Summary Investigation of the influence of non-steroidal anti-inflammatory drugs on the motor activity of the stomach and duodenum. The effect of non-steroidal anti-inflammatory drugs on the electromotor activity of smooth muscle of the stomach and duodenum in normal rats and in the simulation of gastric and duodenal ulcer was investigated. It is shown that cyclooxygenase blockers increase the electromotor activity of the gastroduodenal complex and accelerate the repair processes in the area of g astric ulcers.

Functional diseases of the digestive system (FZOP) is a group of disorders characterized by a violation of the interaction between the central (brain) and peripheral parts of the nervous system, which ensures the activity of the organs of the gastrointestinal tract (GIT).Overlap-syndrome -a syndrome of overlapping functional diseases of the digestive system, in which two or more disorders are combined, united by common pathogenetic mechanisms.The goal is to identify the role of gastrointestinal motility disorders in the intersection of functional diseases of the gastrointestinal tract -functional dyspepsia and GERD.Results and discussion.Identified disorders of motor function include hypomotor dyskinesia of the stomach (77.5%), small intestine (35%) and right colon (53.8%).The results indicate the development of SIBO in the small intestine and dysbiosis in the ascending colon intestines.The predominant spastic activity of the right and left parts of the colon indicates the development of constipation.

Aim - to evaluate the effect of exogenous serotonin on the motility of the bauhinian valve and to identify the mechanism of this effect. Materials and methods. The experiments were performed on 36 Wistar rats weighing 250-270 g. The motor function of the ileum, ileocecal region, and caecum was recorded in the animals of two experimental groups (n=30). tonic contractions and propulsive activity. As a result of the study, it was shown that serotonin has a prokinetic effect on the ileum, the ileocecal junction with the Bauhinian valve and the caecum. 5HT3,4 receptors are located on the cytolemma of intramural serotonergic neurons and EC cells, and 5HT1,2 receptors are located on the cytolemma of effector smooth muscle cells. The Bauhinian valve contains the largest number of 5HT3,4 serotonin receptors, which is due to the complex function of this formation in the regulation of propulsive activity at the border of the small and large intestine.

Introduction. Metabolic correction of the consequences of extensive (especially combined) intestinal resections requires enormous efforts due to weight loss, a decrease in plasma albumin concentration of less than 30 g/l, electrolyte disorders, organ failure, etc. There are consequences in the form of short small intestine syndrome, postcolectomy syndrome and the combined consequences of resections of the small and large intestine. The most severe changes are after combined thin-thick-intestinal resections, the prevalence of which continues to increase. Nevertheless, the data on the occurrence of combined resections (thin-colon) are very contradictory. Aim. To analyze the effectiveness of nutritional correction programs in SBS syndrome due to extensive combined small-colonic resections and to characterize possible ways of correcting metabolic complications with the help of nutritional correction, taking into account the optimization of absorption in the intestine. Materials and methods. We examined 208 patients with combined extensive resection of the small intestine with right-sided hemicolectomy (65% of men and 35% of women). Metabolic changes, nutritional characteristics and reparation under the influence of nutritional correction in this category of patients are described. Results. Data on the restoration of lost functions are presented, which is based on the analysis of the mechanisms of adaptation and cellular regeneration. Regenerative aspects of hormonal (enteroglucagon) regulation of intestinal functions after its extensive resection and artificial alimentation are closely related. Conclusion. It is advisable to introduce teduglutide into the treatment structure to stimulate rehabilitation absorption processes after extensive combined intestinal resections.

Aim. To identify the role of impaired motor function of the gastrointestinal tract (GIT) in the overlap of functional disorders (FD). Materials and methods. Thirty-two abdominal FD patients were followed up, with a predominance of women aged 33.76.1 years (75%). Men aged 31.85.6 years were 25%. All patients had symptoms of GIT FD established according to the Rome IV criteria, endoscopy, and abdominal ultrasound. In addition, patients underwent 2-hour pH-metry and electromyography of the abdominal organs using bipolar silver electrodes with a surface area of 0.50.6 cm2. The amplitude-frequency characteristics of slow waves and spikes and the power of phase and tonic contractions were analyzed using the Canon M hardware and software complex with a transmission frequency of 0.1 to 10 Hz and a noise level of 15 W. Results. Overlapping clinical symptoms of motor disorders in gastrointestinal tract functional disorders are observed at a young age, mainly in women. The abnormal ratio of the gallbladder and common bile duct motility in overlapping GIT FD was 1:1.08, with a pronounced increase in contractions of the common bile duct, which could lead to an increase in pressure in the biliary system, pain, and insufficient flow of bile to the duodenum, disrupting the digestion and worsening the dyspepsia. Conclusion. The study showed a tendency for higher incidence of functional disorders in young women. Patients with overlapping disorders also have more severe pain than those with isolated disorders.

