Aim. To study the management practices of patients with acid-related gastrointestinal (GI) disorders and the factors influencing the choice of antisecretory therapy.

Materials and methods. A nationwide online survey was conducted among 500 physicians (150 gastroenterologists and 350 general practitioners) from 185 cities across Russia. The questionnaire included items on the structure of acid-related diseases (ARD), diagnostic approaches, therapy patterns, challenges associated with proton pump inhibitors (PPIs), and attitudes toward potassium- competitive acid blockers (P-CABs).

Results. ARDs represent a substantial share of outpatient visits: 20–40% of patients in general practice and up to 50% in gastroenterology. The most frequent diagnoses were chronic gastritis, non-erosive gastroesophageal reflux disease (NERD), and Helicobacter pylori associated gastric disorders.

Diagnosis of gastroesophageal reflux disease (GERD) is primarily based on clinical and endoscopic assessment: 96% of physicians perform esophagogastroduodenoscopy, while pH monitoring and pH impedance testing are used by only 7–11%. PPIs remain the cornerstone of GERD therapy (up to 82% of prescriptions). However, several limitations have been identified with their use: 54% of physicians note the risk of adverse effects with long-term therapy, 50% emphasize the need for administration before meals, 30% encounter nocturnal acid breakthrough, and 38% report a delayed onset of action.

According to physicians, the key criteria when choosing an antisecretory agent include 24-hour efficacy, absence of nocturnal acid breakthrough, rapid onset of action, and minimal drug interactions. The introduction of new drug Tegoprex® to the Russian market helps address these unmet needs due to its meal-independent rapid action, sustained 24-hour effect, and protection against nocturnal acid breakthrough. Nevertheless, only 71% of physicians consider Tegoprex® a potential alternative to PPIs in most clinical cases.

Conclusions. Although PPIs remain dominant in ARD therapy, their limitations create a clear demand for alternatives. Tegoprex® demonstrates high clinical potential and is perceived by specialists as a promising replacement for PPIs.

The aim of the study was to compare the efficacy and safety of ET in an adjuvant regimen using the Helinorm metabiotic in combination with antihelicobacter therapy in patients with H. pylori-associated stomach diseases.

Materials and methods. 60 patients with a verified diagnosis of H. pylori-associated chronic gastritis (HCG) type B and duodenal ulcer (duodenal ulcer) in the acute stage were examined, divided into 2 groups by random sampling.

The first group of patients took proton pump inhibitors (PPIs) in a doubled dose, amoxicillin 2.0 g per day, clarithromycin 1.0 g per day for 14 days, the second group of patients also took metabiotic Helinorm against the background of similar therapy.

The antisecretory efficacy of the drugs was assessed by topographic pH measurement, and the diagnosis and assessment of H. pylori eradication according to the Maastricht Consensus was performed using a noninvasive, C14 urease respiratory test (HUBT-20P).

Results. Study has shown that when metabiotic was included in the complex of eradication therapy, there was a significant decrease in the frequency of dyspeptic side effects from the use of antibacterial drugs. This was due to an increase in the content of lacto- and bifidobacteria in the intestine and suppression of the growth of opportunistic microflora.

Conclusion: Metabiotic Helinorm has high eradication activity, good tolerability and absence of side effects, and may be recommended for inclusion in the scheme of H. pylori eradication therapy for associated diseases of the gastrointestinal tract.

The prevalence of obesity and associated metabolic syndrome has reached global epidemic proportions. The intestinal microbiota is a key modulator of not only nutritional status but also systemic inflammation, lipid, and carbohydrate metabolism. Enzymbiotics, which combine enzymes, prebiotics, and metabiotics, represent a promising approach for the correction of metabolic syndrome.

Objective: To evaluate the efficacy and safety of Bactizym Enzymbiotic in the correction of metabolic disorders and the intestinal microbiome in patients with metabolic syndrome.

Materials and Methods: A total of 138 patients with metabolic syndrome were examined (study group: n=92, treated with Bactizym Enzymbiotic for 1 month; comparison group: n=46, no treatment). The dynamics of body mass index, bioimpedance analysis (visceral fat), lipidograms, carbohydrate and hormonal profiles, Colonofl or 16 intestinal microbiota PCR, metabolomics parameters, anxiety, and appetite were studied.

Results. Compared to the control group, 65% of patients in the study group reported an improvement in well-being, while 16% experienced a decrease in appetite. A decrease in waist circumference (∆ -3.8 cm, p < 0.05) and visceral fat (∆ -27.4%, p < 0.01) was noted, as were improved sleep quality and decreased anxiety (∆ -33,3%, p<0.01), as well as a decrease in triglyceride levels (∆ -29.5%, p < 0.05), and an increase in Bacteroides spp. and Akkermansia muciniphila (p=0.02 and p=0.05), a significant decrease in HOMA-IR (∆ -36.4%, p<0.01), LPS endotoxemia (∆ -54.9%, p<0.001), an increase in GLP-1 (∆ +61.9%, p<0.001) and adiponectin (Δ +57.4%, p<0.001).

 Conclusion. The use of Bactizym Enzymbiotic is associated with a multisystemic positive effect: correction of dysbiosis, reduction of metabolic endotoxemia, improvement of insulin resistance and atherogenic profile, modulation of the gut-brain axis. The drug can be considered an effective and safe component of MS therapy.