Aim of the Review. To analyze current data about possible influence of nutritional fiber on the course of GERD.

Key points. Systematic review in PubMed/Medline databases was performed with keywords food, dietary fiber in combination with gastroesophageal reflux, GERD. The review contains data concerning influence of nutritional fiber on the pathogenetic mechanisms of GERD and illuminates results of epidemiological studies suggesting positive correlation between quantities of nutritional fiber in the patient’s diet and manifestations of the disease. The main features of pathogenesis caused by the lack of nutritional fiber include slow gastric emptying, increased gastric volume, increased risk of obesity and hiatal hernia, reduced lower esophageal sphincter pressure. The epidemiological studies suggest the higher incidence of GERD symptoms, higher prevalence of Barrett’s esophagus and esophageal adenocarcinoma in patients who consume low quantity of nutritional fiber.

Conclusion. Despite the lack of interventional studies the literature data about impact of nutritional fiber on the manifestations of GERD show probable approach for the correction of diet in GERD patients. There is a need for prospective studies evaluating correction of diet on the course of the disease.

Aim of the Review. To analyze the publications and the reports devoted to the radiological methods in the diagnostics of the gastroenterological diseases and present to gastroenterologists and other physicians the state-of-the art possibilities of these methods.

Key points. The findings of the research studies and practical use of the radiological methods in the diagnostics of the diseases of the liver, biliary tract, pancreas, gastrointestinal tract, spleen, etc. were presented. The increase in the demands to the imaging studies and the enlarging of the sphere of the questions to be addressed in this regard were marked.

Conclusion. In the recent years the radiological methods are used not only in the detection of the different morbid conditions but in the differential diagnostics of the digestive diseases both in the therapeutic practice as well as during the small invasive interventions. They play the important role in the follow-up of the course of the pathological processes.

Aim of the Study. The elaboration of the diagnostics of the intestinal and mesenterial injuries in the closed abdominal trauma.

Materials and methods. On the basis of the analysis of more than 6500 examinations of the patients with closed abdominal trauma 49 cases were discovered: the rupture of intestinal mesentery with bleeding (22 cases), mesentery hematoma (12 cases), the peritonitis due to the intestinal injury (8 cases), the hematoma of the intestinal wall (7 cases).

Results. The patients were divided into the three groups: the1st group (22 cases) – the discovery of the trauma signs in the first hours after the trauma, the 2nd group (10 cases) – the trauma was discovered during the first two days, the 3d group (17 cases) – in the process of the clinical observation.

Conclusions. The diagnostics of the intestinal and mesenterial injuries in the closed abdominal trauma is based on the combination of the ultrasound signs – the free liquid in the abdominal space, the mass (hematoma) in the intestinal mesentery, the local thickening of the intestinal wall with the minimal quantity of the free liquid inter loops, the peritonitis signs.

Aim of the Study. To analyze the predictive value of the genetic polymorphisms in rs8099917 and rs12979860 loci of the IL28В gene for the assessment of the efficacy prognosis of the combined antiviral therapy on the basis of the standard Interferon of the patients with Chronic Hepatitis C (CHC).

Materials and Methods. The study of IL28B genetic polymorphisms was conducted in 66 patients with HCV who did not receive the treatment earlier. The 24- week or 48-week antiviral therapy by standard Interferon-α2b and Ribavirin was prescribed to all patients, taking into consideration the genotype of the HCV-infection. The analysis of the efficacy of the treatment was conducted on the basis of the assessment of the normalization of the biochemical cytolysis markers during and after the treatment as well as the availability of the rapid, early and stable virology response.

Results. Among the patients with 1-st HCV genotype, the favorable genotype IL28В of alleles rs12979860 and rs8099917 (СС/ТТ) were associated with consider- ably higher frequency of the stable virology response than different versions of unfavorable genotype IL28В. Among the patients who did not have 1-st genotype the polymorphisms of IL28B gene did not affect the efficacy of antiviral therapy .

Conclusion. The studies of genetic polymorphisms of the regions of human genome demonstrates that the positive predictive value of IL28B polymorphisms among the patients with 1-st HCV genotype is higher than among the patients with 2nd and 3d genotypes. This kind of approach enables to take into account the pharmaco-economic aspect of the treatment of chronic HCV-infection.

Aim of the study. To compare efficacy and safety of Algeron 1.5 and 2.0 μg/kg with PegIntron in combination with ribavirin in the treatment of chronic hepatitis C and to determine therapeutic dose of Algeron.

Materials and Methods. 150 adult treatment-naive patients with HCV (all genotypes)were randomized into 3 groups. In the two main groups the patients received Algeron in the dosage of 1.5 or 2.0 μg/kg/week, in the active control group – PegIntron 1.5 μg/kg/week in combination with ribavirin. Primary efficacy endpoints were rapid and early virologic response (RVR and EVR).