This article presents a clinical case of thrombophilia in a patient with short bowel syndrome. Thrombophilia is characterized by a disorder of the blood clotting system, in which the risk of thrombosis increases. Thrombophilia, local vascular insufficiency, intestinal obstruction with fistula formation requiring intestinal resection play a significant role in the pathogenesis of short bowel syndrome. The patient was admitted with the diagnosis “thrombophilia, resection of the small intestine (residual small intestine 17 cm), ileostoma”. Condition after multiple surgical interventions on the abdominal cavity. Surgeries performed: atypical gastric resection, resection of the greater omentum, jejunostomy, resection of the cardial and antral parts of the stomach, derivation of duodenostomy, esophagostomy, derivation of loop jejunostomy, Braun enteroanastomosis, perforation of the colon, suturing, derivation of colostomy, cholecystectomy, GI reconstruction, Roux esophagoenteroanastomosis, resection of the sigmoid colon, small intestine, bearing intestinal fistulas, removal of double-barrel ileostomy, abdominal cavity drainage, relaparotomy, closure of ileal perforation, retrograde intubation of the small intestine, determination of indications for intestinal transplantation. The following tests were performed: CT-enterography, colonoscopy with subsequent morphological examination, abdominal ultrasound, enterogastroscopy, clinical and biochemical blood tests, PCR, coagulogram, urinalysis, percussion and auscultation of the chest. Morphological examination showed fragments of the wall of the colon – with erosion, fragments of fatty tissue – with immature granulation tissue, fragment of stroma covered with multilayer flat keratinized epithelium with the focus of epithelized slit-like ulcer. Clexane was administered as part of the treatment complex, nutritional support additionally included Micrazyme capsules 25000 units, teduglutide, remabipid. Rebamipid and Teduglutide allowed to stabilize the patient's condition and improve the condition of the perioperative area tissues. In case of ineffectiveness of the therapy used the indications for liver transplantation are determined.

Introdiction . The presence of obesity in a patient or, conversely, malnutrition is accompanied by various metabolic disorders and is the focus of modern medical science and healthcare organizers. Objective . To reveal the mechanism of action (impact on motility through the intestinal microbiota) of the drug mebeverine in the structure of concomitant therapy for IBS. Material and methods . The index of nutritional insufficiency was proposed and calculated by us on the basis of the parameters of the alimentary-volemic diagnosis, expressed in points; up to 29 points – a mild degree of nutritional deficiency (the risk of surgery is minimal, the operation is possible after a short-term infusion preparation); 29–30 points – medium degree (the risk is relatively high, the operation is possible only after at least minimal preliminary infusion-alimentation correction); 31–33 – severe degree of nutritional insufficiency (the risk of surgery is high, surgery can only be performed in an emergency after minimal preparation or planned after a long preparation of the patient for surgery until the nutritional status is increased by 1–2 levels; 34–42 – extremely severe (only emergency surgery or palliative after preliminary preparation, raising, if possible, the nutritional status by 1–2 levels).Rehabilitation potential was determined according to generally accepted formulas. Microbiota was also determined by the traditional method. Electrical activity and the nature of motility were determined by it using a mingograph. Results and discussion . During the examination, it was revealed that the microbiota differs with different HN. At 29–30 points, HH and high RR occur. Rehabilitation potential (RP) has 4 levels of assessment: High rehabilitation potential implies the possibility of achieving a full recovery of health Conclution . Gut microbiota is a key regulator of metabolic disease. When taking mebeverine, it is advisable. Apparently, to apply a detoxification correction, because it is metabolized in the liver. There is no doubt that it is expedient to further study the state of the microbiota in the modern world with various TIN.

