This article provides present-date knowledge on irritable bowel syndrome (IBS) and different approaches to therapy. The method of presenting the materials is based on a specific clinical case, which includes the diagnostic algorithm, a list of modern medicines, defines pharmacological targets and, based on them, describes an approach to the selection of an adequate pharmaceutical drug. In the presented case, patient S. (37 years old) had a functional bowel disorder (stool disorder) for seven years, and short-term pharmacotherapy courses did not produce a lasting effect. The course of the disease had become more alarming over time. The medical examination confirmed irritable bowel syndrome (IBS) in the patient – a mixed variant with pain syndrome during exacerbations. The drug of choice was otilonium bromide, an intestinal antispasmodic, which differed from other intestinal antispasmodics in its complex mechanism of action and practically zero absorption (3%). It allowed for a long-term therapy reducing a risk of side effects. The duration of treatment was 15 weeks (40 mg 3 times a day), of which the last three weeks were regarded as the maintenance therapy at a dose of 40 mg once a day. Pain and dysbiosis were completely relieved at 4 weeks of treatment. Motility and stool were restored, which resulted in the improvement of the quality of life and the symptoms of anxiety were resolved almost completely after 12 weeks of treatment. Thus, otilonium bromide had an effect on all pharmacological targets that were established before treatment.

Introduction. Gallstone disease is one of the most common diseases of the digestive system, its prevalence rate averaged to 10–15%, which is associated with high healthcare costs for patient management such as diagnosis, cholecystectomy with over 500 000 operations performed per year in the Russian Federation, and pharmacotherapy, which is increasingly used for the combined treatment.Aim. To assess the clinical efficacy and safety of hymecromon, a domestic drug, in patients with dyspeptic form of GSD.Materials and methods. A total of 30 patients (14 men and 16 women) with gallstones in their gallbladders were observed in the study. The patients were divided into 2 groups: Group 1 included 15 patients who received hymecromone at a dose of 600 mg/ day; Group 2 included 15 patients who received hymecromone at a dose of 1200 mg/day. The course of therapy was 21 days.Results. Intensity of all GSD symptoms significantly decreased by the end of hymecromone therapy in patients of both groups. Almost all patients reported a stool normalization. The use of hymecromone at a dose of 400 mg three times a day did not result in loose stools, and in patients who had loose stools before initiation of treatment, hymecromone contributed to the normalization of its frequency and nature. Vomiting, urge to retch and loss of appetite were completely discontinued in patients who received hymecromone at a dose of 1200 mg/day, however, there were no significant differences between Groups 1 and 2 in the changes in symptoms. No adverse events or side effects were observed during therapy.Conclusion. The therapy had a beneficial effect on upper gastrointestinal symptoms and bowel dysfunction (flatulence, diarrhoea, constipation). A significant improvement in the patients’ quality of life based on GSRS questionnaire scores was noted. The domestic drug Odecromon is considered to be effective in the treatment of dyspeptic GSD.

Introduction. In recent years, a high resistance of H. pylori infection to antibiotics has been recorded both worldwide and in the Russian Federation. This was the basis for introducing diets that increase the sensitivity of H. pylori to antibiotics into eradication schemes.Aim. To evaluate the effect of specialized therapeutic nutrition products LEOVIT GASTRO on the eradication of H. pylori.Materials and methods. Two study groups were formed: the main group – 22 patients and the control group – 20 patients. The groups were randomized from 42 patients suffering from chronic gastritis associated with H. pylori, by random sampling. To assess the tolerability of treatment, in particular, biochemical blood tests were studied.Results. Therapeutic nutrition provides a significant eradication effect against the background of antibiotic therapy. In 92% of patients, a complete absence of H. pylori contamination was detected, and in 8% of patients the degree of contamination was very weak, although initially it was pronounced, while in the control group, a complete absence of H. pylori contamination was detected in 80% of patients. Analysis of the use of specialized food products indicates the possibility of their use in diseases of the gastrointestinal tract associated with H. pylori, as they promote epithelization, healing of the mucosa, reduction and elimination of inflammation, pain, and discomfort in the gastrointestinal tract.Conclusion. Therapeutic dietary nutrition LEOVIT GASTRO is one of the important factors positively influencing the success rate of eradication treatment.

