Periodontal diseases are among the most common human ailments. At the beginning of the 21st century, the concept of «periodontal medicine» emerged, examining the relationship between periodontal pathology and other medical conditions. Currently, more than 50 different somatic diseases are associated with periodontal pathology. Periodontal pathology is closely linked to the periodontal microbiota. We searched the Pubmed database for sources published before January 25, 2026, that examined the relationship between periodontal bacteria and the development of gastrointestinal diseases. In this review, we examine the relationship between the periodontal microbiota and two currently relevant gastrointestinal diseases: non-alcoholic fatty liver disease (55 sources) and inflammatory bowel disease (153 sources). The data presented in this review demonstrate that in non-alcoholic fatty liver disease, the leading member of the oral microbiota, Porphyromonas gingivalis, is found directly in liver tissue. Furthermore, a mouth-gut-liver axis is formed, and bacterial translocation of periodontal bacteria into the systemic circulation becomes important. This is accompanied by the circulation of inflammatory mediators and immune complexes, as well as disruption of metabolic, inflammatory, and immunological homeostasis. The oral microbiota is involved in the development and progression of inflammatory bowel diseases through alterations in the intestinal microbiota along the mouth-gut axis, disruption of the intestinal barrier and permeability, release of inflammatory mediators, and impaired immune response. While periodontal diseases can be prevented and controlled, the oral microbiota should be considered a modifiable disease factor. Control of the oral microbiota, particularly its aggressive representatives such as P. gingivalis, should be considered as a potential strategy for the prevention and treatment of diseases associated with periodontal pathology and the periodontal microbiota.

The oral microbiota has a significant impact on the development and course of gastrointestinal diseases, particularly non-alcoholic fatty liver disease and inflammatory bowel disease. The concept of «periodontal medicine» and the bidirectional relationship between periodontal and somatic diseases is supported by the fact that the treatment of one disease has a positive effect on the other. The first part of this review examines the impact of non-surgical periodontal treatment on the course of non-alcoholic fatty liver disease and inflammatory bowel disease. The second part of the review examines the potential of using probiotics as an adjunct to non-surgical periodontal treatment. Probiotics used to correct microbiome imbalances and maintain normal oral microflora are called dentobiotics. The composition, composition, and therapeutic potential of two dentobiotics from BioMagic are discussed. These properties suggest the potential for preventive and therapeutic use in treating periodontal disease and associated intestinal and liver diseases along the mouth-intestine-liver axis. The potential positive impact of dentobiotics on the microbiota of the upper respiratory tract and ENT organs suggests that they can be considered dentarobiotics – probiotics for correcting microbiome imbalances and maintaining normal microflora in the oral cavity, upper respiratory tract, and ENT organs.

A clinical case of sludge-syndrome in a woman with an episode of short-term obstructive jaundice is presented. The disease was manifested itself with shingles pains, vomiting, a single rise in body temperature, darkening of urine and acolic feces. The diagnosis was made based on data on errors in the diet, the characteristic clinical picture of the disease, the results of a biochemical blood test, the results of ultrasound examination of the abdominal organs, with careful exclusion of other causes of shingles pains.

Introduction. Inflammatory bowel diseases (IBD), which include ulcerative colitis (UC) and Crohn's disease (CD) remain one of the urgent problems of modern gastroenterology, as they affect people of working age, have a recurrent progressive course, can be accompanied by disabling life-threatening complications and require in many cases constant expensive anti-relapse treatment. Biologics and JAK-inhibitors are the most effective in inducing and maintaining IBD remission, and the most pressing issue of their application is to assess whether this therapy will remain effective in the long term in real clinical practice.

The aim of the study: to assess the maintenance («survival») of therapy of CD and UC by biologics and JAK-inhibitors in real clinical practice.

Materials and methods. By the maintenance («survival») of therapy we mean the time period during which therapy was continued with a biologics and JAK-inhibitors until the moment of withdrawal due to ineffectiveness or intolerance, or until the last contact with the patient, if this therapy was not stopped. A retrospective cohort study was conducted on the basis of the specialized IBD city clinic, in which the medical documentation of 96 patients with IBD who received biologics and JAK-inhibitors in the framework of 144 episodes of therapy with the following drugs: infliximab, adalimumab, vedolizumab, ustekinumab, upadacitinib.