Results. Comparative analysis of virologic response rate after 4th and 12th weeks of the therapy and biochemical response did not show any statistically significant differences between the groups. RVR was observed in 64% and 56% of patients receiving Algeron 1.5 and 2.0 μg/kg, respectively, in the PegIntron group – in 66% (mITTanalysis, p>0,05).The frequency of EVR in Algeron groups after 12 weeks of treatment (regardless of a dose – 1.5 or 2.0 μg/kg) was 94%, in the reference group (PegIntron) – 88% (p>0,05). RVR and EVR rate analysis according to HCV genotype also did not showed statistically significant differences between the groups. Safety profiles of Algeron and PegIntron were similar. The complex assessment of the efficacy and safety allowed to make the conclusion about the optimal therapeutic dose of Algeron, equal to 1.5 μg/kg/week.

Conclusions. Results of the study provide evidence of the high efficacy and safety of Algeron for suppression of HCV replication and make it possible to recommend Algeron 1.5 μg/kg weekly in combination with ribavirin for the treatment of chronic hepatitis C in treatment-naÏve patients for 24–48 weeks depending on the HCV genotype.

Aim of the Study. The administration of ursodeoxycholic acid (UDCA) as monotherapy or in combination with lactulose for the treatment of the patients with nonalcoholic steatohepatitis (NASH) has been studied insufficiently. The aim was to assess the impact of the 90-day therapy with Ursoliv® drug (20 mg/kg per day of the UDCA and 25 mg/kg per day of the lactulose) on the biochemical blood tests values of the NASH patients in comparison with the Ursosan® drug (20 mg/kg per day of UDCA).

Мaterials and methods. 60 patients with the NASH were included into the open randomized prospective comparative study without applying control. The patients were separated into 2 equal groups. The 1st group was administered Ursoliv®, and the 2nd group – Ursosan®. The baseline laboratory tests – markers of cytolysis and cholestasis, lipid profiles – and after 45 and 90 days of the treatment were assessed.

Results. The credible dynamic of the biochemical tests values of the cytolysis as compared with the baseline (the reducing of the activity of the alanine transaminase and the aspartate transaminase) and of the cholestasis (gamma-glutamyl transpeptidase) was observed; the positive changes in the lipid profile (the increase in the concentration of the high density lipoproteins and the reduction in the total cholesterol, the low density lipoproteins, the very low density lipoproteins and triglycerides ) were seen during the treatmet in both groups. The tendency towards the more expressed impact of the combination of UDCA and lactulose (Ursoliv®) in comparison to the monotherapy by UDCA (Ursosan®) on the biochemical parameters were discovered. However, the statistical credibility was not reached, which, probably, can be explained by the peculiarities of the sampling.

Conclusions. The administration of the UDCA in the dosage of 20 mg/kg per day as monotherapy as well as in the combination with the lactulose (25 mg/kg per day) in the patients with NASH is characterized by the expressed positive impact on the laboratory markers of cytolysis, cholestasis and the lipid profile. The higher dosages of the UDCA and of the UDCA in combination with the lactulose can be recommended for the treatment of the NASH patients.

Aim of the lecture. To specify indications for the administration of the 5-aminosalicylic acid (5-АSA) in the patients with ulcerative colitis (UC) and to discuss the possibility of correlation between the body mass index, the disease activity and reasonability for the prescription of the mesalazine (Pentasa) as a monotherapy.

Key points. 5-АSA is the first line drug for the UC patients. The efficacy has been demonstrated in a huge number of studies, the indications for the administration have been determined and are dependent on the disease activity index. 5-АSA are used in moderate rate of the inflammatory activity. This article discusses the question of the possible relation between the body mass loss during the disease, www.m-vesti.ru and the body mass index as the additional factors for the determining of the pathological process activity and the indications for the prescription of the 5-АSA drugs. The article points out the possibility of the mesalazine rectal suppositories use for proctitis in the patients with UC that increases the adhesion of the patients to the treatment.

Conclusion. Mesazaline is efficient in the UC patients with both distal as well as extended forms of the disease. The additional factor which determines the disease activity is probably the patients’ nutritional status which is expedient to be taken into account while selecting the therapy.

Aim of Review. To conduct analysis of the publications devoted to the new aspects of the pathogenesis of irritable bowel syndrome (IBS) and up-to-date possibilities of the treatment.

Key points. The data received in the recent years provide evidence about the fact that in the development of IBS the genetic factors, the inflammatory changes of the intestinal mucosa and the violation of the balance of the gut microflora play the important role. The treatment of the patients is based on the IBS clinical subtypes and include the antidiarrheal drugs, laxatives and spasmolytics. The good results were obtained during the administration of the combined drug Meteospasmyl (the combination of alverine citrate and simeticone). The topical corticosteroid drugs, mesalazine and probiotics can take their own place in the therapy scheme in the future.

Conclusion. The establishing of the IBS new pathogenic mechanisms gives more possibilities for the treatment.

Aim of the Review. To characterize the main points of the reports devoted to the functional gastrointestinal disorders presented at the International Congress on Neurogastroenterology and Motility (Bologna, 2012).

Key points. Functional constipation is widely spread in the population. The mechanisms of cardiotoxic effect of cisapride and tegaserod were demonstrated and the safety of the administration of prucalopride was assessed. Currently the new pathogenic mechanisms of the irritable bowel syndrome (IBS) are under active study: the role of the infection, the violation of the intestinal mucosa permeability, the immune shifts, the reduction in the bile acids resorption etc.

Conclusion. IBS is not considered as purely functional disease, it is recognized as multifactorial disease.