The irritable bowel syndrome (IBS) is one of the most prevalent functional gastrointestinal disorders. However, at most, one-third of IBS patients are satisfied with the results of their treatment. A combination of pharmaceuticals or multi-target drugs should be used for the treatment to be effective due to the complexity of IBS pathophysiology. The Russian Expert Panel in gastroenterology, including functional gastrointestinal disorders, currently considered to be disorders of gut-brain interaction, at its open session has discussed the possibilities to increase the efficacy of treatment of patients with IBS with a multitargeted agent alverine citrate combined with simethicone registered under the trade name of Meteospasmyl® (Mayoly Pharma, France) and adopted the respective resolution. Based on the results of multiple experimental and clinical studies, the experts declared that the combination of alverine citrate with simethicone relieves pain through the alleviation of its main mechanisms (spasms, flatulence, visceral hypersensitivity, and inflammation), and normalizes bowel movements demonstrating the normokinetic (eukinetic) properties. All clinical effects of the combination of alverine citrate and simethicone are prolonged. Alverine citrate combined with simethicone improves patients’ quality of life, including their psychological well-being. Due to the efficacy and good safety profile, it is possible to use the combination of alverine citrate and simethicone as on-demand and ex juvantibus treatment. The combination of alverine citrate and simethicone is a single selective antispasmodic that allows for a simultaneous solution of two clinical challenges: to rid the patient of abdominal pains and to properly prepare the patient for instrumental examinations (colonoscopy, abdominal ultrasound, and radiological examination), due to a high simethicone dose and spasmolytic properties of alverine citrate. In addition, Meteospasmyl® is a single antispasmodic, which has demonstrated high efficacy and safety in a clinical study of its combination with a probiotic (Probiolog® IBS), containing the strains (Lactobacillus plantarum CECT 7484, Lactobacillus plantarum CECT 7485, and Pediococcus acidilactici CECT 7483) acting on all IBS pathogenesis steps. This is extremely important, considering the proven role of gut dysbiosis in IBS pathophysiology.

The main symptom of irritable bowel syndrome (IBS), a recurrent functional GI disorder, is abdominal pain associated with defecation, a change in the frequency of bowel movements and a change in the consistency of stool. Until recently, it was the only specific disease that was included in the international classification of the 10th revision. Another 53 functional disorders will be included in the classification of the 11th revision and receive the status of ICD diseases. There are four main variants of IBS: IBS with constipation, IBS with diarrhea, IBS with mixed bowel habit and IBS unclassified. The very concept of IBS was fast-changing. The latest Rome IV (2016) guidelines suggested a mechanism of intraepithelial contact disruption as one of the pathogenetic mechanisms, which activates a minor intramucosal inflammation. It could be relevant to the chronicity of the process and require the use of anti-inflammatory drugs and agents in the treatment that restore intraepithelial contacts, which increases the percentage of patients with a positive treatment effect. The report provides data on the pharmacotherapy of drugs that have a combination (concomitant) effect of action, for example, Meteospasmyl®, which is superior to drugs with antispastic action or action that restores impaired motility in terms of the final effect of the action. The author of this report invites to participate in the discussion about the feasibility of introducing a new IBS variant, which may have a chronic course, and the inclusion of anti-inflammatory drugs in the combination treatment (if drugs that affect motor disorders have insufficient effect).

Introduction . Dietary nutrition is one of the most important and physiological therapeutic and preventive approaches for chronic reflux gastritis (CRG), not associated with HP infection. Aim . To analyze the effectiveness and safety of the use of specialized therapeutic nutrition (produced by LEOVIT) in chronic reflux gastritis (CRG), not associated with HP infection, in the acute phase. Materials and methods . A comparative randomized study included 40 patients with CRG, not associated with HP infection, in the acute phase. During the one-month course, standard diet therapy was used in the control group (20 patients), and in the patients of the main group (20 patients), diet therapy was carried out using specialized dietary products. The dynamics of clinical manifestations, changes in esophagogastroduodenoscopy (EGDS), blood test parameters, and the severity of dysbiosis were studied. Statistical processing of the research results was carried out with the determination of the significance of the mean values using the Student’s t-test. Results . It was found that the studied specialized therapeutic nutrition (oatmeal porridge with herbs and flax seed, vegetable soup with herbs and oatmeal, gastric jelly LEOVIT) have pleasant organoleptic properties, do not cause intolerance and allergic manifestations, restore digestion, improve the state of intestinal microflora, improve the quality of life of patients. According to endoscopic studies in the esophagus of patients in the main group, compared with patients in the comparison group, “normal” mucosa was statistically significantly more common (95 vs. 60% of cases) and catarrhal esophagitis was less common (5 vs. 40% of cases). The number of patients with an admixture of bile in the lumen of the stomach in patients of the main group compared with patients of the control group was found significantly less frequently in 20% of cases versus 75% of cases. Conclusion . The investigated approach to diet therapy with the use of specialized therapeutic nutrition in CRG is completely safe and recommended by the authors for long-term use in patients with this pathology.

