The aim of review. To carry over for consideration the basic mechanisms of bacterial infections at liver cirrhosis (LC), their consequences, methods of diagnostics and prophylaxis.

Original positions. Bacterial infections is a cause of high mortality in liver cirrhosis patients. These patients are more predisposed to infections than others hospital patients due to disorders of immune system along with bacterial translocation from intestine, that, in turn, depends on immune changes of the latter and bacterial overgrowth. Bacterial translocation even without clinical signs of infection results in deterioration of hemodynamic status at patients with liver function decompensation that causes progression of portal hypertension and hepatorenal syndrome. Proinflammatory response related to bacterial complication stimulates progression of liver failure, encephalopathy, disorders in blood coagulation system, thus triggering gastro-intestinal bleeding.

Conclusion. Bacterial infections is the important cause of morbidity and mortality in patients with LC that is caused, first of all, by immune-compromised state. Prophylaxis, early diagnostics and well-timed treatment of infections considerably increase survival rate of these patients. Various methods of prophylaxis, including the use of antibiotics, pre- and probiotics, bile acids can be applied to alter bacterial overgrowth and bacterial translocation. Each of these methods proved its efficacy in scientific studies.

The aim of review. To present literature data on development and treatment of constipation at pregnancy.

Original positions. Pregnant women, who suffer of constipation, ingest less amount of products, containing plant fibers and less water. It is supposed, that high progesteron level during pregnancy results in increased production of renin, activation of rennin-angiotensinaldosterone system causes increased absorption of water in the large intestine. In late pregnancy the large intestine is pushed aside and compressed by enlarged uterus that can impair passage of fecal masses and provoke constipation. Polyethylene glycol-containing laxatives, are safe and recommended as treatment of choice in constipation at pregnant and breast-feeding women. Macrogol-4000 is not metabolized and not absorbed, having therefore no undesirable effect on fetus.

Conclusion. Treatment of constipation during pregnancy should begin with nonpharmaceutical methods. However, if sure nutrition, keeping of proper lifestyle and moderate physical activity do not result in desirable effect, drugs should be prescribed. Macrogol 4000 is effective and safe at pregnancy even at long-term intake.

Aim of investigation. To estimate antisecretory response to single dose of rabeprazole in patients with peptic ulcer (PUD) of duodenum by 24-hour intragastric pH-metry.

Material and methods. Antisecretory response to oral intake of 20 mg of rabeprazole (pariet) was studied in 48 patients with uncomplicated PUD of duodenum by 24-hour intragastric pH-metry. Results. The antisecretory response to the first dose of rabeprazole was revealed in 43 (89,6%) patients. Resistance to the first dose was found in 5 (10,4%) patients. «Variability of antisecretory response phenomenon» was revealed, that is based on individual differences of antisecretory effect in different patient groups.

Conclusion. Original study demonstrated high efficacy of rabeprazole in the first day of intake.

The aim of review. To discuss the factors promoting resistance of gastroesophageal reflux disease (GERD) to treatment and possible ways to overcome this phenomenon.

Original positions. It was demonstrated, that the causes of resistant forms of GERD are diverse and connected related both to subjective factors (poor patient compliance) and to objective factors («night acid breakthrough», episodes of non-acid reflux, etc.). Potentials of treatment of resistant forms of GERD include increase of proton pump inhibitors (PPI) dose, application of parenteral forms of PPI if necessary and combination to Н2-blockers. Further prospects of improvement of acidsuppressive agents action are related to development of new generations of PPIs.

Conclusion. Resistant forms of GERD are quite frequent in clinical practice. Now there are various options to increase treatment efficacy.