Introdiction. In recent years, many new technologies for the management of patients with short bowel syndrom (SBS), including SBS-IF (short bowel syndrom with intestinal failor), have appeared. The implemented surgical techniques are aimed at slowing down the progress of intestinal contents (antiperistaltic inserts, the creation of artificial valves in the small intestine, loops or pockets from the small intestine, etc.); surgical elongation of the small intestine (the most common STEP, Bianchy technique); intestinal transplantation. At the same time, when the intestine is shortened to 1.5–2,0 m, the adaptive rearrangements are still able to provide (albeit suppressed), but partially preserved absorption processes (in 80% of cases, the surface of the intestine is sufficient for slow transport of nutrients from the intestine to the blood). Therefore, it is important to increase the efficiency of adaptive rearrangements in any conservative way shown.Аim. Тo evaluate the role of hormonal stimulation of adaptive rearrangements in the residual bowel stump.Materials and methods. Рarameters of the well-known alimentary-volemic diagnosis, assessment of adaptive changes in the gastrointestinal tract (performed by determining citruline and GLP-2, as well as by morphological method). To stimulate the regulation of adaptive processes, a hormone preparation GLP-2 (teduglutide) was used in the nutritional support program.Results. It was shown that the length of the intestinal stump up to 1.5–2.0 m allows for digestive and transport processes due to adaptive rearrangements of the intestinal epithelium. With a super-short intestine, it is advisable to choose surgical methods of correction.Conclusion. For conservative correction of adaptive processes in the intestine, it is advisable to use a GLP-2 hormone preparation, in particular, teduglutide.

The purpose is the tactics of nutritional rehabilitation after extensive intestinal resection. The metabolic characteristics of the short intestine syndrome and the consequences of combined finebinding resections, as well as the adaptive and regenerative possibilities of the intestine. The optimal scheme of nutritional correction is given in consequences of intestinal combined resection.

The Aim: Is to identify the features of the motor activity of the gastrointestinal tract and the gastrointestinal tract in combined IBD -PSC.Materials and Methods: 10 patients with PSC -IBD were under observation, and the ratio of men: women is 2:3.Clinically, patients (PSC -CD) had ileum lesion to varying degrees, total damage to the colon, stool from 1 to 3 times a day without blood.The motor function of the gastrointestinal tract and the gastrointestinal tract in the studied patients was recorded electromyographically using the Nihon Kohden hardware and software complex (Japan).Statistical analysis was performed by the Mann-Whitney small sample method at p<0.05.Results: With PSC -IBD, hypermotor gastric dyskinesia of a weak degree is observed with a proportional increase in the motor function of the longitudinal, circular and oblique muscles.Hypomotor dyskinesia was detected in the duodenum.High hypermotor dyskinesia was detected in the jejunum, and moderately pronounced in the iliac.Signs of dysbiosis were revealed in the cecum and in the ascending colon.Hypermotor dyskinesia was detected in the descending colon and sigmoid.The lack of propulsive activity of choledochus in PSC -IBD is compensated by hypermotor dyskinesia of the gallbladder, which supports the motility of the duodenum and jejunum due to the intake of concentrated bile into the intestine.

Adhesive disease is a syndrome caused by the presence of adhesions in the abdominal cavity, formed due to various reasons, and characterized by frequent bouts of relative intestinal obstruction.Purpose. Determine the complex of rehabilitation measures for adhesive disease.Material and methods. Patients with the following forms were observed: a) with pain syndrome (84.1%); b) with periodically recurring attacks of intestinal obstruction; c) there may also be asymptomatic SB (not found in observations). All patients had the following symptoms as pain, thirst, nausea (sometimes vomiting that does not bring relief), a feeling of heaviness in the abdomen, tachycardia, discomfort, flatulence, arterial hypertension. Ultrasound of the abdominal organs and laparoscopy, MSCT of the abdominal organs and plain radiography of the abdominal cavity and electrogastroenterography were performed to detect violations of the motor function of the gastrointestinal tract.Results and discussion. The complex of rehabilitation measures included the following rehabilitation. Outside the attack of adhesive disease (an attack of intestinal obstruction) and with adhesive dynamic obstruction, patients were treated conservatively; surgical rehabilitation was prescribed for an attack of adhesive mechanical obstruction. Conservative rehabilitation included exercise therapy, diet, folk remedies, medical correction.