The article presents the latest international guidelines on functional gastrointestinal disorders (Rome IV criteria). It is difficult to consider all functional disorders within one paper, and therefore it was decided to address the problem using the example of the most common functional disorder – irritable bowel syndrome (IBS) and a similar IBS-like syndrome (IBS-LS), which is particularly problematic in clinical practice. The case is illustrated by our own findings i.e. an analysis of 130 patients (80 with IBS and 50 with IBS-LS). The treatment included a specialized probiotic ProbioLog IBS (1 capsule per day) and involved several steps (each step comprises 2 weeks, 6 weeks in total). At the end of each treatment step, the therapy was evaluated followed by correction of the following step. The effectiveness of treatment was 80%; additional correction was required for 10% of patients with persistent pain, which was relieved by adding Meteospasmil to the treatment combination. Administration of digestive enzymes was required for 10% of patients with IBS-PS, which developed due to chronic pancreatitis at the stage of exocrine pancreatic insufficiency. Thus, the therapeutic effect on altered microbiota, one component of the pathological symptom group (IBS and IBS-LS), with a probiotic containing three bacterial strains targeted in IBS (ProbioLog IBS) was effective in 80% of patients, and only 20% needed additional correction of treatment with motility regulators and enzyme drugs.

Clinical masks or variants of a course of biliary pathology are analyzed in the article. The knowledge of these masks (course variants) is very important because it expands our view of pathology, considerably reduces process of diagnostics and narrows range of nosologies between which differential diagnostics should be carried out. Brief description of the most frequent variants – masks, which form biliary pathology, is presented in the article. Among them the following variants are indicated: 1) cutaneous; 2) cardiac; 3) oesophageal; 4) autonomic dysfunction; 5) pancreatic; 6) dyspeptic; and 7) colitis-like variant. Each variant has a clinical sign that allows it to be classified as biliary pathology. Due to the large number of mask variants, a unified examination programme and diagnostic steps, a probable diagnosis wording is given, allowing the most rational therapy to be chosen. Clinical trial included 120 patients: 10 pregnant women with cholestasis (a small but very important study, as pregnant women are often encountered in therapeutic practice, and they are often subjected to unnecessary investigations, resulting in lost time, and therapy requires markedly more effort), 45 with organic pathology and 65 with problems of functional nosologies. The pharmacotherapy included a highly effective artichoke drug, which has a pathogenetic effect on most of the pharmacological targets and has a choleretic and protective effect. Overall treatment efficacy was 90% with good tolerability and no side effects.

Introduction . Dietary nutrition is a physiological therapeutic and prophylactic approach for chronic pancreatitis during an exacerbation. Given the acute reaction of patients to various foods, specialized dietary products designed specifically for this pathology are of great importance. Aim . Evaluation of the clinical efficacy, safety and tolerability of the use of specialized therapeutic nutrition – jelly “Pancreatic” in chronic pancreatitis in the acute stage. Materials and methods . 20 patients of the main group with pancreatitis, along with standard therapy, received a dietary food product twice a day. The dynamics of pain, dyspeptic syndromes and intestinal dysfunction syndrome was studied; dynamics of the ultrasound picture of the pancreas; intestinal motility according to carbolene test; safety and tolerability of therapy by registering side effects and assessing the quality of life according to the SF-36 questionnaire, assessing well-being according to the visual analogue scale, and the organoleptic properties of the medicinal product. The comparison group consisted of 20 patients who received only standard pharmacotherapy. Results . The use of a dietary therapeutic food product is accompanied by a significant decrease in the frequency of nausea, belching, heaviness and flatulence in patients of the main group. The terms of relief or reduction in the intensity of symptoms of bitterness, nausea, heaviness in the abdomen, feelings of rapid satiety, flatulence were significantly lower in the main group (5–8 days compared to the control group (10–14 days). A significant normalization of GGT and CRP levels was established in the main group, while in the comparison group there was only a decrease in CRP. The ongoing complex therapy was accompanied by an improvement in the ultrasound picture of the pancreas, potentiation of the effects of pharmacotherapy and a significant improvement in the quality of life of patients. Conclusions . The conducted studies have shown high efficiency, good tolerability and safety of the therapeutic product “Pancreatic jelly” in the treatment of patients with chronic pancreatitis. Kissel “Pancreas” is recommended by the authors for active use in patients with pancreatitis as a therapeutic diet.