Results. The median duration of retrospective follow-up of CD patients was 173 weeks, UC patients – 93 weeks. At the end of the follow-up period, ustekinumab therapy continued in 87 % of patients, upadacitinib in 80 %, adalimumab in 52 %, vedolizumab in 40 %, infliximab in 11 %. According to the results of the Kaplan-Meier method, it was found that in CD, ustekinumab and upadacitinib had the greatest therapy maintenance, and the latter was superior to TNF-α inhibitors and vedolizumab only after 12 months of treatment. In UC patients ustekinumab had the greatest therapy maintenance: in none of the patients, therapy with this drug was discontinued due to ineffectiveness or intolerance. Multivariate analysis using the Cox regression, adjusted for bionaive patients, prescribing of the drug in the early period of the course of IBD and the age of diagnosis, allowed to establish that the risk of discontinuation of ustekinumab therapy due to ineffectiveness/intolerance in comparison with TNF-α inhibitors was lower by 4.8 times (95 % CI 1.9–12.5).

Conclusion. Considered in the study, biologics and JAK-inhibitors had different therapy maintenance, the best results on this parameter in real clinical practice was demonstrated by the interleukin‑12/23 inhibitor ustekinumab. However, when prescribing any existing biologics and JAKinhibitors, it is necessary to take into account the potential situation of loss of effect, which requires changing the drug used to another. For this reason, the search for new targeted drugs is relevant, among which the most promising is guselkumab, selectively inhibiting interleukin‑23, which demonstrated an advantage over ustekinumab in the framework of direct comparison in phase III clinical trials of both in relation to the onset of endoscopic response and endoscopic remission, and in the frequency of histological remission of CD by the 48th week of therapy.

The aim of the study was to study the associations of viscoelastic, electrical parameters of red blood cells and levels of fatty acids in their membranes and blood serum in patients with fatty liver disease.

Materials and methods. 84 men (average age 48.4±13.9 years) with fatty liver disease (FLD) of various origins (alcoholic, non-alcoholic, mixedalcohol + metabolic) with fibrosis grade 0–1 (FibroScan® 502 (Echosens, France) were examined. According to the test data from NashTest, AshTest as part of FibroMax, and ActiTest as part of FibroTest (BioPredictive, France), minimal necroinflammatory activity was found in 44 patients, and pronounced activity in 40 patients. The study of the electrical, viscoelastic parameters of erythrocytes was carried out using dielectrophoresis in an inhomogeneous alternating electric field using an electro-optical cell detection system. The content of fatty acids (FA) in the membranes of erythrocytes and blood serum was determined using gas chromatography/mass spectrometry (Agilent 7000B (USA).

