gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLCgastro-j-1391Research ArticleНАЦИОНАЛЬНАЯ ШКОЛА ГАСТРОЭНТЕРОЛОГОВ, ГЕПАТОЛОГОВNATIONAL COLLEGE OF GASTROENTEROLOGISTS, HEPATOLOGISTSРефрактерные и рецидивирующие формы колита, ассоциированного с Clostridium difficileRefractory and relapsing forms of Clostridium difficile-associated colitisШептулинА. А.SheptulinA. A.2011260320112125053Copyright © Шептулин А.А., 20112011Шептулин А.А.Sheptulin A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/1391

Цель обзора. Рассмотреть факторы, способствующие возникновению рефрактерных и рецидивирующих форм колита, ассоциированного с Clostridium difficile, изложить современные подходы к лечению больных с указанными вариантами течения заболевания.Основные положения. Рецидивирующие формы колита, ассоциированного с Clostridium difficile, отмечаются у 15–30% больных. Их возникновению способствуют пожилой возраст пациентов, значительная длительность диареи при первом обострении, прием ингибиторов протонной помпы. В лечении таких больных применяются курсы ванкомицина и метронидазола, дополняемые пробиотиками (Sacharomyces boulardi), адсорбентами (колестирамин, смекта) и рифаксимином.Заключение. Проблема рефрактерных и рецидивирующих форм колита, ассоциированного с Clostridium difficile, требует дальнейших исследований, направленных на повышение эффективности их лечения.

The aim of review

The aim of review. To discuss the factors promoting development of refractory and relapsing forms of colitis, associated to Clostridium difficile infection, to present the state-of-the-art in management of patients with these variants of the course of disease.

Original positions

Original positions. Relapsing forms of the Clostridium difficile-associated colitis, are seen in 15– 30% of patients. Their development is promoted by elderly age of patients, significant duration of diarrhea at the first relapse, intake of proton pump inhibitors. In treatment of such patients courses of vancomycine and metronidazole, supplemented by probiotics (Sacharomyces boulardi), adsorbents (Colestyraminum, smecta) and rifaximin are applied.

Conclusion

Conclusion. The problem of refractory and relapsing forms of Clostridium difficile-associated colitis, requires the further studying to increase treatment efficacy.

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The authors declare that there are no conflicts of interest present.