Purpose: to evaluate the efficacy and safety of the Tummy Ease dietary supplement in the treatment of patients with functional constipation and IBS with a predominance of constipation.

In different periods of time, the leading pathology determining pharmacotherapy has become one that has reached a new level of study. At present, this pathology is intestinal flora disorder, which affects the trophicity of the intestinal wall, functional disorder and the formation of pain. The second type of disorder is enzyme insufficiency, which forms polypathology. These two disorders are primarily targeted by the search for pharmacological agents (their synthesis) for more successful treatment. This report provides information on two new drugs that qualify as dietary supplements. The first belongs to the group of probiotics (metabiotic), the second to the group of enzymes (predominantly herbal). Documents for registration were submitted by “Vitabiotics” in 2020. They are currently approved for use. Supporting materials have been submitted by the company and include two reviews and results of the effectiveness of the treatment of different gastrointestinal pathologies (organic and functional) with the indicated drugs in 613 patients. The clinical effects shown by the authors are associated with normalisation of the intestinal flora and restoration of functional disorders (or in reverse sequence, normalisation of motility followed by normalisation of the flora carried by the metabiotic). The second drug contains a set of herbal enzymes. Its effects are as good as those of animal enzymes, it expands the range of nosologies of use and has ‘psychological benefits’. Overall, the results are evaluated as positive, no severe complications have occurred. Lactase deficiency, which is quite common, is highlighted as a prospective use.

This review of the literature is devoted to the importance of nutritional support in the treatment and prevention of diseases of the gastrointestinal tract associated with Helicobacter pylori. Modern data on the biological properties of H. pylori and the mechanisms of colonization of the microorganism in the gastrointestinal mucosa are presented. Information is provided on the virulence factors and factors that promote adhesion, depolymerization and dissolution of protective mucus, damage and circulatory disorders of the gastrointestinal mucosa, secreted by H. pylori (lipopolysaccharides and proteins of the outer shell of the bacterium, enzymes – mucinase, protease, phospholipase, urease, VacA cytotoxin). The article pays special attention to the issues of diet therapy, the role of various foods and their components in the dietary correction of disorders in gastrointestinal diseases associated with H. pylori. The causes of nutritional disorders in patients with gastrointestinal diseases are described and a detailed description of food products and their biologically active components with anti-Helicobacter activity is given. A special section is devoted to the use and effectiveness of specialized dietary products for therapeutic and preventive nutrition of domestic production (LLC “Leovit nutria”) and the features of use in diseases of the gastrointestinal tract mediated by H. pylori. The authors provide information on the composition of dietary products, their anti-inflammatory, antioxidant, immunotropic and other activities that underlie clinical efficacy. The article provides detailed recommendations on the use of specialized dietary foods for this pathology.

COVID-19 infection may present with gastrointestinal lesions in up to 25% of patients. One of the target organs of the SARS-CoV-2 virus is the intestine. The pathogenesis of intestinal damage in a new coronavirus infection remains unclear and requires further in-depth study. Possible mechanisms include a direct cytotoxic effect of the virus, a persistent reduction in butyrate-producing bacteria, side effects of drugs, Clostridioides difficile infection, microvascular thrombosis, and the immune-mediated inflammatory reactions in the intestine. The most common symptom of intestinal damage during coronavirus infection, both in the acute phase and in the post-COVID period, is diarrhea. The impact of many aggressive factors on the intestines can form both long-term functional disorders and be the cause of the onset of organic diseases. Treatment should be aimed at possible causes of intestinal damage (Clostridioides difficile), as well as reducing inflammation, restoring intestinal permeability, cytoprotection of mucosal cells, replenishing butyric acid deficiency. When choosing a therapy for intestinal disorders, preference should be given to drugs with a pleiotropic effect in order to influence various possible pathogenetic mechanisms.

