This review article is about the mechanisms of bi-directional pathogenetic comorbidity of irritable bowel syndrome and obesity. The special attention is paid to the hormonal profile, psychosomatic features and quantitative and qualitative characteristics of the microbiota. The study of the mechanisms of comorbidity may be advisable in terms of a more detailed study of pathophysiology and optimization of therapy for irritable bowel syndrome and obesity.

Complications from the upper Gl tract associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) is a serious social and medical problem. The number of people who need NSAIDs and low doses of aspirin is steadily increasing. Most of them are represented by elderly people who have a serious comorbid pathology, significantly increasing the risk of developing drug complications. The incidence of NSAID-gastropathy remains high even after the introduction of selective inhibitors of cyclooxygenase-2 (COX) and obvious success in the treatment of H.pylori-associated peptic ulcers. Gastrointestinal bleeding and perforation, which occur when taking NSAIDs, are accompanied by high mortality and require serious costs for treatment. This determines the need for adequate prevention of this pathology. The main methods for the prevention of NSAIDs are the management of risk factors, the use of safer drugs of this group and the appointment of antiulcer drugs that reduce the risk of erosive ulcer changes and bleeding. A new drug for the prevention of gastrointestinal complications against the background of NSAIDs and antithrombotic agents is the gastroenteroprotector rebamipide. The advantage of this drug is associated with the ability to prevent not only the development of erosions and ulcers of the upper gastrointestinal tract, but also of the small and large intestine.

The article provides a fragment of the Multi-Center Epidemiologic Gastro Esophageal Reflux Disease Research fragments arranged by the Russian Scientific Foundation of Gastroenterologists. It stresses out the cardiac Gastro Esophageal Reflux Disease (GERD) symptoms. The data analysis shows that 16.9 % of respondents with GERD experience precordialgia. This aspect should be considered in differential diagnosis and treatment.

Goal. A review of the literature on the problem of argyria and the presentation of its own observation. Materials and methods. Description of the clinical case of a patient with generalized arginia caused by long-term use of the drug Argovit-S, in which the silver content is 0.75-0.85 mg/ml. Results. The data of a physical, laboratory and instrumental examination of a patient with generalized arginia are analyzed. The diagnosis of argyria is confirmed by anamnestic data and histological examination. Conclusions. Argyria is a serious risk factor for the manifestation and progression of diseases of the digestive organs, which requires mandatory comprehensive examination of such patients.

The antipsychotic preparations which are widely used in medical practice possess an extensive range of the negative side effects including operating on organs of system of digestion. In the final part of the offered review the pathology of the liver associated with reception of separate concrete antipsychotic medicines of the second generation is considered.

The article presents the results of a standard study and the quality of life of 109 patients before cholecystectomy, after 1 year and 5 years after cholecystectomy. It is shown that functional disorders of the digestive system predominate in patients regardless of the period of cholecystectomy. The best quality of life indices after 5 years after cholecystectomy were obtained in patients after a planned cholecystectomy with symptomatic course of cholelithiasis. Also, risk factors associated with a decrease in quality of life scores five years after cholecystectomy were identified.

The article presents the current concepts of the etiology, pathogenesis, types of diaphragmatic hernia. The clinical features and peculiarities of pain are described. Special attention is paid to pantoprazole as preparation of choice for patienls’ treatment; the advantages of the pantoprazole in comparison with other proton pump inhibitors are presented.

In the last quarter of a century, epidemiological studies have shown a steady increase in the incidence of non-alcoholic fatty liver disease (NAFLD) in all countries of the world among various population groups, including adolescents and children. NAFLD is described as a pathological condition characterized by a significant lipid deposition in hepatocytes or liver parenchyma in patients who have no history of alcohol abuse. The review provides the latest relevant data on the development, course and diagnostics of NAFLD. Much attention is paid to the methods of primary and secondary prevention of the disease. The purpose of therapeutic measures in NAFLD is to prevent the development of steatosis, by affecting the modifiable risk factors, and in case of its presence to prevent the outcome of steatosis in non-alcoholic steatohepatitis, cirrhosis and hepatocellular carcinoma by using the secondary prevention methods. Particular attention is paid to the use of preparations of ursodeoxycholic acid (UDCA). The accumulated experimental and clinical data show that UDCA is a drug of pleiotropic action, which is expressed in its multifactorial effect on the liver. In turn, the drug of choice is Urdoksa (AF Obolenskoe, Russia), which is produced in accordance with GMP criteria, and has a proven pharmaceutical equivalence and bioequivalence with leading UDCA drugs.

The consequence of persistent viremia in chronic viral hepatitis is mediated by cytokines, the activation of resident liver macrophages (Kupffer cells), leading to paracrine activation of stellate cells, enhanced the generation of reactive oxygen species, the progression of fibrosis.The use of energotropic antihypoxants in pathogenetic therapy of chronic viral hepatitis helps to reduce the severity of oxidative stress and activity of processes of lipid peroxidation of cell membranes, to restore the functional activity of various cells, including hepatocytes and cells of the mononuclear phagocyte system.In vivo clinical effects remaxol in hepatitis of various etiologies surpass the effects of traditional drug therapy: accompanied by restoration of the functional state of the liver (decrease in the severity of syndromes of cytolysis, cholestasis, recovery of synthetic liver function), the normalization of lipid and pigment exchange, reduces the severity of the main clinical syndromes of chronic viral hepatitis.