References

nogr

Экспериментальная и клиническая гастроэнтерология

Experimental and Clinical Gastroenterology

1682-8658

«Global Media Technologies»

10.31146/1682-8658-ecg-233-1-114-118

nogr-2950

Research Article

ОБЗОР

REVIEW

Функциональная диспепсия:текущее понимание патофизиологических механизмов

Functional dyspepsia:current understanding of the pathophysiological aspects

https://orcid.org/0000-0002-5869-2893

Печкуров

Д. В.

Pechkurov

D. V.

dmpechkurov@yandex.ru

https://orcid.org/0000-0001-5946-4801

Романова

А. А.

Romanova

A. A.

noemail@neicon.ru

https://orcid.org/0000-0001-8552-1662

Тяжева

А. А.

Tyazheva

A. A.

noemail@neicon.ru

Федеральное государственное бюджетное образовательное учреждение высшего образования «Самарский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияSamara State Medical UniversityRussian Federation

2025

17012025

01114118

2025

Печкуров Д.В., Романова А.А., Тяжева А.А.

Pechkurov D.V., Romanova A.A., Tyazheva 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.nogr.org/jour/article/view/2950

Введение. Функциональные расстройства желудочно-кишечного тракта (ФР ЖКТ) - это нозологически самостоятельные состояния, не связанные со структурными или биохимическими нарушениями, но сопровождающиеся выраженными клиническими проявлениями. Среди них особое внимание уделяется функциональной диспепсии (ФД), патогенез которой остаётся до конца неясным. Методы. Проведён обзор современных публикаций, включая систематические обзоры, экспериментальные и клинические исследования, касающиеся механизмов формирования ФР ЖКТ, в частности ФД. Рассмотрены данные по нейрогенной регуляции, висцеральной гиперчувствительности, микробиоте, воспалительным реакциям слизистой оболочки, а также роли инфекции H. pylori и COVID-19. Результаты. Установлены основные патогенетические механизмы: нарушения моторики желудка, висцеральная гиперчувствительность, иммунная инфильтрация слизистой ДПК, нарушение нейронной регуляции, участие энтеральных гормонов и нейромедиаторов. Подтверждена связь ФР ЖКТ с перенесёнными кишечными инфекциями и COVID-19. Отмечена роль пробиотиков и ингибиторов протонной помпы как потенциальных средств терапии и профилактики. Обсуждение. ФР ЖКТ у детей значительно влияют на качество жизни и требуют комплексного патогенетически обоснованного подхода. Необходима разработка индивидуализированных стратегий профилактики, в том числе с использованием пробиотиков и антисекреторных препаратов. Несмотря на положительные данные, остаются нерешёнными вопросы дозировки, длительности и эффективности терапии. Заключение. Функциональные расстройства ЖКТ являются многофакторными состояниями. Систематизация существующих данных позволяет выработать направления раннего вмешательства и превентивной терапии, особенно у детей. Включение пробиотиков и ИПП может быть перспективным, однако требует дальнейших исследований для выработки чётких рекомендаций.

Introduction. Functional gastrointestinal disorders (FGIDs) are independent clinical entities not associated with structural or biochemical abnormalities but manifest with significant symptoms. Among these, functional dyspepsia (FD) stands out due to its unclear pathogenesis. Methods. A literature review was conducted including systematic reviews, experimental and clinical studies on the pathophysiology of FGIDs, particularly FD. Factors examined include neurogenic regulation, visceral hypersensitivity, microbiota alterations, mucosal inflammation, and the roles of H. pylori and COVID-19. Results. Key mechanisms identified include gastric motility disorders, visceral hypersensitivity, immune infiltration of the duodenal mucosa, impaired neuronal regulation, and the involvement of enteric hormones and neurotransmitters. A strong association was observed between FGIDs and prior gastrointestinal infections or COVID-19. The potential of probiotics and proton pump inhibitors (PPIs) as preventive and therapeutic agents was highlighted. Discussion. FGIDs significantly impact children’s quality of life and require a multifaceted, pathogenetically oriented approach. Development of individualized preventive strategies using probiotics and acid-suppressing agents is essential. Despite promising findings, issues regarding optimal dosing and treatment duration remain unresolved. Conclusion. FGIDs are multifactorial disorders with complex pathogenesis. Synthesizing current evidence supports early intervention and prevention strategies, particularly in pediatric patients. The use of probiotics and PPIs appears promising but needs further research for clear clinical guidelines.

функциональная диспепсияпатофизиологияпостинфекционные гастроинтестинальные расстройства

functional dyspepsiapathophysiologyPost-infection FGIR

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