Results. When analyzing the associations between the electrical, viscoelastic parameters of red blood cells and the levels of fatty acids in their membrane and blood serum, it was found that the indicators of red blood cells reflecting their ability to deform (amplitude of deformation at a frequency of 106Hz, degree of deformation at a frequency of 0.5×106 Hz), the state of the membranes (capacity), the amount of surface charge (dipole moment, velocity movement of cells to the electrodes), resistance of red blood cells (polarizability at different frequencies of the electric field, relative polarizability) directly correlated with the levels of omega‑3 PUFA in erythrocyte membranes, blood serum, both their total content and concentrations of individual FAs (eicosapentaenoic, docosapentaenoic, docosahexaenoic), the level of monounsaturated oleic FA, as well as two saturated FAs (pentadecanoic, margarine). On the contrary, there are associations with the predominant part of saturated FAs, both individual (especially highly reliable – palmitic, stearic), and the total content of monounsaturated, unsaturated, including polyunsaturated, ratios of omega‑6/ omega‑3 PUFA, SFA/UFA, SFA/PUFA turned out to be the opposite. The summarized rigidity of cells with high binding strength and statistical significance was associated with the erythrocyte content of palmitic acid (C 16:0) (r=0.674, p<0.000001), stearic acid (C 18:0) (r=0.443, p<0.000006), linoleic acid (C 18:2n‑6) (r=0.345, p=0.0006), total saturated fat content (r=0.640, p<0.000001), omega‑6/omega‑3 PUFA ratios (r=0.605, p<0.000001), SFA/PUFA (r=0.428, p=0.000015). The closest correlations for the level of membrane electrical conductivity were with erythrocyte levels of palmitic (r=0.551, p<0.000001), linoleic (r=0.470, p=0.000042), total contents of saturated (r=0.484, p<0.000001), unsaturated (r=0.468, p<0.000001), monounsaturated (r=0.504, p<0.000001), omega‑6 PUFA (r=0.414, p=0.00003), as well as with the omega‑6/omega‑3 PUFA ratio (r=0.568, p<0.000001). For the erythrocyte aggregation index, associations of high strength and statistical significance were found in relation to erythrocyte concentrations of palmitic acid (C 16:0) (r=0.691, p<0.000001), stearic acid (C 18:0) (r=0.486, p<0.000001), total SFA content (r=0.672, p<0.000001), ratios of omega‑6/omega‑3 PUFA (r=0.611, p<0.000001), SFA/UFA (r=0.475, p<0.000001), SFA/PUFA (r=0.478, p<0.000001). The indices of erythrocyte destruction were directly related to the total content of unsaturated FA in both erythrocyte membranes and blood serum, the erythrocyte level of digomo-γ-linolenic acid (r=0.205, p=0.046) and inversely to the content of C 15:0 (r= –0.224, p=0.028), C 17:0 (r= –0.151, p=0.039) and oleic acid C 18:1; c9 (r= –0.206, p=0.045).

Conclusion. The revealed associations indicate the dependence of the structural and functional parameters of red blood cells on the levels and ratios of fatty acids in their membranes and blood serum. Deterioration of the rheological properties of blood in patients with fatty liver disease is a factor associated with an increase in hypoxia in liver tissue with the potential for fibrogenesis and progression. The ability to modulate the electrical, viscoelastic parameters of red blood cells by exposure to fatty acids, including dietary ones, defines new additional treatment targets for patients with fatty liver disease.

The purpose of the study. Spasmolytics are the leading and most pathogenetically determined component of therapy for patients with biliary dysfunction. Mebeverine hydrochloride is the optimal choice in this case.

Materials and methods. This review analyzes the results of treatment of 120 patients with biliary dysfunction using the mebeverine hydrochloride.

Results and conclusion. Mebeverine hydrochloride has a beneficial effect on the process of bile excretion in patients with biliary dysfunction.

The aim of this study. To compare different methods of adipose tissue assessment (body mass index (BMI), bioelectrical impedance analysis (BIA), ultrasound (US)) in patients with inflammatory bowel disease (IBD).

Materials and methods. The study included 136 patients with IBD (62 with ulcerative colitis, 74 with Crohn's disease) and 30 control subjects. All participants underwent anthropometry (BMI, circumferences), handgrip strength measurement, BIA, and adipose tissue ultrasound according to a standardized protocol.

Results. According to BMI, overweight and obesity were found in 28.7 % of IBD patients. BIA revealed excess fat mass in 31.9 % of patients; notably, 30.2 % of these individuals had a normal BMI. Ultrasound detected increased adipose tissue in 47.3 % of patients, allowing for differentiation of obesity types. Excess fat was found by ultrasound in 44 % of patients with normal BMI. A negative correlation was found between fat mass percentage and handgrip strength (r= –0.363; p<0.001).

Conclusions. There is a need to include instrumental methods for assessing body composition in the examination algorithms for patients with IBD for timely correction of nutritional status and prevention of complications. The high prevalence of excess fat mass and its association with decreased muscle strength (dynapenia) justify the need for screening for sarcopenic obesity in patients with IBD.

Relevance. Functional bowel diseases (FBD) represent one of the most significant and complex problems in modern gastroenterology and general medicine. Their relevance is determined by a combination of factors: their extremely high prevalence, significant negative impact on patients' quality of life, significant direct and indirect economic costs to healthcare systems, diagnostic difficulties, and the limited effectiveness of existing therapeutic approaches. The constant updating of scientific understanding of pathogenesis and the refinement of diagnostic criteria (Rome IV criteria) only highlight the dynamic nature of this field of medicine and the need for close attention from researchers and clinicians. The study was conducted at the Elizavetinskaya Hospital.

