RATIONAL PHARMACOTHERAPY OF SYMPTOMATIC UNCOMPLICATED DIVERTUCULAR DISEASE OF THE COLON

Objective. Search for a rational regimen for the treatment of diverticular disease of the colon (DDC) depending on the age of the patient, the duration of the anamnesis of the disease and the presence of concomitant pathology. Methods. Between 2003 and 2016, 396 patients aged 24 to 89 years (mean age 61.4±9.3 years) with an instrumentally confirmed diagnosis of symptomatic uncomplicated diverticular disease (SUDD) of the colon characterized by high comorbidity were under observation. As a therapy, patients were prescribed myotropic antispasmodics (trimebutin or mebeverine), lactulose or psyllium for constipation, non-absorbing intestinal antiseptics (rifaximin or nifuroxazide) in the syndrome of excessive bacterial growth. In addition, some of patients have received protected butyrate (combined preparation of butyric acid and prebiotic inulin with sustained release of active substances in the colon). Results. In patients with SUDD, reduction of the pain syndrome using trimebutin was more pronounced than with mebe-verine. In patients with intractable symptoms of intestinal dyspepsia (stomach bloating, rumbling, unstable stool), rifaximin was superior to nifuroxazide in efficiency. The drugs psyllium and lactulose were prescribed for 2 years. In the psyllium group, the number of recurrences of SUDD was 20% less than in the lactulose group. An additional therapeutic effect in relieving the symptoms of SUDD was achieved with the use of the preparation of butyric acid. Conclusions. Trimetabutine remains the most effective drug for the relief of abdominal pain in patients with DDC in all age groups. It is reasonable to assign intestinal antiseptics (rifaximin, nifuroxazide) for patients younger than 45 years, and to normalize the stool with the predominant use of laxatives with prebiotic actionthose in patients over 75 years of age. Psyllium is the drug of choice in case of combination of DDC and constipation with hyperlipidemia. For senile patients, the use of protected preparation of butyric acid with the purpose of correction of possible ischemia of a wall of a gut at microscopic level is indicated.

diverticular disease of the colon, symptomatic uncomplicated diverticular disease, antispasmodics, prebiotics, intestinal antiseptics, salicylates