Aim: to compare the efficacy of different therapeutic regimens for managing functional dyspepsia in outpatients after COVID-19 infection.Materials and methods. 42 post-COVID-19 outpatients (age: 26–47 years) diagnosed with functional dyspepsia (FD) according to the Rome IV Criteria were enrolled in two parallel groups. All patients were divided in 2 groups by randomization: Group 1 received omeprazole at a dose of 80 mg/day, Group 2 received a combination of omeprazole and Kolofort® (a combined action drug product containing technologically processed antibodies to S100, TNF-alpha, and histamine) at a dose of 80 mg/day. At baseline and after treatment, a 10-point VAS was used to measure symptoms and an SF-36 questionnaire to evaluate the quality of life.Results. By Day 28 of the treatment, the intensity of epigastric pain (VAS score) in the group receiving proton-pump inhibitor (PPI) + Kolofort® was significantly lower. In both groups, fully resolved dyspeptic syndrome was observed in up to 90 % of patients, without significant differences (p < 0.06). According to the SF-36 data, a combination treatment resulted in higher scores (pain and general health subscales) as compared to the PPI alone.Conclusion. Kolofort® relieves symptoms and improves the quality of life when added to the treatment regimen against functional dyspepsia in post-COVID-19 patients.

Patients with COVID-19 often suffer from a variety of gastrointestinal disorders. Often this is directly related to the effect of the virus on the epithelial cells of the gastrointestinal tract, as well as the prescription of drugs for the new coronavirus infection treatment. In some patients, gastrointestinal disturbances precede the onset of respiratory symptoms and remain for a long time after recovery, significantly reducing the quality of life. Approximately every second patient who had a COVID-19 infection suffers from stool disorders and dyspeptic symptoms. The most common variant of post-covid lesions of the gastrointestinal tract is functional dyspepsia and irritable bowel syndrome, which outpatient doctors have recently encountered more and more often. In most cases, the attending physician pays more attention to the pulmonary and cardiological manifestations of coronavirus infection, while the symptoms of gastrointestinal lesions are considered minor. The purpose of this article — is to consider possible methods for correcting the functional pathology of the gastrointestinal tract in patients after a COVID-19 infection.

The pandemic of a new coronavirus infection in recent years has led to more frequent and aggressive prescription of antibiotic therapy, which could not but affect the intestinal microbiota. In addition, the direct effect of coronavirus on enterocytes leads to the development of subclinical inflammation in the intestinal wall, contributing to the disruption of the qualitative and quantitative composition of the normal intestinal microflora. Against this background, the number of patients with antibiotic-associated diarrhea, including diarrhea caused by C. difficile, including severe ones. Moreover, the number of clostridial diarrhea resistant to classical vancomycin therapy has increased, which dictates the need to find new ways to treat patients and methods for further prevention of such conditions.

Currently, in the Russian Federation, as well as throughout the world, there is an increase in allergic diseases, including an increase in the number of gastrointestinal manifestations of allergies. Moreover, along with Ig-E-mediated reactions, anaphylactoid reactions occur due to the excessive release of histamine and other biologically active substances from mast cells. These pathological processes can contribute to exacerbation of functional disorders of the gastrointestinal tract, enhancing subclinical inflammation of the mucous membrane, contributing to the development of visceral hypersensitivity and gastrointestinal motility. At the same time, most medical practitioners do not pay due attention to the possible impact of allergic and pseudo-allergic reactions on the course of irritable bowel syndrome and functional dyspepsia. At the same time, it is necessary to take into account that in the case of the syndrome of low resistance to histamine in most patients, the introduction of restrictions on the diet is sufficient and there is no need to prescribe excess drugs. Given the widespread prevalence of functional disorders of the gastrointestinal tract and their significant impact on the quality of life of patients, it is necessary to search for new methods of prevention and treatment of this group of pathological conditions.

В настоящее время в России и во всем мире прослеживается отчетливая тенденция к росту заболеваемости и распространенности гастроэзофагеальной рефлюксной болезни, однако истинные данные об эпидемиологии данного заболевания отсутствуют. Затруднение при своевременной постановке диагноза приводит к несвоевременному назначению адекватной медикаментозной терапии, снижению качества жизни и развитию осложнений. В данной работе проведен анализ частоты встречаемости клинических и эндоскопических симптомов гастроэзофагеальной рефлюксной болезни у пациентов на амбулаторном приеме, возможности терапии данного состояния и динамика качества их жизни на фоне лечения.

Currently, patients quite often and often uncontrollably take antibacterial drugs, which leads to the development of various complications from many organs and systems. One of the most common adverse reactions to taking antibiotics is antibiotic-associated diarrhea. Moreover, such a pathological condition is due to both the direct effect of the drug, and a change in the composition of the intestinal microflora. Despite the frequent occurrence of antibiotic-associated diarrhea, this problem raises many questions among practitioners, since the risk factors for its development and methods of prevention have not been fully studied. This is especially important in patients who have undergone surgical interventions, since the combination in this contingent of the appointment of broad-spectrum antibacterial drugs and altered body reactivity in most cases leads to the development of adverse effects.