Aim of investigation: to evaluate the effectiveness and safety of the use of dietary supplement "Tummy ease" in the treatment of patients with functional constipation and IBS with a predominance of constipation. Materials and methods: The treatment of 33 patients was analyzed. 18 patients with FС (2 men and 16 women, mean age 50.6 ± 4.0 g) and 15 patients with IBS-C (2 men, 13 women, mean age 51.8 ± 4.5 years). Patients received Tummy ease 2-3 capsules/day for 28 days. The safety of treatment was assessed by the dynamics of biochemical parameters, the frequency and presence of side effects. To evaluate the effectiveness, we studied: the time of the carbolenic test, the dynamics of constipation symptoms according to the sum of points of the counting scale for assessing the severity of constipation and the PAC-SYM questionnaire, the dynamics of symptoms of the gastrointestinal tract according to the GIS questionnaire, the dynamics of quality of life according to the GSRS questionnaire. Results of the study: in patients with FC and IBS, there was a significant decrease in the symptoms of constipation (difficulty/pain during defecation, feeling of incomplete emptying, abdominal pain, time spent in the toilet, assistance with defecation, unsuccessful attempts to empty) and an increase in the frequency of defecation. According to the PAC-SYM questionnaire, patients with FC and IBS-C showed a significant decrease in abdominal discomfort, bloating, straining, feeling of incomplete emptying, defecation scarcity and difficulty, and the total symptom score. Patients with IBS-C additionally noted a decrease in abdominal pain, painful bowel movements and the number of false urges. The time of the carbolenic test significantly decreased in patients with FC from 49.4 ± 3.8 to 30.0 ± 2.3 hours (p = 0.00003), in patients with IBS-C from 62.7 ± 6.9 to 43.8 ± 6.4 hours (p= 0.002). In patients with FC and IBS-C, there was a significant positive dynamics of the symptoms of the gastrointestinal tract according to the GIS questionnaire and a significant improvement in the quality of life according to the GSRS questionnaire. Conclusion: The drug (BAA) Tummy ease is effective and safe in the treatment of patients with functional constipation and IBS-C and can be used as an alternative therapy.

Introduction. Diverticular disease of the colon is one of the most common gastrointestinal diseases. During the last 30–40 years, there has been a “rejuvenation” of the disease. Today, the prevalence of the disease in people under 40 years of age is 5–10%, and therefore the costs of diagnostic testing and treatment are gradually increasing, which makes the disease socially significant.Aim. To study the clinical features of diverticular disease, the features of diagnosis and treatment, and prophylactic approaches. The specific objectives of the analysis were to study epidemiology; study the role and a necessary minimum set of laboratory diagnostic test methods for the diagnosis of diverticular disease; study the incidence rate of SIBO and its impact on the clinic presentation and treatment; develop an algorithm for the diagnosis, treatment, prevention, and management of patients with diverticular disease.Materials and methods. A total of 195 patients with different forms of diverticular disease were examined. As diagnostic tests, we used blood tests, stool tests, biochemical tests; inflammatory tests: calprotectin, CRP, fibrinogen, ferritin; ultrasound imaging, irrigoscopy, CT, NMR, colonoscopy (if medically required); clinical manifestations at different stages of the course of diverticular disease. 5-aminosalicylates were used to treat exacerbation with inflammation; alpha-normix and motility regulators were used to treat exacerbation without signs of inflammation.Results. On the basis of the study results, we suggested an algorithm for the diagnosis, management and treatment of patients with diverticular disease. According to the particulars of the management, it is reasonable to divide all patients with diverticular disease into three groups: 1) patients who underwent acute diverticulitis; 2) patients with uncomplicated diverticular disease; 3) patients with complicated diverticular disease.Conclusions. The first two groups should be followed up by a gastroenterologist/general practitioner, the third group should be followed up by a surgeon. The patient tested positive for SIBO should receive drugs to eradicate SIBO. The treatment regimens for exacerbation of diverticular disease are proposed.

