The paper presents information on modern functional disorders of the gastrointestinal tract and biliary system, based on the recommendations of the Rome IV. Own studies on the effectiveness of treatment of biliary functional disorders with Niaspam (mebeverine hydrochloride) are presented. We studied 30 patients with biliary pain and functional disorders of the gallbladder. As a result of studies, it was found that the symptoms of biliary dysfunction stop in 83.3 % of patients, the contractility of the gallbladder is restored in 86.7 %. No side effects have been reported.

The article presents the results of a clinical investigation of 53 patients conducted to identify potential mechanisms of comorbidity of obesity and irritable bowel syndrome. Patients with a combination of these diseases are more likely to experience impaired fasting glycemia, pronounced and emotionally colored complaints on the internal organs, recorded with the Giessen questionnaire of psychosomatic complaints.

The comorbidity of various diseases requires the use of drugs that affect common etiological and pathogenetic aspects, which reduces the risk of side-effect.

The Aim. Find out the state of calcium regulating system in the comorbidity of peptic ulcer disease (PUD) with osteoporosis (OP), and the effect of their shifts on the acid secretion and regional microcirculation.

Materials and methods. We examined 10 patients with comorbid relapse PUD with OP and a group of patients corresponding to them by gender, age and location of the ulcer, only with a relapse of PUD. In all patients, except for clinical and endoscopic studies, the levels of parathyrin, calcitonin, calcium and phosphorus in the blood were studied, the secretory function of the stomach, densitometry was performed.

Results. Relapse of ulcer was characterized by a increase in parathyroid hormone and calcium, a decrease in blood phosphorus. These changes were more pronounced in patients with a comorbidity of PUD with OP and were accompanied by an increase in acid secretion and regional microcirculation.

Conclusion. The comorbidity of PUD with OP is accompanied by functional changes in calcium regulating system, which is one of the common pathogenetic mechanisms of these conditions and requires correction in their treatment.

The incidence and prevalence of inflammatory bowel diseases rapidly increased in last years in developed countries and the rise witnessed in the rest of the world closely correlates with adopting a western lifestyle. These observations support the notion that a variety of environmental factors contribute to the pathogenesis of intestinal diseases. In the developed countries, peoples’ lifestyle has changed significantly, being affected by serious modifications in dietary habits and physical inactivity. Those changes in lifestyle may have a bearing on the course of the disease and require correction with the use of physical exercises and other non-drug methods of treatment.

The article represents contemporary data on the illness development mechanisms, the main disease manifestation forms and the treatment methods of the alcoholic liver disease. It also covers the disease progression reasons and the main risk factors.

Aims. Characterization of the composition of the enteric parietal microbiota and its role in impaired functional state of the small intestine (SI) in individuals with metabolic syndrome (MS).

Materials and methods. 68 patients with MS were examined. The quantitative and qualitative composition of the near-wall microbiota of SI and the level of endotoxinemia were determined using an Agilent gas chromatograph with mass-selective and flame-ionization detectors. In evaluating the absorption function, substances that were not subjected to enzymatic processing, glucose and D-xylose, were used. The state of parietal digestion in the SI was evaluated by the results of the assimilation of sucrose disaccharide, and cavity digestion by the assimilation of soluble starch. Blood levels of total cholesterol, cholesterol of high density lipoproteins, triglycerides were determined. Carbohydrate metabolism was evaluated using an oral glucose tolerance test.

Results. According to GC–MS data of microbial blood markers in patients with MS, parietal bacterial growth in SI increases due to opportunistic microbiota (bacteria such as Firmicutes, fungi of the genus Candida, Herpes Simplex viruses). In patients with increased absorption of monosaccharides in the postprandial period, inhibition of abdominal and parietal digestion is observed. In MS, an increase in the level of endotoxin in the blood by more than six times was established in comparison with the control group. A correlation study revealed a strong positive relationship between the degree of endotoxinemia increase and the level of atherogenicity coefficient.

Conclusion. The results of the study suggest that the interconnected violation of hydrolysis, resorption and parietal ecosystems in SI is an important link in the complex pathogenetic circle of MS.

Objective. Evaluation of the effectiveness of non-drug treatment in patients with non-alcoholic fatty liver disease using the method of quantitative ultrasound steatometry.

