The active development of research in recent years has revealed new aspects in the formation of irritable bowel syndrome. More recently, the vast majority of research has been devoted to the development of psychosomatic mechanisms of functional disease. Conducting an active scientific research has revealed a greater incidence of allergic rhinitis, bronchial asthma in patients with irritable bowel syndrome, increased serum immunoglobulin E of patients, as well as a positive response to the anti-allergic treatment, which confirms the participation of allergy in the formation of disease.

In the presented report, a new hepatoprotector Laennec’ and its clinical possibilities are considered from the perspective of comorbid pathology. This is due to the fact that the drug was obtained from placenta hydrolyzate, contains eight growth factors that affect different pathogenetic links of many diseases. 575 patients with different pathologies were studied. Overall effectiveness ranged from 83 to 92 %. It is concluded that Laennec is an effective hepatoprotector. With its various growth factors, the drug can be successfully used in the treatment of comorbid pathology.

The article presents data on the state of intestinal digestion in patients with chronic alcoholic pancreatitis, whose disorders serve as an additional pathogenetic mechanism for the progression of exocrine pancreatic insufficiency in these patients. Aim of the study. To study the state of intestinal digestion in patients with chronic alcoholic pancreatitis. Materials and methods. The state of intestinal hydrolysis was studied in 37 patients with alcoholic pancreatitis based on studies of amylolytic activity of the small intestine mucosa, the activity of enzymes in the membrane stage of intestinal digestion, the regulatory function of intestinal enzymes and the protein content in small intestine mucosa. In 30 patients, the ultrastructure of the intestinal epithelium was studied. Results and discussion. It was noted that in patients with alcoholic pancreatitis there was a violation of both cavitary and membrane intestinal digestion. The latter was associated with low protein supply of small intestine mucosa, weakening of the regulatory function of intestinal enzymes. The morphological substrate of the disturbed intestinal digestion was the destruction of the brush border elements. Сonclusion. Disorder of intracavitary and membrane stages of intestinal digestion can cause the development and progression of symptoms of exocrine pancreatic insufficiency in patients with alcoholic pancreatitis.

Two cases with newly diagnosed acute intermittent porphyria in patients who are direct relatives of the first and second generation (son and mother) are described. The clinical symptomatology of the manifestation of acute intermittent porphyria is analyzed. For the verification of the disease, a quantitative determination of the excretory profile of porphyrins, especially the porphyrin precursors: δ-aminolevulinic acid and porphobilinogen, is recommended. Patients with newly diagnosed acute intermittent porphyria should undergo a comprehensive genetic examination. The results of this study allow us to identify mutations in genes that can determine the likely risk of hereditary chronic liver disease.

The article describes the result of the treatment of erosive reflux esophagitis, formed by the acidic refluxate according to the results of 24-hour pH impedance measurement, in patients with IHD. The study included 176 patients who were divided into two groups: primary (OG) of 92 patients with erosive reflux esophagitis and IHD and control (CG) of 84 patients with erosive reflux esophagitis without IHD. IPP (Controlok) was used as a drug for the main and supporting treatment. During the period of primary treatment, patients of both groups received Kontrolok 80 mg per day, and during the period of maintenance therapy 40 mg per day. The dynamics of clinical symptoms and endoscopic picture was evaluated. According to the results of the study, complete epithelialization of defects of SOP occurred in 100 % of patients with OG by the 84th day of therapy, in patients with CG, this indicator was achieved by the 56th day of the main course of therapy. The study showed that the use of Kontrolok in a daily dose of 80 mg for 84 days was effective and safe and led to the complete epithelization of SOP defects in 100 % of patients in the OG.

Chronic constipation remains a current issue in clinical medicine. The publication presents the results of an open non-comparative observational study of the efficacy and safety of the Zajecicka horka' mineral water on functional constipation. The study included 31 patients with functional constipation. All patients were treated with sulfate-magnesium mineral water in a dose of 100 ml for 15 days. After the end of treatment, a statistically significant decrease in the main symptoms of functional constipation was recorded: rare bowel movement, form of stool, straining during bowel movement, a feeling of incomplete defecation. 74.2% of patients rated the effectiveness of mineral water as good. Thus, magnesium-sulfate mineral water can be prescribed as a first-line therapy in the treatment of functional constipation.

NSAID-gastropathy is one of the most relevant medical and social problems of health care, which is at the crossroads of many therapeutic areas. Nowadays acetylsalicylic acid is one of the most widely used drugs in the world. According to the international cardiological and gastroenterological associations, the use of ASA in a dose of 75 mg leads to an increase in side effects from the gastrointestinal tract by 2-4 times. This fact determines the importance of the management of such patients by the doctors of the district physicians, as well as the prevention of NSAIDs-gastropathy in general.

This article describes the possibility of diagnosis of GERD, indications for use of daily esophageal pH-metry and pH-impedancemetry, difficulties in interpreting the data from these studies. The article presents clinical cases in which the conduct of daily pH impedance has helped to confirm or to refute the diagnosis of GERD, and it optimized the treatment.

The article describes a patient with a rare disease of the gastrointestinal tract: eosinophilic gastroenteritis with a muscular-serous form of the disease (with eosinophilic infiltration and eosinophilic ascites).

This article contains data on Achalasia in terms of epidemiology, clinical development and its diagnosis. It also overviews the X-ray diagnostics results from the three patients with different stages of the disease.

Justification. There is information about the adverse effects of connective tissue dysplasia (DST) on the development, course and prognosis of diseases of various organs and systems. In recent years, much attention has been paid to hereditary diseases of the digestive organs, among which celiac disease is isolated. The widespread presence of CT in the digestive organs determine the adverse course of the pathology of the gastrointestinal tract (GIT) in the DST. In this regard, of particular interest is the study of the combined course of DST and celiac disease. Purpose of the study. The study of the frequency and structure of external and visceral stigmas of disembriogenesis, their influence on the course of celiac disease and their contribution to the development of comorbidity. Methods. 90 patients aged from 18 to 67 years old were examined with a verified diagnosis of celiac disease. The survey included an analysis of clinical and anamnestic data, the results of laboratory and instrumental studies. Screening for the identification of signs of disambiogenesis was based on the Russian National Recommendations (2012). The research materials were processed in the Statistica application, Microsoft Excel. Results. According to the severity of symptoms of DST, the patients with celiac disease were divided into 3 groups: 1 st with mild severity - 32 people (35.5 %); 2nd with an average degree of severity - 37 (41.1 %); 3rd with severe DST - 21 (23.3 %). The increase in the frequency of occurrence of flat-stop, Gothic palate, diaphragmatic hernia, gallbladder anomaly, and tracheobronchial dyskinesia (p < 0.051) corresponded to the increase in the degree of DST. In patients of the 3rd group, signs of dysfunction of the sphincter apparatus of the upper GI tract, biliary tract and increased asthenia were diagnosed more often than in patients of the 1st and 2nd groups. Conclusion. In celiac disease, there is a high level of stigmatization of symptoms of disembriogenesis, coupled with the severity of DST, which causes a variety of clinical manifestations, systemic disorders and contributes to the unfavorable prognosis and course of the underlying disease.