatment all the patients with GERD, FD and IBS-C showed a reduction of clinical symptoms (p<0.05) and normalization of pH-metric parameters (р<0.001). Conclusion: GERD course in patients with concomitant FD and IBS-C has the following peculiarities: predominance of women, absence of classic GERD-symptoms in almost half of these patients, and frequent combination with other functional symptoms. Combination therapy with lactulose and itopride hydrochloride enables successful control of GERD and FD symptoms as well as esophageal pH normalization

ОПРЕДЕЛЕНИЕ ВЕРОЯТНОСТЕЙ СПОНТАННОГО ИЗЛУЧЕНИЯ И КОЭФФИЦИЕНТОВ СТОЛКНОВИТЕЛЬНОГО САМОУШИРЕНИЯ СПЕКТРАЛЬНЫХ ЛИНИЙ МОЛЕКУЛЫ СО2

The technique of simultaneous determination of the spontaneous emission probabilities Аmn and the collision self-broadening coefficients γmn of the СО2 spectral lines is presented. The dependence of the absorption coefficient on the gas pressure, obtained for the СО210R22 line at temperature 300 K was measured. Using the data, the spontaneous emission probability Аmn and the collision self-broadening coefficient γmn were calculated.Представлены методика и результаты одновременного определения вероятности спонтанного излучения А и коэффициента столкновительного самоуширения γ для спектральной линии R(22) перехода 1000-0001 молекулы СО2 по измеренным ненасыщенным коэффициентам поглощения в углекислом газе на центральной частоте этой линии при температуре 300 К и давлениях, обеспечивающих фойгтовский контур линии

Effectiveness of mebeverine in patients with post-cholecystectomy gastrointestinal spasm: results of prospective observational program “odyssey”

Aim: to assess the effectiveness of mebeverine 200 mg BID in patients with post-cholecystectomy gastrointestinal spasm not requiring surgical treatment. Materials and methods. 218 patients were included in 16 clinical centers in 14 cities in Russia. All patients had post-cholecystectomy gastrointestinal spasms, not requiring surgical treatment and received mebeverine (Duspatalin®) 200 mg BID. The observational assessment period lasted from the moment of their inclusion into the study up to 6 weeks post inlusion. The therapy results were evaluated using visual analog scales (GPA and 11-point numeric rating scale) by patient self-assessment of the dynamics of spasm/discomfort and other post-cholecystectomic gastrointestinal symptoms after 2 and 6 weeks of treatment. Gastrointestinal Quality of Life Index (GIQLI) was used to assess patient quality of life. Results and discussion. All 218 patients completed the 2-week mebeverine treatment course, 101 of them finished the 6-week course (“prolonged population”). Significant positive changes in the relief of abdominal pain and dyspepsia were noted as well as normalization of stool frequency and consistency. A more marked change in values was observed during prolonged (up to 6 weeks) therapy. Both 2-week and 6-week mebeverine courses led to a normalization of patient quality of life. After 6 week therapy, an effect of mebeverine on the quality of life 91% of patients was observed comparable to cholecystectomy itself, speficially related to the quality of life subscore ‘symptoms’. Conclusion. The results of our study demonstrate that mebeverine (Duspatalin®) therapy leads to an effective elimination of clinical symptoms associated with post-cholecystectomy GI-spasm disorders, like abdominal pain, symptoms of dyspepsia and stooldisorders. A more marked change in values was observed during prolonged (up to 6 weeks) therapy

Collisional self-broadening coefficients and probabilities of spontaneous emission of the CO2 1000–0001 transition lines

Using a tunable frequency-stabilized CO2 laser, the pressure dependences of unsaturated absorption coefficients (AC) are measured in pure carbon dioxide in the pressure range from 5 to 30 Torr, where the spectral line shape is described by the Voigt profile. The absorption coefficients are measured in the centers of R(8), R(22), R(34), P(22), and P(36) spectral lines of the 1000–0001 transition in the temperature range 300–700 K. By means of the least-squares method, the inverse problem is solved for the system of equations for AC at different pressures in the temperature range under study. The self-broadening coefficients and the probabilities of spontaneous emission Aik are derived. A new formula is proposed for (T) dependence

Multifrequency laser diagnostics of vibrational nonequilibrium gas media containing CO2 molecules

The technique for multifrequency diagnostics of a vibrational nonequilibrium gas mixture that contains CO2 molecules is proposed. The technique uses data on unsaturated gains at lines of the 0001– [1000, 0200]I, II and 0002–[1001, 0201]I, II transitions obtained with the help of a tunable CO2 laser. Results of the study of the influence of accuracy of gain measurements and the number of sensing lines on errors in determining populations of vibrational levels and gas mixture translational temperatures are presented

DETERMINATION OF THE SPONTANEOUS EMISSION PROBABILITIES AND THE COLLISION SELF-BROADENING COEFFICIENTS OF THE СО2 SPECTRAL LINES

The technique of simultaneous determination of the spontaneous emission probabilities Аmn and the collision self-broadening coefficients γmn of the СО2 spectral lines is presented. The dependence of the absorption coefficient on the gas pressure, obtained for the СО210R22 line at temperature 300 K was measured. Using the data, the spontaneous emission probability Аmn and the collision self-broadening coefficient γmn were calculated

The Role of Motility Impairment in the Pathogenesis of Functional Disorders of the Gastrointestinal Tract and Modern Possibilities for Their Treatment (Resolution of an Expert Council and Literature Review)

Aim. To present the materials of an Expert Council, which was held on September 23, 2019 in Istanbul (Turkey) under the auspices of a World Gastroenterology Organisation congress and the support of the Abbott company.General provisions. During the work of the Expert Council, the role of motility disorders of the stomach and duodenum, intestines, gall bladder and the sphincter of Oddi in the development of functional diseases of the digestive system, such as functional dyspepsia (FD), irritable bowel syndrome (IBS), biliary dyskinesia (BD) was discussed, and the effectiveness of antispasmodics and prokinetics in their treatment was shown. At the same time, the advantages of the mebeverin antispasmodic drug, as well as the high efficiency and safety of the itopride hydrochloride prokinetic drug were noted. It is emphasized that, at the stage of a diagnostic search in the absence of “alarm symptoms” in patients with suspected FD, IBS, and BD, these drugs can be prescribed empirically.Conclusions. When selecting pharmacotherapy for patients with motor impairment, it is extremely important to consider the nature of these disorders. The use of modern medical preparations, which are characterized by a high level of safety and the targeted action towards a specific motility disorder, allows optimal therapy results to be achieved with minimal risks for the patient