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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">gastro-j</journal-id><journal-title-group><journal-title xml:lang="ru">Российский журнал гастроэнтерологии, гепатологии, колопроктологии</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Journal of Gastroenterology, Hepatology, Coloproctology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1382-4376</issn><issn pub-type="epub">2658-6673</issn><publisher><publisher-name>«Gastro» LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.22416/1382-4376-2021-31-3-7-16</article-id><article-id custom-type="elpub" pub-id-type="custom">gastro-j-573</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group></article-categories><title-group><article-title>Диагностика функциональных нарушений желудочно-кишечного тракта у пациентов с запорами и выбор тактики лечения</article-title><trans-title-group xml:lang="en"><trans-title>Diagnosis of Functional Gastrointestinal Disorders and Choice of Treatment Regimen in Constipation Patients</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6114-564X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Маев</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Maev</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Маев Игорь Вениаминович — доктор медицинских наук, академик РАН, профессор, заведующий кафедрой пропедевтики внутренних болезней и гастроэнтерологии.</p><p>127473, Москва, ул. Делегатская, д. 20, стр. 1</p></bio><bio xml:lang="en"><p>Igor V. Maev — Dr. Sci. (Med.), Full Member of the Russian Academy of Sciences, Prof., Head of the Chair of Internal Disease Propaedeutics and Gastroenterology.</p><p>127473, Moscow, Delegatskaya str., 20, bld. 1</p></bio><email xlink:type="simple">igormaev@rambler.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0327-4280</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Казюлин</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Kazyulin</surname><given-names>A. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Казюлин Александр Нисонович — доктор медицинских наук, профессор кафедры пропедевтики внутренних болезней и гастроэнтерологии.</p><p>127473, Москва, ул. Делегатская, д. 20, стр. 1</p></bio><bio xml:lang="en"><p>Alexander N. Kazyulin — Dr. Sci. (Med.), Prof., Chair of Internal Disease Propaedeutics and Gastroenterology.</p><p>127473, Moscow, Delegatskaya str., 20, bld. 1</p></bio><email xlink:type="simple">alexander.kazyulin@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7760-2091</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кучерявый</surname><given-names>Ю. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kucheryavy</surname><given-names>Yu. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кучерявый Юрий Александрович — кандидат медицинских наук, заведующий гастроэнтерологическим отделением АО Ильинская больница, научный руководитель образовательного проекта DiaGastro для врачей по вопросам гастроэнтерологии и смежных дисциплин агентства Eventum Medical Consulting.</p><p>143421, Московская обл., г.о. Красногорск, д. Глухово, ул. Рублевское предместье, д. 2, к. 2</p></bio><bio xml:lang="en"><p>Yuriy A. Kucheryavy — Cand. Sci. (Med.), Head of the Gastroenterology Unit, Ilyinskaya Hospital; Scientific Advisor, Eventum Medical Consulting Agency's DiaGastro Education Programme for Physicians in Gastroenterology and Related Specialties.</p><p>143421, Moscow Region, Krasnogorsk, Glukhovo settl., Rublevskoe Predmestye str., 2, korp. 2</p></bio><email xlink:type="simple">proped@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0982-2006</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Черемушкин</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Cheryomushkin</surname><given-names>S. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Черемушкин Сергей Викторович — кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней и гастроэнтерологии.</p><p>127473, Москва, ул. Делегатская, д. 20, стр. 1</p></bio><bio xml:lang="en"><p>Sergey V. Cheryomushkin — Cand. Sci. (Med.), Assoc. Prof., Chair of Internal Disease Propaedeutics and Gastroenterology.</p><p>127473, Moscow, Delegatskaya str., 20, bld. 1</p></bio><email xlink:type="simple">svch555362@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5483-9325</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гончаренко</surname><given-names>А. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Goncharenko</surname><given-names>A. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Гончаренко Александра Юрьевна — кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней и гастроэнтерологии.</p><p>127473, Москва, ул. Делегатская, д. 20, стр. 1</p></bio><bio xml:lang="en"><p>Alexandra Yu. Goncharenko — Cand. Sci. (Med.), Assoc. Prof., Chair of Internal Disease Propaedeutics and Gastroenterology.</p><p>127473, Moscow, Delegatskaya str., 20, bld. 1</p></bio><email xlink:type="simple">vintikdoctor@bk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8136-222X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гилюк</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Gilyuk</surname><given-names>А. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Гилюк Анастасия Владимировна — аспирант кафедры пропедевтики внутренних болезней и гастроэнтерологии.</p><p>127473, Москва, ул. Делегатская, д. 20, стр. 1</p></bio><bio xml:lang="en"><p>Anastasiya V. Gilyuk — Postgraduate Student, Chair of Internal Disease Propaedeutics and Gastroenterology.</p><p>127473, Moscow, Delegatskaya str., 20, bld. 1</p></bio><email xlink:type="simple">an.giluck2016@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ВО Московский государственный медико-стоматологический университет им. А.И. Евдокимова Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Yevdokimov Moscow State University of Medicine and Dentistry</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Ильинская больница, АО</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Ilyinskaya Bolnitsa [Ilyinskaya Hospital]</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>07</day><month>10</month><year>2021</year></pub-date><volume>31</volume><issue>3</issue><fpage>7</fpage><lpage>16</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Маев И.В., Казюлин А.Н., Кучерявый Ю.А., Черемушкин С.В., Гончаренко А.Ю., Гилюк А.В., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Маев И.В., Казюлин А.Н., Кучерявый Ю.А., Черемушкин С.В., Гончаренко А.Ю., Гилюк А.В.</copyright-holder><copyright-holder xml:lang="en">Maev I.V., Kazyulin A.N., Kucheryavy Y.A., Cheryomushkin S.V., Goncharenko A.Y., Gilyuk А.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.gastro-j.ru/jour/article/view/573">https://www.gastro-j.ru/jour/article/view/573</self-uri><abstract><sec><title>Цель обзора</title><p>Цель обзора: представить информацию о возможностях диагностики функциональных нарушений желудочно-кишечного тракта у пациентов с запорами и дать обоснование выбора тактики лечения.</p></sec><sec><title>Основные положения</title><p>Основные положения. Функциональный запор широко распространен среди разных возрастных групп и оказывает негативное влияние на качество жизни. Современный диагностический алгоритм хронического запора включает идентификацию признаков заболевания согласно Римским критериям IV пересмотра, выявление симптомов «красных флагов» и лабораторно-инструментальное исследование. Следует учитывать, что при функциональном запоре часто обнаруживают нарушения аноректальной зоны, диагностика которых важна для разработки дальнейшей терапевтической стратегии. Аноректальная манометрия, тест на ректальную чувствиельность, эвакуаторная проба — хорошо изученные и важные методы исследования для объективной оценки сенсомоторной функции аноректальной зоны у пациентов с функциональными запорами. В статье приведены современные методики диагностики функциональных расстройств дефекации.</p></sec><sec><title>Заключение</title><p>Заключение. Представленные алгоритмы обследования и лечения помогут повысить диагностическую эффективность и применить наиболее оправданную тактику ведения пациентов с функциональной патологией органов пищеварения, ассоциированной с запорами.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Aim</title><p>Aim. A practical review of functional gastrointestinal disorder diagnosis in constipation patients and the rationale for opting treatment.</p></sec><sec><title>Key points</title><p>Key points. Functional constipation commonly afflicts different ages and negatively impacts the quality of life. The current diagnostic algorithm in chronic constipation includes the disease identification according to Rome Criteria IV, red-flag symptom detection and instrumental laboratory examination. Functional constipation is notably often associated with anorectal abnormalities that bear a diagnostic value to elaborate an apt treatment strategy. Anorectal manometry, rectal sensation and balloon expulsion tests are the well-studied and significant probing techniques for objective anorectal zone sensorimotor function assessment in patients with functional constipation. The article reviews modern diagnostic methods in functional defecation disorders.</p></sec><sec><title>Conclusion</title><p>Conclusion. The examination and treatment algorithms presented will help improve diagnosis and apply the most suitable management in a constipation-associated functional digestive pathology.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>хронический запор</kwd><kwd>функциональный запор</kwd><kwd>синдром раздраженного кишечника</kwd><kwd>функциональные расстройства дефекации</kwd><kwd>аноректальная манометрия Конфликт интересов: авторы заявляют об отсутствии конфликта интересов</kwd></kwd-group><kwd-group xml:lang="en"><kwd>chronic constipation</kwd><kwd>functional constipation</kwd><kwd>irritable bowel syndrome</kwd><kwd>functional defecation disorders</kwd><kwd>anorectal manometry</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Маев И.В., Маевская Е.А., Черемушкин С.В., Кучерявый Ю.А. Реалии и перспективы лечения хронического запора. 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