The presented study is devoted to one of the urgent problems of the conservative treatment of chronic pancreatitis — relief of painful abdominal and dyspeptic syndromes. Polymorphism of the etiopathogenetic variants of the formation of pancreatic diseases naturally justifies the need for complex therapy, including secretolytics, antispasmodics medications and polyenzyme drugs. The use of Meteospasmyl in complex therapy effectively relieves abdominal pain and dyspepsia, modifies the composition of the intestinal microbiota and improves the quality of life in patients with chronic pancreatitis.

The review article is about the mechanisms of comorbidity of irritable bowel syndrome and obesity. Special attention is paid to the genetic, hormonal mechanisms of comorbidity, the role of anxiety and depressive disorders, the influence of microbiota. Studying the mechanisms of comorbidity may be appropriate in terms of a more detailed study of the pathophysiology and optimization of the treatment of irritable bowel syndrome and obesity and obesity.

Treatment of iron deficiency conditions by nutritive support media is one of the debatable areas. In the analysis of nutritional status, nutritional risk and ferrumdeficiency parameters in patients with operated colorectal cancer in different stages, the possibility of correction of prelatent and latent iron deficiency with ferrum‑containing media of nutritional alimentation is shown. With the development of anemia, the use of с intravenous correction (preferably with drugs sorbed on a special matrix that allows the gland to be isolated in portions) is shown.

The first colproctrectomy with the formation of a pelvic intestinal reservoir was performed in 1970. Since then, the technique has been thoroughly tested and currently it is the gold standard in the surgical treatment of ulcerative colitis and familial adenomatous polyposis. This operation allows to improve the quality of patients’ life, reducing the need to form a permanent ileostomy, improving the psychomotional, social and physical rehabilitation of patients. However, this intervention is associated with a high risk of postoperative complications. Impairment of the the pelvic reservoir functioning, as well as the addition of infection, are terrible complications that significantly worsen the patient’s quality of life. Surgeons performing this type of surgery have to face a number of intraoperative and postoperative complications that require repeated interventions. The aim of the study is to improve the results of treatment of patients with the small bowel reservoir. A review and analysis of the literature is performed in this issue. Successful results of performing colproctectomy with the formation of a pelvic enteric reservoir depend on careful preoperative planning, experience of the surgeon, prevention of intra‑ and postoperative complications.

The article is devoted to the results of our own research into the possibilities of ultrasound diagnostics of various clinical and morphological forms of chronic pancreatitis (CP). It was shown that pronounced structural changes in the pancreas (pseudocysts, calcinates, wirsungolithiasis, pronounced fibrosis) make it possible to diagnose clinical and morphological forms of CP.

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.

In this review authors discuss modern condition of treatment and prophylaxis of human metabolic diseases associated with microecological imbalance of intestinal symbiotic microbiota. Now the most frequently for these aims various probiotic nutrient additives and functional fermented foods prepared on the basis of living bacteria have been used. Unfortunately such probiotics have not possessed the real effectiveness and are not completely safe. Instead of traditional commercially available living probiotics the authors suggest to use novel microecological means (metabiotics) that are structural components of probiotic bactrerial strains, and/or their metabolites and/or signaling molecules with known chemical structure. Metabiotics can optimize host‑specific physiological, regulator, metabolic and/or hormone/behavior functions and reactions. Metabiotics possess some advantages in future personalized medicine because they have exact chemical structure, well dosed, safe and long shelf‑life.

Clinical and endoscopic results of a study at 94 patients with gastroesophageal reflux disease (GERD) and obesity, as well as 85 patients with GERD are presented. A high incidence of atypical clinical manifestations of GERD on the background of obesity (an extraesophageal form of the disease) was revealed. An endoscopic study has mainly established reflux esophagitis of grades B and C (LA) in patients with obesity and a high percentage of cases (up to 59.5%) of duodenogastric reflux with a combination of GERD and obesity, especially in patients with atypical clinical form of reflux disease.

The high prevalence of metabolic syndrome in population has led to the cholelithiasis is important problem of modern health care along with coronary heart disease, arterial hypertension and diabetes. The main role in the formation of gallbladder pathology in patients with metabolic syndrome belongs to insulin resistance, atherogenic dyslipidemia, and non‑alcoholic fatty liver disease. Тhe prescription of ursodeoxycholic acid is pathogenetically justified. This article presents modern views on the mechanisms formation of gallstone disease in the conditions of metabolic disorders and management of this patients based on the results own research.