The aim. Analytical review of the provisions of the Rome Consensus IV, dedicated to functional gallbladder disorders and sphincter of Oddi disoders. Functional gallbladder disorders and sphincter of Oddi among the least studied of functional disorders of the gastrointestinal tract. Currently, there are no high-quality studies that can serve as a basis for the development of a fully informed algorithm of diagnosis and treatment of patients with Functional gallbladder disorders and sphincter of Oddi disoders. In turn, obtain new information on the pathogenesis, the optimal methods of diagnosis and treatment of this disease can significantly change ideas about Functional gallbladder disorders and sphincter of Oddi disoders.

The article describes the role of iron deficiency in the development of anemia in inflammatory bowel diseases (IBD), existing approaches to treatment. The problems of insufficient efficiency and poor tolerance of standard iron preparations are discussed, which is associated with the presence of malabsorbtion and chronic inflammation of the intestinal wall, the possibility of using a new oral form of sucrasomal iron is being studied. The aim of the study was to determine the efficacy and safety of the new Sucralomal oral form of iron Sideral Forte in patients with anemia in IBD. The materials of the study included data from 56 patients with anemia and IBD. In 28 patients, iron metabolism and anemia characteristics were studied in detail, and 28 others studied the efficacy and safety of antianemic treatment using Sideral Forte. The results of therapy showed a significant increase in the concentration of hemoglobin, serum iron for three months. Good tolerability of sucrasomal iron has been demonstrated.

The term "pigmentary hepatosis” has become a collective concept, including various disorders of bilirubin metabolism. The main diseases are the syndromes Gilbert, Kriegler-Nayyar, Dabin-Johnson and Rotor. With Gilbert s syndrome, the sequence of the gene responsible for the formation of phosphate hydroge-nase has been violated, Kriegler-Nayyar syndrome - congenital chronic non-hemolytic jaundice with increased unbound bilirubin, Dabin-Johnson syndrome - a disease that is hereditary benign conjugated bilirubinemia due to impaired excretion of pigments in bile, Rotor syndrome is similar to the Dabin-Johnson syndrome, but the excretion defect is less pronounced. The article deals with morphology, clinical picture, main syndromes, differential diagnosis, prognosis and treatment regimens specific for each syndrome.

Aim: to determine the condition calcium-regulating system, calcium-phosphate balance in the period of recurrence of peptic ulcer disease and possibility of correction changes in calcium-regulating system (drugs calcitonin, calcium channel-blocking agent and bifo). Materials and methods: 200 patients with peptic ulcer recurrence were examined with examinations of parathyrin, calcitonin, calcium and phosphorus in blood and urinary excretion of electrolytes, secretory and motor functions of a stomach. Results: it was established that a recurrence of peptic ulcer disease accompanied by significant increase of parathyrin and calcium in blood, small increase of calcitonin in blood, significant decrease phosphorus in blood. These changes, accompanied by a significant increase of secretory and motor functions of a stomach, reducing production gas-tromucoproteids. Application in the treatment of peptic ulcer disease calcitrinum and especially nifedipinum leads to a significant clinical effect, the normalization of the level of calcium in blood and functions of the stomach. Conclusion: recurrence of peptic ulcer disease has changes in calcium-regulating system. Application in complex treatment of recurrence of peptic hormone C-cells of the thyroid calcitrinum and calcium channel-blocking agent nifedipine are clinically effective, especially with nifedipine.

In the clinical observation the reasons for late diagnosis and difficulties in the therapy of diabetic enteropathy are analyzed. A feature of this observation isa patient who has a long history of type 1 diabetes mellitus with the first diagnosed autonomic diabetic enteropathy. The lack of adequate compensation of carbohydrate metabolism in combination with frequent hypoglycemic conditions, as well as the presence of other risk factors for autonomic neuropathy, contributed to the progression of clinical symptoms and inefficiency of therapy for this complication. Patients with diabetic enteropathy symptoms must be examinated by gastroenterologist as soon as possible.

In experiments on Wistar rats, the effects of probiotic bacteria Enterococcus faecium L3 and Escerichia coli M17 on the restoration of the microbiota and activities of the intestinal digestive enzymes after experimental dysbiosis were compared. Dysbiosis was caused by intragastric administration of ampicillin and metronidazole for 3 days. Subsequently, probiotics containing E. faecium L3 (E. f.) and E. coli M17 (E. c.), or milk (control-1, K1) were administered to the animals intragastrically for 5 days. In the control K0, rats were given water, instead of antimicrobials, and then milk. Activities of the enzymes in the small intestinal mucosa were evaluated by biochemical methods, and the microbiota composition - bacteriologically and by PCR in real time. After using the E. f. there was a faster recovery of the intestinal microbiota than after using the E. c. or without probiotics (in the group K1). In the group K1, the activity of maltase, lactase, alkaline phosphatase and aminopeptidase N in the small intestine was increased in comparison with the control K0 (without antimicrobial agents and probiotics). Use of the E. f. and E. c. did not affect a recovery of the activity of aminopeptidase N, but was accompanied by a partial restoration of alkaline phosphatase activity and a tendency to restore maltase activity, and in the case of the E. f. a complete recovery of lactase activity was also observed. Thus, the probiotic E. faecium L3 bacteria, compared to the E. coli M17, are more effective in restoring the microbiota and the activity of some key intestinal enzymes (in particular lactase) after the disorders caused by intestinal dysbiosis.

The urgency of the problem of nonalcoholic fatty liver disease at the present time is that the disease is associated with risk of development of cardiovascular pathology, given the fact of their common pathogenic mechanisms for the development. Heart rate variability is informative and a promising indicator in assessing the autonomic regulation of heart rate. The authors showed a reduction of heart rate variability in patients with nonalcoholic fatty liver disease and marked reduction of parasympathetic effects on the heart, which is an important pathogenetic factors contributing to the development of electrical instability of the myocardium.

The article describes the basic issues of epidemiology, classification, clinical manifestations and radiological diagnosis of Zenker’s diverticulum (DZ). Authors present a clinical case of DZ of the fourth grade according to Brombart classification.

A wide range of etiological factors, leading to the occurrence of mechanical jaundice, causes difficulties in diagnosing. Timely and accurate diagnosis, in the future, determines the success of treatment and a low level of complications. Retrograde interventions on extrahepatic bile ducts are the most common and gentle methods that allow performing not only diagnostics, but also therapeutic manipulations. An analysis of the results of X-ray endoscopy in 213 patients with mechanical jaundice is presented. The expediency and effectiveness of endoscopic retrograde cholangiopancreatography (ERCP) in the form of detection of radiologic signs of biliary and intra-pancreatic hypertension accompanying choledocholithiasis was noted. Methods for increasing the level of efficiency of ERCP with use of EPT and modern tools are demonstrated.

The modern data of terminology, criteria of metabolic syndrome are presented in the article. At the modern times constant tendency to increase metabolic syndrome appearance is annually noted. In this time the last epidemiological researches have shown the leading positions gastroesophageal reflux disease (GERD) in the gastroenterological diseases structure. One of the main provocative factors for intensive GERD prevalence is obesity. In this article pathogenetic mechanisms of obesity influence to GERD formation are presented. The original study of gastroenterological manifestations of metabolic syndrome is submitted. Treatment of this category patients should be complex, including the main approaches of metabolic syndrome therapy also GERD pharmacotherapy.