Abstract Introduction. Modern gastroenterology is characterized by the combined (comorbid) nature of the diseases. In treatment, this promotes polypharmacy and increases complications (drug lesions, allergic reactions, exacerbation of diseases of other organs and systems), and, importantly, increases the cost of pharmacotherapy.Aim. To compare two pharmacotherapy options for patients with gallstone disease at the stage of biliary sludge and patients with biliary sludge combined with irritable bowel syndrome.Materials and methods. In the work, based on the experience of treating 170 patients, two options for pharmacotherapy are considered, which may well turn out to be rational in all respects. Option 1 - monotherapy aimed at one of the components that form a complex pathogenetic symptom complex. The basis for offering this treatment option is the biological concept of the “regulatory cascade”. Option 2 – “stepwise” (stepwise) therapy with the choice of the “base” drug for the first step. Evaluation of the effectiveness and rational correction for the second step of treatment and subsequent ones – if necessary. Results. The biliary sludge was eliminated or reduced in patients who received the UDCA monotherapy against the background of recovery of gastrointestinal motility. The overall treatment effect (for each nosology) in patients with biliary sludge and irritable bowel syndrome using the complex therapy (UDCA and mebeverin) was 84 and 87.8% respectively.Conclusions. Both options are rational today: 1st requires further study; 2nd – active use. Both options exclude polypharmacy and other adverse effects.

This article provides an overview of the data on postcholecystectomy syndrome (PCES). The entire period of study of this frequent complication (up to 40%) can be divided into 2 periods: surgical and therapeutic. Surgical complications of cholecystectomy accounted for 10% and were studied by surgeons. This study led to the correction of surgical treatment, formulated the examination program and reduced and minimized surgical complications. The second part of the complications is made up of functional disorders of the sphincter of Oddi, which today are the leading ones and, apparently, remain so. The article gives an idea of PCES as a dynamic disorder of the sphincter of Oddi, gives the last definition of PCES given by the IV Roman Concensus, suggests an algorithm for diagnosis and treatment. As a clinical illustration, the authors present their own data on the diagnosis and treatment of 60 patients with PCES, which confirmed the point of view proposed by the international gastroenterological community. The authors separated two types of postcholecystectomy syndrome: one with a predominance of sphincter of Oddi (SO) spasm and another with a predominance of sphincter of Oddi hypotension. The drug of choice in the spastic type is the selective antispasmodic gimecromone, in which case a dose is of the essence. In case of a hypotonic type of postcholecystectomy syndrome, motor regulators to increase the SO tone should be used. The therapy should be stepwise with an assessment of the effect and correction of the next step of treatment. This treatment option for patients with postcholecystectomy syndrome we see today as the leading one. The features of treatment associated with the developing syndrome of bacterial overgrowth (SIBO) and chronic biliary insufficiency (CBI), which require constant monitoring (diagnosis) and permanent treatment, are considered.

Aim of investigation: to assess the effectiveness and tolerance of dietary supplements (BAA) STIM and STIM LaxMaterials and methods: The analysis of the treatment of 73 patients who were divided into 2 groups. Group 1-32 patients with functional constipation (8 men and 24 women; mean age — 45.7 ± 12.4 years), Group 2-41 patients with functional diarrhea (19 men and 22 women; mean age — 41.0 ± 15,8 years). The study of clinical symptoms was carried out according to the data of an individual diary, using specialized questionnaires with a scoring of symptoms before and after the course of treatment, before and after treatment, the result of the carbolene test, the content of short-chain fatty acids in the feces was assessed. Tolerability was assessed by recording side effects and adverse events.Monotherapy was carried out with STIM LAX for patients with functional constipation at a dose of 1 tablet 3 times a day for 30 days. STIM for patients with functional diarrhea was prescribed in a dose of 2 tablets 3 times a day for 30 days.Results of the study: The results of the study showed that FC therapy with StimLax effectively reduces the frequency and intensity of symptoms such as difficulty / pain, discomfort during defecation, feeling of incomplete emptying, abdominal pain, time spent in the toilet and the number of failed bowel movements. We observed the normalization of transit time according to the carbolene test and an increase in stool frequency up to 5 times a week.Treatment of patients with FD with Stim led to a significant decrease in the intensity of abdominal pain, rumbling, flatulence, stool frequency, an increase in the time of the carbolene test and the normalization of its consistency.Adverse events were observed in 8 (10.9%) patients (4 patients with FD and 4 patients with FD). On the 3-5th day of treatment, there was an increase in flatulence, rumbling in the abdomen. A temporary decrease in the dose of the drug to 1-2 tablets per day removed these phenomena and the symptoms that appeared were resolved within 1-3 days. After that, the dose of the drug was gradually increased to the initial (effective), which the patients tolerated normally.Conclusions: The results of this study indicate high clinical efficacy and good tolerability of treatment with drugs StimLax and Stim in patients with FC and FD. In some cases, it is necessary to titrate the dose of the drug (downward), but this is not accompanied by a decrease in the effectiveness of therapy. The use of these drugs with metaprebiotic properties helps to modify the microbiota of patients with functional bowel diseases. With constipation, the number and activity of both lactic acid flora and microorganisms that produce butyric acid are stimulated; in addition, calcium lactate is an additional source of butyric acid due to metabolism. With diarrhea, along with the stimulation of the number and activity of the lactic acid flora, there is an improvement in the utilization of butyrate by intestinal cells.