Currently, the problem of early rehabilitation of stroke patients is important, since in terms of the prevalence of cerebrovascular diseases and disability after suffering a stroke, Russia is one of the first places in the world. The complex of medical rehabilitation of such patients should provide for the early and most complete restoration of all body functions, patient education for lost skills, re-socialization of the patient and improvement of the quality of life. One of the factors contributing to a significant reduction in the quality of life after a stroke is the development of chronic constipation. The article reflects the modern methods of correction of chronic constipation in patients with limited mobility.

Currently, there is an increase in the number of patients with irritable bowel syndrome (IBS). However, to date, there is no single concept of the etiopathogenesis of functional disorders of the digestive tract. Initially, great attention was paid to disorders of motility and impaired regulatory interactions of the brain‑intestine as causes of irritable bowel syndrome, but in recent years the focus has shifted to subclinical inflammation in the colon mucosa and the development of visceral hypersensitivity. The reasons contributing to the formation of immune inflammation in the intestinal wall, include a violation of the composition of the intestinal microbiota, as well as food allergies and food intolerance. This article discusses the qualitative and quantitative changes in the intestinal microbiota in patients with irritable bowel syndrome if they have food allergies, as well as the effect of the composition of the intestinal microbiota on the clinical variant of irritable bowel syndrome. The study included 257 patients with IBS. At the first stage, an assessment was made of the history of food allergies, such as IBS, in accordance with the Bristol scale, as well as a microbiological study of feces. At the second stage, the evaluation of intestinal microbiota correction schemes was carried out in patients who had food allergies. The patients were divided into two equal groups, the first group received intestinal antiseptic in combination with multi‑component probiotic, the second — intestinal antiseptic in combination with Saccharomyces boulardii. When analyzing the obtained results, it was noted that approximately half of patients with IBS in the anamnesis had manifestations of food allergy. In most cases, food allergy was associated with the development of patients with IBS variant with diarrhea and excessive growth of conditionally pathogenic microflora with a decrease in the number of lactic and bifidobacteria. When comparing schemes for the correction of disorders of the intestinal microbiota, the greatest efficacy was observed with the combination of intestinal antiseptic and Saccharomyces boulardii.

АннотацияАртериальная гипертония часто сопровождается наличием депрессивных состояний, что способствует формированию функциональных расстройств желудочно-кишечного тракта (ЖКТ).Помимо этого, к развитию последних приводит нерациональное питание и нарушение пищевого поведения, хронические психоэмоциональные перегрузки, постоянное нарушение режима сна и бодрствования, сопутствующий прием медикаментозных препаратов, влияющих на моторику пищеварительного тракта.Терапия таких пациентов требует пристального внимания ввиду высокой распространенности патологии и снижения качества жизни пациентов.В данной работе проведен анализ различных схем терапии функциональных расстройств ЖКТ, а также лечение пациентов при перекресте функциональной патологии в условиях поликлиники.При лечении пациентов учитывалось наличие сопутствующей артериальной гипертонии

Aim: To develop evidence-based recommendations for primary care physicians and general practitioners (GP) on choosing the proper management tactics and making valuable & quick diagnostic decisions at outpatient phase for patients with symptoms of dyspepsia, and also reveal possible oncology on time. Summary of recommendations: Approximately 40% of the patients in Russia presenting to primary care with symptoms of dyspepsia. A doctor has to focus on the warning signs, which may require an urgent additional examination & the consultation with a surgeon/onco-surgeon or other specialists if required. With regard to a risk of cancer, a doctor should be more cautious in patients over 45 years of age. Early diagnosis of oncology depends mainly on cautiousness of GP, primary care physicians and their knowledge, future tactics with regard to the patients. From the mandatory diagnostic tests during the first visit, esophagogastroduodenoscopy and H. pylori diagnostics helps to exclude any organic esophagus and stomach pathology, possible oncology. While waiting for endoscopy results, a physician should use the preliminary diagnoses “Uninvestigated Dyspepsia” (ICD-10 К 31.9) (disease of stomach and duodenum, unspecified). After exclusion of all warning signs, therapy of dyspepsia should be in accordance to the order of the Ministry of Health No 248 which gives an option to use proton pump inhibitors (omeprazole or rabeprazole 20 mg daily) in combination with prokinetic (domperidone 30 mg daily). Fixed drug combination of omeprazole 20 mg and modified-release domperidone 30 mg/daily (Omez® DSR) is medically reasonable. Conclusion: The introduction of this recommendation into clinical practice will help clinicians to prevent diagnostic mistakes, unreasonable use of expensive diagnostic examinations and inappropriate treatment leads to improvement in the overall prognosis and quality of life for the patients.