No 2 (2014)

The article considers the physiological mechanisms of regulation of gastric acid production; the characteristic of the modern groups of drugs used in the treatment of acid-related disorders, especially proton pump inhibitors, are described. It is emphasized that the use of modern drugs provides a high level of acid control, quality of life of patients, and the possibility of treatment in outpatient settings. The ways to improve the effectiveness and safety of pharmacological methods of correction of intensity of hydrochloric acid secretion are discussed.

Diverticular disease is the most common organic pathology of the colon in patients older than 60 years. Uncomplicated (i.e. without endoscopic signs of inflammation) diverticular disease in 20-35 % of patients occurs with severe pain, flatulence and/or impaired stool that leads to reduction of quality of life of patients and requires prescribing of drugs of various pharmacological groups in addition to dietary recommendations. Standard therapy with antispasmodics is not always high effective, because patients with diverticular disease of the colon represent heterogeneous group. This requires an individual approach to the treatment. The article discusses the various groups of drugs and the potentials for their application depending on the predominance of certain symptoms.

The emergence of various disorders of the gastrointestinal tract in infants (including constipation, regurgitation, crying/irritability, cramps and excessive flatulence) is a common problem and can cause numerous visits to the pediatrician. Around the world, occurrence of these disorders often leads to the replacement of infant formula due to the fact that parents or clinicians regard these symptoms as manifestations of intolerance to infant formula. As a rule, rates of physical and neuropsychological development of children are not violated. Group of pediatric gastroenterologists and pediatric allergists from Europe, Latin America, Asia and the US, has developed recommendations and practical algorithms designed to assist physicians in the management of patients with functional disorders of the gastrointestinal tract.

The article presents the results of evaluation of 62 patients with chronic hepatitis C and 103 patients with hepatic cirrhosis of viral etiology. Besides clinical parameters, vegetative features were examined by analysis of heart rate variability at rest and active orthostasis. Indicators of frequency analysis of heart rate in the studied patients with chronic hepatitis C and hepatic cirrhosis of viral etiology have confirmed increase in sympathetic activity and weakening of parasympathetic activity in all parameters, with the sympathetic influence amplified in active orthostasis. Indices of regulatory systems of the autonomic nervous system (stress index and the index of autonomic regulation) are also indicated a statistically significant predominance of sympathicotonia at rest and active orthostasis, indicating serious violations of adaptation in the studied patients. The article presents the main groups of drugs that were used in the study, the properties of silymarin and indications for its use in hepatology are described in detail.

The article describes the modern aspects of the clinical manifestation, diagnosis and treatment of gastrointestinal bleeding (GIB) from upper and lower gastrointestinal tract. The main diagnostic criteria for GIB are considered; signs that allow to determine the degree of blood loss, crucial for the choice of treatment are discussed. The role of the modern multi-component drug Ferro-Folgamma in restoring hematopoiesis within the therapy of GIB is emphasized.

Currently, the role symbiotic microflora of the human body in maintaining of homeostasis and the implementation of many important physiological functions that provide normal functioning is recognized. At the same time, in recent years disbiotic violations of intestinal microbiocenosis are widespread. The article considers the classification, diagnosis and correction of dysbiotic disorders of the gastrointestinal tract. The clinical significance of probiotics and probiotics as means potentiating the clinical effect of the primary treatment in most pathological processes is substantiated. The evidence-based benefits, indications and conditions of application of the main probiotics and probiotics are described.

The article describes the current data on the prevalence, causes, diagnosis and treatment of functional bowel disturbance - loss of the ability of the rectum to retain feces. The mechanism of action of superselective 5-HT4 receptor agonists, allowing to achieve control on the function of defecation are described.

The article discloses the modern aspects of the clinical manifestation, diagnosis and treatment of the functional dyspepsia (FD). The main clinical variants of the disease and the characteristics of their course are considered. Modern algorithm, revealing the main stages of diagnosis and treatment of patients with FD in clinical practice are described. The role of proton pump inhibitors as basic drugs used in the treatment of this pathology is highlighted.

High therapeutic effect of the method of dose starvation in some internal diseases and neuropsychiatric diseases is practically assured. However, long-term uncontrolled courses of starvation can do harm to human health, as all fat reserves are depleted and the body begins to consume the necessary proteins, resulting in impaired function of vital organs. Lecithin deficiency is significant and results in impaired liver function. Application of drugs containing essential phospholipids at the end of starvation promotes soft withdrawal from starvation and rapid recovery of liver function. Hepaguard Active* contains the basic vital components, deficiency of which is significant during starvation.