Material and methods. We examined 118 patients aged 18–75 years, including 52 (44 %) men and 66 (56 %) women using a single diagnostic algorithm of four stages: questioning and collecting complaints, assessing the quality of life, clinical examination, non-invasive bioimpedansometry, followed by assessment of fat mass index, ultrasound examination of the liver in the B-mode, quantitative ultrasound steatometry by evaluating the attenuation coefficient of the ultrasonic wave. Individual non-drug therapy is prescribed to patients in the form of an individual program of therapeutic nutrition and physical activity. A dynamic assessment of the decrease in the proportion of adipose tissue and the severity of fatty liver infiltration was carried out at points of 6, 12, 18, 24 months. A liver biopsy followed by histological analysis on an SAF scale was performed in 32 patients.

Results. To assess the effectiveness of non-drug treatment in patients, a tendency of reducing the proportion of fat content and the severity of fatty infiltration in the liver was observed. All patients were divided into two groups according to their level of compliance with the prescribed treatment. Decrease in the proportion of adipose tissue in patients with a high level of compliance – up to 76.2 %, in patients with a low level of compliance – up to 89.1 % of the initial values. Decrease in fatty liver infiltration in patients with a high level of compliance – up to 80.2 %, in patients with a low level of compliance – up to 92.1 % of the initial one.

Conclusion. Ultrasound steatometry is an informative method for non-alcoholic fatty liver disease screening. The correlation of quantitative ultrasound diagnostics data for steatosis with a biopsy at stage S0 corresponds to r = 0.85; at stage S1 r = 0.72, at S2 r = 0.73, at stage S3 corresponds to r = 0.84, which indicates the high informativity of this method.

The current course of diseases of the digestive system is characterized by a multi-system pathology. The long-term existence of isolated diseases of the organs of the gastrointestinal tract is impossible: the pathology of some organs of a single functional system affects the development of the pathology of other organs.

Purpose. To study the features of intestinal digestion in patients with peptic ulcer.

Material and methods. 152 patients with peptic ulcer who were hospitalized in the gastroenterological department of Mordovian Republican Clinical Hospital were examined in 2011–2017. The main indicators of intestinal digestion by the activity of intestinal enzymes were studied.

Results. Symptoms of impaired intestinal function are observed in 47 % of patients with peptic ulcer disease. In their development, a violation of membrane hydrolytic processes, which were expressed as a decrease (p < 0.05) in the activity of the main intestinal enzymes of maltase in 74 %, alanine aminopeptidase – 73 %, alkaline phosphatase – 62 %, glycyl-L-leucindipeptidase and protein – 37 % (p < 0.01).

Conclusions. With peptic ulcer, the processes of membrane intestinal digestion are disrupted, which contributes to the development of clinical symptoms of a violation of the basic functions of the small intestine.

The work was performed on experimental material. A model of hypothyroidism was obtained in 66 white rats, males of the Wistar strain, by thyroidectomy. Healthy rats aged 8–9 months weighing 250–300 g were selected for the experiment. The operation was performed under general anesthesia. Both thyroid lobes were removed. For histological examination, pieces of gland tissue were taken from both lobes. Pieces were fixed in a 10 % buffered formalin solution for 10 days, then histopreparations were prepared in the standard way. Histological examination revealed diffuse myxedema edema, severe vascular disorders (plethora, stasis, diapedetic hemorrhage), degenerative and destructive changes in hepatocytes, collicative necrosis, plasmolysis, the formation of cavities filled with edematous fluid, atrophy and thinning of the liver beams. When antioxidants α–tocopherol and mexidol are introduced in the postoperative period, stereotypic changes occur: myxedema, vascular disorders, dystrophic and destructive changes, lymphocytic infiltrates, however, these changes occur much later (on the 28th day), are focal in nature, the intensity of edema less pronounced, few lymphocytic infiltrates. When using antioxidants, an increase in reparative processes is observed: the multiplication of binuclear hepatocytes, the proliferation of fibroblasts with the formation of foci of sclerosis.

The article demonstrates results of research of ammonia level in capillary blood in patients with inflammatory bowel diseases (IBD) depending on nonalcoholic fatty liver disease (NAFLD) presence. There is a trend in elevation of ammonia level in capillary blood in patients with IBD and NAFLD, especially if small intestine is affected.

Sjogren's syndrome is a systemic connective tissue disease characterized by pronounced clinical polymorphism, which can be encountered in outpatient practice by doctors of various specialties. The article discusses the problems of the resistant course of gastroesophageal reflux disease, which developed against the background of the primary Sjogren syndrome, on the example of clinical observation. The role of in-depth examination of the patient for the correct clinical diagnosis and the involvement of a team of specialists to achieve remission of Sjogren's syndrome is emphasized.