Introduction. The high prevalence rates of biliary sludge and its frequent development into the stone stage of cholelithiasis constitute grounds for studying this issue, as the effective action on biliary sludge can prevent overall disease progression.Purpose of the study. To determine the options for diagnosis of biliary sludge in the polyclinic settings. Objectives: 1) Estimate the frequency of diagnosis of biliary sludge. 2) Assess the features and dependence of treatment on the type of biliary sludge. 3) Assess the outcome of treatment depending on the follow-up managing of patients. 4) Propose an algorithm for managing patients after biliary sludge has been diagnosed.Materials and methods. In the work used data of the clinics of the President of the Russian Federation. The total number of people surveyed for 1 year was 1.117. These patients underwent an ultrasound examination (dispensation) and 218 were fitted with biliary sludge (BS), which was 19.4%. Of the 70 patients with BS, 4 groups were formed: 1st group (20 patients) with BS type, 2nd (20 patients) – with BS type, 3rd (20 patients) – with BS type, 4th (10 patients) – with BS-type (BSS) type.All patients received Exchhol therapy at the rate of 15 mg/kg of weight; patients with a pronounced spastic component in the sphincter system – myotropic spasmolytic Sparex (20 mg x 2 times a day); patients of the 4th group (with a near-located sediment indicating the presence of inflammation) – Adisord (derived nitrofuran) 200 mg x 4 times a day (5 days).Results. The type of precipitation was cupped in 4 weeks of treatment; Type – for 8–12 weeks of treatment, type V – for 13–14 weeks.Conclusions. The presented data allow us to hope that early diagnosis of biliary sludge and the factors of its development will help start timely treatment and prevention of the disease.

Introduction. Functional gastrointestinal disorders (FGID) occupy one of the leading positions among intestinal pathologies. At present, scientific data indicate the lack of efficiency of existing methods of FGID treatment and the need for further research. This study is devoted to the assessment of the impact of STIM Lax and STIM treatment on clinical manifestations in patients with FC and FD.Aim of the study. Evaluation of the effectiveness of biologically active additives (BAA) STIM and STIM Laks in 39 patients with functional gastrointestinal disorders. Objectives of the study: to evaluate the effect of the drug on clinical symptoms according to an individual diary and using specialized questionnaires with a score of symptoms before and after treatment.Materials of the research. 39 patients divided into two groups were admitted to the research. Of these, 20 patients were with FC (4 men and 16 women; mean age – 40.3 ± 8.9 years). Monotherapy with STIM Laks was conducted (1 tablet 3 times a day for 30 days), and 19 FD patients (10 men and 9 women; mean age – 36.9 ± 14.1 years). Before and after the course of treatment a carbolene sample was conducted, stool form and frequency, intensity of flatulence, purring, transfusion, abdominal pain were clinically evaluated.Results. Therapy of FС and FD with STIM and STIM Laks effectively reduces the frequency and intensity of clinical symptoms, normalizes the transit time of the carbolene sample, the frequency of stool. Increase of flatulence was observed in 7 (17.9%) patients, its resolution within 1–3 days led to a decrease in the dose of the drug, without affecting the end result.Conclusions. This study indicates a high efficacy and good tolerability of treatment with STIM Laks and STIM in patients with FGID.