The article presents the results of a clinical study involving 59 overweight or obese patients with gastroesophageal reflux disease. Non-erosive reflux disease was diagnosed in 30 (51%), erosive esophagitis A (Los Angeles endoscopic classification) in 29 (49%) patients. The severity of the main symptoms of GERD was assessed, physical examination, esophagogastroduodenoscopy, daily pH impedance monitoring of the upper gastrointestinal tract, psychometric testing were performed. The body mass index correlated with age (0.35); the presence of a diaphragmatic hernia (0.32); cough (0.35); pH in the stomach (0.30); the number of slightly alkaline gastroesophageal refluxes (0.32); slightly alkaline time in the esophagus in minutes (0.30) and percent (0.32); reactive anxiety (0.30), number of points of FF scale (–0.26) and MH scale of the SF-36 questionnaire (–0.25). Waist circumference correlated with the presence of erosive esophagitis (0.25); male sex (0.32); diaphragm hernia of (0.40); duodenogastric reflux (0.42); DeMeester index (0.31), the duration of the longest acid gastroesophageal reflux (0.25). Patients with erosive esophagitis compared with patients with non-erosive reflux disease more often consumed alcohol; had higher BMI; more often had epigastric pain and oral bitterness, longer bolus time in the esophagus and poorer quality of life according to the MH scale of the SF-36 questionnaire. Taking into account the revealed features of pathogenesis, the drugs of choice in the treatment of GERD in overweight and obese patients may be multitarget molecules of itopride hydrochloride (Itomed®), ursodeoxycholic acid (Ursosan®) and rebamipid (Rebagit®).

Diagnosis, determination of the degree of activity of inflammatory bowel diseases (IBD) and prediction of the response to therapy is based on a comprehensive approach, including clinical, laboratory, endoscopic and histological methods of research. The possibility of using laboratory biomarkers of ulcerative colitis (UC) in practice is characterized by a great potential for solving such problems as early diagnosis of the disease, monitoring the course and predicting the response to therapy. The Committee on Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) recommends the use of targeted strategies for the treatment of UC from the perspective of the individual needs of the patient. Restoring intestinal permeability will play an important role in the treatment of IBD. It is known that a violation of intestinal permeability is associated with changes in the content of zonulin in the blood serum and in the feces. Currently, most methods of studying the permeability of the muco-epithelial barrier are used only for scientific purposes. The review highlights the current view on the possibility of using existing biomarkers in the diagnosis of UC in practice. The results of a pilot study in which the level of zonulin in the feces was determined in patients with diagnosed UC are presented.

With oncopathology, the role of Katepsin L in proteolysis is not sufficiently studied, in particular, its connection with the nutritional status and the nutritional forecast.
The purpose of the study. To determine the effect of impaired metabolism in lysosomes and its connection with the development of nutritional failure.
Material and methods. The study includes 156 patients (65 with pancreatic cancer, 69 with СP). In the serum, MMP-9, TIMP-1 and GC were determined by the ELISA method. Statistical analysis was carried out by the criterion of Mann–Whitney. The results were presented in the form of medians (intercomdlic range). The reliability of differences was considered essential at p < 0.05.
Results. It was revealed that the dynamics of changes in the epidermal-mezenchymal transition markers indicates an increase in the level of cystatin C (inhibitor of cathepsins), a decrease in the level of RSB in relations with the Catencin L, which is subsequently reflected in the reduction of the level of prehalet (marker of somatic protein deficiency). Cathepsin L in the complex with RSB determines one of the mechanisms for the development of nutritional failure and can predict it.
Conclusions. The definition in the colprix of the RSB, cathepsin L and prehaletbin can serve as an early prognostic marker of nutritional insufficiency.

The aim of the study was to determine the prevalence of organic and functional pathology at an outpatient appointment with a gastroenterologist before and during the COVID-19 pandemic. An assessment of 428 outpatient clinical cases over two periods was carried out. The analysis revealed a significant increase in functional gastrointestinal pathology. During the first study period, 36% of all applied patients had functional gastrointestinal diseases, in the second period the number of patients increased to 57%.
The results obtained allow us to conclude that, despite the fact that COVID-19 affects the digestive organs along with the respiratory tract, the forced isolation that arose during the pandemic and general anxiety significantly increased the growth of the functional pathology of the gastrointestinal tract, which should be taken into account when developing treatment regimens and managing gastroenterological patients.

The article presents a clinical case of cross-syndrome of autoimmune hepatitis type 1 with primary sclerosing cholangitis. The main symptoms, laboratory and instrumental criteria of these diseases are discussed. Detection of specific antibodies is necessary for an accurate diagnosis. Interpretation of changes in the colon obtained by stepwise biopsy requires special attention. The described morphological picture does not allow to make an accurate diagnosis, it can be regarded as initial manifestations of Crohn's disease, microscopic or eosinophilic colitis, signs of worm-parasitic invasion. An example of a differential diagnostic search in such a situation is discussed.

Non-steroidal anti-inflammatory drugs (NSAIDs) are drugs used to treat acute and chronic pain associated primarily with inflammatory changes. This group of drugs is widely used in neurology, rheumatology, traumatology, etc. The main mechanism of action of the drugs is associated with the effect on cyclooxygenase-2 (COX-2) and blockade of the synthesis of pro-inflammatory prostaglandins (PG), as well as the effect on COX-1 and suppression of the synthesis of cytoprotective PG, which determines the possibility of side effects from the gastrointestinal tract. In the pandemic, the use of this group of drugs has increased many times over. Features of the clinical course of both the viral infection itself and the use of other drugs leads to a significant change in the pharmacodynamics and pharmacokinetics of NSAIDs, which may lead to the development of undesirable side effects.

IBS-like syndromes are one of the most important problems in gastroenterology. The clinical picture is identical to that of irritable bowel syndrome can be associated with inflammatory bowel disease, colorectal cancer, celiac disease, food allergy, lactase deficiency enteropathy, non-celiac sensitivity, gluten and other diseases. In this regard, irritable bowel syndrome is a diagnosis of exclusion and always requires a rather complex differential diagnosis to establish the true cause of the disease, conduct adequate therapy and achieve a stable remission. The purpose of the review was to obtain scientific knowledge about IBS-like syndromes and to develop optimal management tactics for these patients. The review demonstrates that the clinical manifestations of IBS are largely nonspecific due to the frequent transition of one form of the disease to another, which creates certain difficulties in making a diagnosis. Timely diagnosis of IBS-like syndromes, often superimposed on the already existing IBS pathology, significantly improves the results of treatment of patients with intestinal symptoms and ensures long-term preservation of remission of the disease.

Irritable bowel syndrome is a very urgent problem in modern gastroenterology. A deeper understanding of the ethology and pathogenesis, the variety of drugs for the treatment of IBS gives hope for the possibility of effective control over the disease in the near future. The article provides a brief overview of the latest advances in the study of irritable bowel syndrome, which were reported at the next UEG Week Virtual 2020, held in October 2020.