Experience in the Treatment of Irritable Bowel Syndrome Developed after a New Coronavirus Infection (COVID-19)

Aim. To study the effectiveness of Kolofort® (affinally purified antibodies to tumor necrosis factor α, to the brain-specific protein S-100 and to histamine) in patients with various variants of irritable bowel syndrome (IBS) that developed after a new coronavirus infection (COVID-19).Materials and methods. Clinical and laboratory data of 32 patients with IBS who had a history of COVID-19 pneumonia were analyzed. Course therapy with Kolofort® is prescribed according to the standard scheme for 3 months. Before and after treatment, the dynamics of the symptoms of IBS was assessed according to the questionnaire, the dynamics of anxiety was assessed according to the Hamilton scale.Results. There were a statistically significant decrease in the severity of IBS symptoms (normalization of the consistency of the stool, cessation of flatulence, a decrease in abdominal  pain; p < 0.05) and a decrease in anxiety after the end of treatment.Conclusions. Kolofort® may be effective in eliminating the symptoms of post-infectious  IBS and anxiety that developed after COVID-19

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

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

Functional dyspepsia: modern aspects of diagnosis and treatment from the positions of the Rome criteria IV

Modern therapy of functional dyspepsia (FD) based on the Rome criteria for revision IV includes the use of drugs that reliably eliminate clinical manifestations of the disease and are well tolerated in their use

Nafld and cardiovascular risks: clinic, diagnostic, features of therapy

The relationship between non-alcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVD) is considered. The main mechanisms for increasing the cardiovascular risks induced by NAFLD are insulin resistance, oxidative stress, endothelial dysfunction and inflammation. Dyslipidemia, arterial hypertension, type 2 diabetes mellitus, often present in patients with NAFLD, also contribute to an increase in cardiovascular risks. It is shown that with the progression of NAFLD, the risk of developing CVDs increases. Mortality of patients with NAFLD is mainly due to the development of CVD complications. Thus, NAFLD should be considered as an independent risk factor for CVD.Treatment of NAFLD includes lifestyle modification (diet therapy, physical activity), as well as the use of drugs from different groups: omega-3 polyunsaturated fatty acids, statins, S-adenosylmethionine, essential phospholipids, ursodeoxycholic acid, metadoxine, glycyrrhizic acid, vitamin E, herbal drugs. In particular, the use of phospholipides, which has a high safety profile and is well tolerated when used, including with a combination of NAFLD and CVD, is justified

Non-alcoholic fatty liver disease: new therapeutic options

The past decades have recorded sustainably high incidence of non-alcoholic fatty liver disease (NAFLD) globally. The disease is more prevalent among people with obesity and diabetes mellitus (DM), dyslipidemia and metabolic syndrome (MS) [3, 4]. NAFLD is an independent nosological unit including a range of clinical and morphological changes of the liver parenchyma: steatosis (fatty degeneration) and non-alcoholic steatohepatitis. NAFLD pharmacotherapy asks for a search of new effective methods of treatment

EFFECTIVE PREVENTION AND TREATMENT OF CHRONIC HEPATITIS B IN THE CONTEMPORARY PRACTICE OF HEPATOLOGY

Modern approaches to the prevention and treatment of chronic hepatitis B are based on the use of vaccination of the population, on the one hand, and rational choice of antiviral therapy schemes in patients - on the other. This allows the physician to predict results of treatment and preventive measures. Modern analogues of nucleosides, in particular, Entecavir, has high efficacy, good tolerance and high safety profile when used in long term conditions

IRRITABLE BOWEL SYNDROME: FROM DIAGNOSIS TO THERAPY

The problem of functional intestine diseases has been a discussion subject for many years. Diagnostic criteria of FID presuppose no morphological and biochemical disturbances. But search of substrates for verification of this pathology continue till now

THE ROLE OF URSODEOXYCHOLIC ACID IN THE TREATMENT OF CHRONIC VIRAL HEPATITIS

Along with etiotropic antiviral therapeutic schemes, treatment of chronic viral hepatitis today involves administration of medications that eliminate the clinical manifestations of the disease. In particular, the use of ursodeoxycholic acid (Urdoxa®), with its high safety profile and good tolerability in case of long-term administration, is justified for the effective prevention of cholestasis

Alcoholic liver disease: a modern look at diagnosis and treatment

Alcohol is one of the leading etiological factors in liver damage. In alcoholic liver disease (ALD), hypoxia occurs due to an imbalance between the energy requirement of hepatocytes and energy production in the mitochondrial oxidative phosphorylation system. Diagnosis of ALD includes the taking of an anamnesis, questioning of patients, clinical examination data, laboratory and instrumental study. For the treatment of ALD, agents are used that protect cell membranes from oxidative stress factors and restore the energy potential of cells under conditions of tissue hypoxia. One such hepatotropic infusion is Remaxol®, the original polyionic succinatemethionine complex based on succinic acid. Aim of the study: to consider the effects of using Remaxol® infusion drug in the group of ALD patients. Materials and methods: treatment of 40 patients (male) with ALD was carried out, all of whom had a distinct history of the disease with regular and prolonged alcohol abuse. The duration of the disease in the group was 4.8 ± 0.7 years. Initially, all of them showed increased lipid peroxidation, depression of antioxidant protection, as well as pronounced sings of cytolysis, cholestasis and lipid metabolism. Then, all patients in the group were treated with Remaxol®. The course of treatment ranged from 5 to 10 daily intravenous drip infusions. After treatment, the parameters of lipid peroxidation malondialdehyde (MDA), diene conjugates (DC), enzymes of antioxidant system catalase (Cat), superoxide dismutase (SOD), glutathione peroxidase (GP), markers of cytolysis, cholestasis and lipid metabolism were again investigated in the serum of patients. Results of the study: a positive effect after monotherapy with Remaxol® was observed in 34 patients, which amounted to 85% of the group. They recorded a significant decrease in lipid peroxidation and a compensatory increase in antioxidant system enzymes. The indicators of cytolysis and cholestasis syndromes significantly decreased, lipid metabolism was restored, and the subjective status of patients improved. There were no side effects during the treatment with Remaxol® in the group of patients with ALD. Conclusions: It was noted that therapy with Remaxol® caused positive laboratory dynamics in 34 patients, which amounted to 85% of all treated patients with ALD. Thus, it has been shown that therapy with Remaxol® is an effective method of treating alcoholic liver disease