The aim of the study was to evaluate microbial diversity and markers of intestinal inflammation in patients with functional bowel diseases.

Materials and methods. The study involved 30 patients with a confirmed diagnosis of functional bowel disease: 15 patients with irritable bowel syndrome with predominantly constipation and 15 with functional constipation. All patients completed an original questionnaire, underwent a complete physical examination, and underwent laboratory and instrumental diagnostics. Gastroscopy and colonoscopy were performed to rule out organic pathology of the upper and lower gastrointestinal tract. To assess the level of fecal calprotectin and intestinal biocenosis, two stool samples were collected from each patient without the use of laxatives and not frozen.

Results and conclusions. Patients with functional constipation had a longer duration of constipation compared to patients with irritable bowel syndrome and constipation. Fecal calprotectin levels were elevated to the «gray zone» more frequently in patients with functional constipation than in patients with irritable bowel syndrome and constipation. Patients with irritable bowel syndrome and constipation had a more pronounced reduction in the key commensal flora than those with functional constipation. However, pathogenic and opportunistic flora were virtually absent in the group of patients with irritable bowel syndrome and constipation, unlike those with functional constipation.

Вackground. Non-alcoholic fatty liver disease (NAFLD) occupies a leading place in the world among liver diseases and is accompanied by the development of steatosis and steatohepatitis, and in some cases progressing to cirrhosis and hepatocarcinoma. It is generally believed that NAFLD in most cases is associated with overweight and obesity. However, excess visceral fat is also found in patients with normal body weight (BMI).

Aim. The aim of this study was to evaluate the role of visceral obesity (VO) in the formation of hepatic and cardiac changes in patients with NAFLD and normal body weight, overweight and obesity.

Materials and methods. The study included 135 patients with cardiovascular diseases (arterial hypertension, ischemic heart disease (IHD)) and NAFLD between the ages of 45 and 65, what formed 3 groups: with normal body weight (NBW) overweight and obesity. The control group – 30 patients without a history of NAFLD, aged 50 to 63 years. All patients underwent an assessment of anthropometric parameters (height, weight, body mass index, measurement of WHR (W: H) = Waist circumference / Hip circumference, echocardiography, biochemical blood tests with determination of liver condition by calculated Fatty Liver Index (FLI) and Fibrosis‑4 index (FIB‑4), calculation of Visceral Adiposity Index (VAI) and Relative Fat Mass (RFM) indexes.

Results. It was found that the severity of VO in patients with NAFLD and NBW was comparable with patients who were overweight and obesity in indexes: Waist circumference / Hip circumference (WHR), VAI, presence of signs of severe dysfunction of Visceral adipose tissue (VAT), and the RFM index. In the group of patients with NAFLD and NBW, VAI correlated with the severity of liver fibrosis FIB‑4, and RFM with indicators characterizing liver damage.

Conclusion. The data obtained indicate the need to understand the pathogenetic features of the formation of a new NAFLD phenotype in order to develop effective therapy for this category of patients.

Esophageal diseases are common among the population, particularly gastroesophageal reflux disease (GERD). Long-term GERD, delayed diagnosis, and inadequate treatment increase the risk of Barrett's esophagus and esophageal adenocarcinoma. Non-reflux-related esophageal diseases, such as infectious and eosinophilic esophagitis, are becoming increasingly common. Damage to the esophageal mucosa is caused by an imbalance between protective and aggressive factors. The main groups of drugs used to treat GERD include proton pump inhibitors (PPIs), potassium-competitive proton pump inhibitors, alginates, antacids, and prokinetic agents. Recently, a group of esophageal protectors based on hyaluronic acid and alginates has been actively used. We conducted a study to evaluate the effectiveness of combination therapy for reflux esophagitis B-D associated with GERD, including a proton pump inhibitor (PPI) and the domestically produced esophageal protector Ezogard. Adding the esophageal protector Ezogard to the combination GERD treatment (lifestyle and PPI) for one month results in faster relief of the main symptom – heartburn – and more effective healing of esophageal mucosal erosions.