Vol 26, No 5 (2024): Гастроэнтерология

Studies of morphological changes in the mucous membranes of the digestive tract under stress are highly relevant in medical science and practice. Understanding these changes can be key to developing effective prevention and treatment methods for related problems. It is also important to improve the quality of life of people who are stressed in various areas of life. The literature review examines the physiological changes in the digestive tract under stress. Stress causes a complex effect on the functional state of the digestive system, including changes in blood supply, peristalsis and enzyme production. Such processes can lead to digestive disorders and aggravation of disorders.

Background. Over the past 10–15 years, there has been a clear trend towards improving the diagnosis and treatment of acute pancreatitis. However, even at the current stage of technology development, a number of difficulties arise in making an accurate diagnosis, in determining the volume and timing of surgical intervention, in organizing measures to prevent complications, treatment and further recovery of patients after acute pancreatitis.

Aim. To analyze the structure of morbidity and treatment outcomes of patients with acute pancreatitis in an emergency surgical hospital.

Materials and methods. We analyzed the structure of pathology and incidence of acute pancreatitis in patients of the 5th and 6th surgical departments. The sample consisted of 2033 patients diagnosed with acute pancreatitis. Of these, 973 people are patients of the 5th surgical department, 1060 people are patients of the 6th surgical department. The work used standard mathematical and statistical methods of data processing.

Results. The results indicate that in the structure of surgical pathology, the predominant diagnoses are acute pancreatitis, unspecified, and other acute pancreatitis. At the same time, these are also those forms of the disease that are characterized by high mortality. On average, 1 patient takes 9–10 bed days, which indicates the high medical and social significance of these forms of pathology. All the data obtained confirm the fact that many patients require emergency surgical care, even at a stage when the diagnosis has not yet been definitively confirmed. As a rule, indications for emergency surgical intervention appear already at the first stages of diagnosis, according to the main ultrasound criteria. The mortality rate averages 3–4%.

Conclusion. The data obtained are approximately comparable with data obtained by other authors. In general, the literature notes that among all patients with pancreatitis, the acute form of the disease predominates. However, in terms of mortality, the results we obtained were slightly lower compared to the results for the country as a whole.

Hepatobiliary disorders contribute significantly to the structure of morbidity, causes of disability and mortality of the world’s population. Therefore, the search for and development of effective and safe hepatoprotective agents for the pharmacotherapy thereof remains a problematic issue. This article presents a pharmacological profile for each of the active ingredients of the composite phytopharmaceutical Dipana, and reviews the evidence for its effectiveness and safety in chronic hepatobiliary disorders.

Hymecromone (4-MU) is a recognized agent currently used in clinical practice. Since 1960, hymecromone has been used in many countries as a choleretic and cholespasmolytic, a drug approved for use in humans with biliary tract disorders. The review presents both traditional European and Russian studies of the selective antispasmodic and choleretic properties of hymecromone, due to which hymecromone is the drug of choice for the treatment of biliary tract diseases, as well as new fundamental and clinical studies of numerous pleiotropic effects of 4-MU associated with inhibition of hyaluronic acid and many other properties of this exciting molecule. These include antibacterial, antiviral, and nonspecific anti-inflammatory effects. Positive results have been demonstrated in carbohydrate and lipid metabolism disorders, autoimmune diseases, as well as liver, heart, and kidney diseases. Numerous in vitro and in vivo studies have been presented in pancreatic, prostate, skin, esophagus, breast, liver, ovary, bone cancers, metastatic lesions, leukemia, autoimmune and inflammatory diseases. Hymecromone is indicated not only as a choleretic and cholespasmolytic but also as a choleseptic in cholangitis and chronic cholecystitis, including opisthorchiasis, which does not disagree with its label. Odecromone® (hymecromone, tablets 200 mg) is available on the Russian market; it replaced the originator drug and is its fully equivalent generic.

The gut microbiota participates in all metabolic processes in the human body, and its state determines the course of pathological processes. Intestinal infections, IBS, IBD, SIBO, diverticular disease, celiac disease, cancer, food intolerance, allergies, liver and pancreatic diseases, obesity, diabetes, metabolic syndrome, hematological, cardiological, genitourinary, rheumatological, neurological, neuropsychiatric and other disorders are associated with dysbiosis and increased permeability of the intestinal barrier. The means of correcting the gut microbiota are constantly being improved. The importance and expediency of using pro- and prebiotics as part of the complex therapy of many diseases is currently confirmed not only by large international clinical studies, but also by modern methods of diagnosing microbiota disorders. The review article presents clinically confirmed data on the effectiveness of the use of synbiotic Maxilac® for the correction of gut microbiota disorders and increased intestinal permeability in infectious diseases, postCOVID syndrome, IBS, including post-infectious IBS, as well as in severe atopic dermatitis in children.