The article presents the results of a study of 48 patients who suffered from chronic pancreatitis pancreatitis in the stage of exocrine insufficiency with an assessment of the incidence of their excess bacterial growth syndrome (EGBS). EGBS was established in 50 % of patients. Adequate enzyme therapy leads to the elimination of EGBS in 47 % of patients, the rest required antibacterial therapy, since EGBS weighted clinical symptoms and prolonged the stage of exacerbation of pancreatitis.

The article presents the results of the investigation of effectiveness of initial and maintenance treatment with proton pump inhibitors in patients with gastroesophageal reflux disease (GERDJ.The dates of effectiveness of constant, course treatment and therapy on demand' in patients with non-erosive and erosive forms of GERD and adherence to this options of therapy are in this article.

Introduction: In article the data on interrelation between gallbladder contractility and a level of hormones of a thyroid gland (threeiodethyronine, thyroxine, thyrotropin hormone [TTH] and antibodies to thyreoperoxidase [АТtoTPO,]) in plasma of blood at 470 healthy persons and 540 patients with gallstone disease are submitted. The contractility function of a gallbladder on ultrasonic at persons with gallstone disease is authentic less, than at healthy persons. Dysfunction of a thyroid gland is found out in women with gallstone disease: increase TTH and АТtoТPО. Among men hormonal shifts are not revealed. Contact chemical litholysis with methyl tert butyl ether of cholesterol stones in gallbladder except for their dissolution, improves its contractility activity.

The main mechanisms of development and prevention of functional dyspepsia and stress-ulcerative lesions of the gastrointestinal tract in surgical gastroenterology are considered in the article. The schemes of complex treatment of patients and features of the use of bismuth-containing drugs are presented. The complex differentiated approach to the treatment of functional dyspepsia of helicobacterial genesis and the prevention of stress erosive and ulcerative lesions of the gastrointestinal tract, including direct exposure to the stomach and intestinal mucosa, is most effective in interrupting the mechanisms of development of functional dyspepsia and the formation of stress ulcers.

Introduction. The huge role of Helicobacter pylori in the development of a number of diseases, the importance of eradication of H.p. in the treatment of these diseases, and the prevention of stomach cancer on the background of reducing the effectiveness of the modes of the 1st line anti-H.p. therapy requires a search for new more effective modes. The aim of the study was to determine the effectiveness of the modified antihelicobacter therapy in combination with complex synbiotic preparation of Natuma Bactoflor 12+. Materials and methods. It was conducted a double-masked controlled study of a tailor-made protocol. In the 1st group (n = 31) patients received a 14-day modified sequential therapy (MSty on the background of a synbiotic preparation of Natuma Bactoflor 12+. In the 2nd group (n = 31) patients received only MST. The comparison group had not significant differences in all criteria, which could influence the final results of the study. Results. Eradication of H.p. in the 1st group of 93.5 % (ITT and 97 % (PP), respectively, in the 2nd group of 77.4 and 85.7 %. In total, the development of adverse events in the 1st group, with 19.4 % of all the surveyed and 20 % of patients treated according to protocol, and in the 2nd group respectively 38.7 and 42.9 % (p < 0.05). The activity of the inflammatory process in the mucosa of antrum and body of stomach had no differences before treatment and was significantly less after treatment in the study group when the adjuvant use Natuma Bactoflor 12+ than in the control group (p < 0.001). Conclusions. The use of Natuma Bactoflor 12+ on the background of modified sequential therapy, increases the percentage of eradication of H. pylori, reduces the severity of inflammation in gastric mucosa, reduces the frequency of adverse events among included and completed the study and increases compliance.

A brief review of the literature on the problem of acute intermittent porphyria and analysis of their own observations. Patient K., 18 years old, throughout the year was observed on the attacks of abdominal pain, which were interpreted as an exacerbation of chronic pancreatitis. The disease manifest the classic combination of syndromes: abdominal pain, neurological disorders, changes in urine color from yellow to red and burgundy. At relapse there was defined excretory profile of porphyrins and their precursors. Aminolevulinic acid found to increase by 3.5 times and 36 times porphobilinogen, which confirms the diagnosis of acute intermittent porphyria. Risk factors and concomitant pathology are analyzed.

In this review we described the most frequently detected genomic alterations, defects in the genes TP53, KRAS, TGFBR 2, PIK3CA, CDKN2A, SMAD4, changes of the main signaling pathways those genes, certain immunological mechanisms of tumor progression and metastasis in pancreatic cancer (PC). The review reflects the possibility of using the identified molecular and genomic alterations to choose new targets for targeted therapy in order to increase the effectiveness of treatment of patients with PC and further development of personalized medicine.

Proton pump inhibitors are widely used in clinical practice. Rabeprazole is a potent and irreversible inhibitor of H⁺/K⁺-AT-Pase (i.e. proton pump), and is indicated for the treatment of acid-dependent diseases. Based on the evaluation of pharmacokinetics and pharmacodynamics, rabeprazole provides a marked suppression of acidity, starting with the first dose, and its effect persists after repeated use. Due to predominantly non-enzymatic metabolism, rabeprazole has a low potential for inter-drug interactions. Rabiet® is a domestic rabeprazole, which is the drug of choice as effective, quality, safe and affordable.

The effects of probiotic bacteria Lactobacillus fermentum Z and Enterococcus faecium L3 on the intestinal digestive enzymes, involved in carbohydrate metabolism, are demonstrated using the experimental model of dysbiosis in rats.

This review represents the data on classification of chronic pancreatitis; discusses symptoms of this disease; studies diagnostic standards at inspection of patients with pancreatitis; acquaints with principles of complex treatment of this pathology.