The purpose is the tactics of nutritional rehabilitation after extensive intestinal resection. The metabolic characteristics of the short intestine syndrome and the consequences of combined fine-binding resections, as well as the adaptive and regenerative capabilities of the bowel, are presented. The optimal scheme of nutritional correction for the consequences of combined bowel resections is presented.Conclusion. To stimulate adaptive-regenerative processes in the intestine, it is advisable to use teduglutide (analogue of GLP-2); if ineffective, surgical rehabilitation can be recommended.

The aim is to study motor disorders of the gastrointestinal tract and biliary tract with erosion of the stomach. Materials and methods. Electromyography (EMG) of the gastrointestinal tract and biliary tract was performed in 35 patients with gastric erosions; the control group consisted of 10 patients with gastric ulcer. A morphological study of biopsies of the antrum of the stomach was carried out. Results. Patients with erosion of the stomach were characterized by severe hypermotor dyskinesia of the stomach with a decrease in the motor function of the small intestine and multidirectional changes in the motor function of the colon. Motility of the biliary tract is characterized by an increase in tonic activity with a slight increase in phase activity. Histological examination revealed areas of fibrinoid necrosis in its own plate and foci of destruction of the end sections of the pyloric glands. Conclusion. Motor function of patients with gastric erosion is characterized by a greater power of muscle contractions of the stomach, a smaller power of muscle contractions of the small intestine and multidirectional changes of the power contractions of various sections of the colon.

Focal intrahepatic biliary dilation (Karoli's disease) is characterized by non-obstructive sac-like dilatation of the intrahepatic bile ducts.The aim: To identify gastrointestinal and ZHVP disorders in Karoli's disease.Materials and Methods: There were 16 patients under observation with signs of dilation of the bile ducts, of which 75% were women aged 47.9 ± 6.5 years, 25% were men aged 56.0 ± 7.1 years.Additionally, 75% of cases had chronic (25% -biliary) pancreatitis, gastroesophageal reflux disease, liver fibrosis -in half of the patients, the remaining syndromes -diverticulosis, liver cysts, sphincter dysfunction Oddi -in every eighth patient.The presence of Karoli's disease was verified by ultrasound examination during visualization of dilatation of the bile ducts.Results: Karoli's disease revealed a decrease in the propulsive activity of the common bile duct and possibly a compensatory increase in the motility of the gallbladder.The decrease in the motility of the biliary tract is caused by sac-like extensions of their walls.That is, in Karoli's disease, hypermotor dyskinesia of the colon progressing distally is observed. Conclusion:The presence of a turbulent flow of bile through choledochus in Karoli's disease causes the development of intestinal dysbiosis.Pronounced changes in the motor function of the colon are due to the development of dysfunction of the Oddi sphincter and liver fibrosis observed in the studied patients.

Introduction . Despite the rather long path of development of nutritionology and its significance, a number of doctors and managers of medical institutions do not take into account the level of nutritional safety of the patient. Even after evaluating the operational and anaesthetic risks, there is still a risk of developing metabolic complications that lead to a prolonged postoperative period and surgical problems. The goal . To show the need for metabolic counseling (consultation of a nutritionist) already in the preoperative period, which may limit the choice of the nature of surgery. Material and methods . Two groups of patients with pancreatic head adenocarcinomas (who have passed neoadjuvant consultation only by a surgeon and anesthesiologist and who have passed consultation by a surgeon, anesthesiologist and nutritionist). All patients were assessed for operational, anaesthetic and nutritional risks using standard methods. Results . Neoadjuvant nutritional correction is a mandatory component of treatment of patients with pancreatic cancer. In determining the treatment strategy, consultation with a nutritionist before surgery on the pancreas is mandatory, as consultation with an anesthesiologist and a surgeon.

The method of bioimpedance measurement allows to evaluate the use of a complex of surgical and chemotherapeutic methods accompanied by nutritional support. Patients with colorectal cancer need different saturation of postoperative nutritional support in 90 % of cases, as well as dynamic operational control of the corrected nutritional status. Vector analysis of bioimpedansograms provides qualitative indicators of soft tissue changes that do not depend on body size (information on hydration, exicosis, body cell mass and cell integrity). The study of body composition by bioimpedance method allows to reveal latent sarcopenia and to choose personalized nutritional correction programs that take into account the dynamics of metabolic disorders at the cell level.