TherapyTherapyТерапия2412-40362713-1823Bionika Media63380510.18565/therapy.2024.3.116-124LECTURES & REPORTSЛЕКЦИИ & ДОКЛАДЫReview ArticleIrritable bowel syndrome in new clinical practiceСиндром раздраженного кишечника в современной клинической практикеhttps://orcid.org/0000-0001-6114-564XMaevIgor V.МаевИгорь Вениаминович
Russian Federation

MD, Dr. Sci. (Medicine), professor, academician of RAS, vice-rector for academic affairs

д. м. н., профессор, академик РАН, проректор по учебной работе

igormaev@rambler.ruhttps://orcid.org/0000-0003-0485-6802OsadchukMikhail A.ОсадчукМихаил Алексеевич
Russian Federation

MD, Dr. Sci. (Medicine), professor, head of the Department of polyclinic therapy of N.V. Sklifosovsky Institute of Clinical Medicine

д. м. н., профессор, заведующий кафедрой поликлинической терапии Института клинической медицины им. Н.В. Склифосовского

osadchuk.mikhail@yandex.ruhttps://orcid.org/0000-0002-8488-9235OsadchukAlexey M.ОсадчукАлексей Михайлович
Russian Federation

MD, Dr. Sci. (Medicine), professor of the Department of gastroenterology

д. м. н., профессор кафедры гастроэнтерологии

a.m.osadchuk2020@mail.ruRussian University of Medicine of the Ministry of Healthcare of RussiaФГБОУ ВО «Российский университет медицины» Минздрава РоссииI.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University)ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский университет)Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of RussiaФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России270620241031161242606202426062024Copyright ©; 2024, Bionika MediaCopyright ©; 2024, ООО «Бионика Медиа»2024Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/2412-4036/article/view/633805

Basic component of irritable bowel syndrome (IBS) is intestine and brain dysfunction initiated by a fairly large number of risk factors. Dynamism of this system determines the variety of clinical manifestations and creates significant difficulties in diagnosis and treatment of the disease. In this regard, the initial tactics of the physician should be aimed at determining IBS phenotype in a certain patient and only after that – at selecting the appropriate treatment. In case of persistent, severe and/or aggravating symptoms or in case of adiaphoria to therapy, further testing is recommended to clarify the cause of treatment resistance and develop new tactics for patient management.

Основой синдрома раздраженного кишечника (СРК) выступает дисфункция кишечника и мозга, инициируемая достаточно большим количеством факторов риска. Динамичность этой системы определяет многогранность клинических проявлений и создает значительные трудности в диагностике и лечении данного заболевания. В связи с этим первоначальные усилия врача должны быть направлены на определение фенотипа СРК у конкретного пациента и только после этого – на подбор соответствующего лечения. При стойких, тяжелых и/или усугубляющих симптомах либо в случае рефрактерности к терапии рекомендуется дальнейшее тестирование для уточнения причины невосприимчивости к проводимому лечению и выработки новой тактики ведения больного.

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