Stomach cancer (RV) belongs to the category of oncological diseases of the digestive system, the prevention of which remains at a fairly high level, and measures to reduce it do not yet give the desired results. This article is a kind of report on the results of 5 years of work for the first time in the world of gastroenterology created a registry of patients with precancerous diseases of the stomach. A comparative analysis of the effectiveness of complex therapeutic and preventive work with patients included in the register (167 patients with atrophic gastritis with large intestinal metaplasia and 78 patients with atrophic gastritis with intestinal dysplasia), and 179 and 61 patients with similar morphological changes in the intestinal tract, respectively, were treated by therapists or gastroenterologists in local hospitals. polyclinics. Every year, after a control study and assessment of risk factors for prostate cancer, laboratory tests, FGDS and histological analysis of gastrobioptates, all patients underwent an automated prognosis of prostate cancer using the gastric cancer prognosis map developed by the author, which included an analysis of 36 risk factors for prostate cancer, followed by software of the data obtained in computer calculations of the degree of risk of prostate cancer. Patients in the study group with an alarming prognosis of breast cancer received individualized dynamic follow-up programs with recommendations for correcting breast cancer risk factors. Depending on the phase of the disease, they underwent prognostically based drug treatment with the inclusion of courses of the “gastro-oncoprotector” Regastim Gastro. The patients of the control group received different, but not systematic treatment complexes prescribed by the attending physicians of polyclinics. Oncoprotectors were not prescribed to them. The results of therapeutic and preventive work with patients included in the register of patients with precancerous diseases of the stomach showed, in comparison with patients in the control group, a higher motivation of patients in the fight against their established risk factors for prostate cancer, a decrease in the incidence of precancerous changes in the gastrointestinal tract - colonic metaplasia and dysplasia in 44.3% of patients, a decrease in the severity of atrophy CS in 38.5% of patients, a decrease in the number of patients with the development of prostate cancer by 14.0% compared with the control group. The high preventive efficacy of the oncoprotector Regastim Gastro has been proven in cases of unfavorable prognosis of prostate cancer in patients with atrophic gastritis.

The aim of the study was to analyze clinical symptoms, endoscopic and histological changes in the colonic mucosa of patients with psoriatic arthritis. Materials and methods. 36 patients with psoriatic arthritis were examined, of whom 52.7% were women and 47.2% were men, with a mean age of 43.6±11.7 years. All patients underwent standard clinical, laboratory and instrumental examinations, ultrasound, and radiography of the hands, feet, and pelvis. Microbiological testing was conducted to detect intestinal dysbiosis, and colonoscopy with intestinal mucosal biopsy was performed. Results. Colonoscopy revealed pathological changes in 66.6% of cases. In 88.8% of cases, pathological changes in the intestines were detected only through histomorphological examination, which highlights the importance of this method in diagnosis and implementation of targeted appropriate therapy for gastrointestinal tract involvement in patients with psoriatic arthritis.

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 tegoprazan 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. 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.

Functional gastrointestinal disorders, particularly irritable bowel syndrome (IBS), are among the most prevalent gastrointestinal conditions in children. Post-infectious IBS develops following acute intestinal infections due to persistent neuroimmune disturbances and is characterized by chronic abdominal pain that significantly impairs patients’ quality of life. The aim of this study was to evaluate the efficacy of different therapeutic regimens for IBS in children aged 4-17 years. This open-label, prospective, randomized, multicenter trial included 106 patients divided into three groups: Group 1 received probiotic monotherapy (Bifidobacterium spp., Lactobacillus rhamnosus); Group 2 received monotherapy with Spascupreel® (a homeopathic spasmolytic agent); and Group 3 received combination therapy (probiotic + Spascupreel®). Treatment efficacy was assessed using validated scales IBS-SSS and SF-36, along with 4- and 5-point clinical rating scales. Statistical analysis was performed using Student’s t-test, Mann-Whitney U test, and Spearman’s rank correlation. Results demonstrated that Spascupreel® monotherapy provided the most rapid symptomatic relief in the short term - significant pain reduction and improved physical functioning were observed as early as week 2. However, the most sustained and comprehensive improvement - including pain reduction, enhanced emotional well-being, increased social activity, and overall quality of life - was achieved with combination therapy. Complete resolution of pain was observed in 53.7% of all patients, with the highest rates in Group 2 (65%) and Group 3 (53.3%, accompanied by greater symptom stability). Combination therapy also led to statistically significant reductions in abdominal bloating (p=0.03) and improved nighttime sleep (p=0.03). These findings support the clinical utility of the bioregulatory agent Spascupreel®, both as monotherapy and in combination with probiotics, for the management of IBS in children. The combined approach demonstrates a synergistic effect, not only alleviating symptoms but also improving long-term outcomes. Results underscore the need for further randomized, placebo-controlled trials with objective assessment methods to standardize treatment protocols for functional gastrointestinal disorders in pediatric practice.

Relevance. Despite active research into the influence of maternal obesity on offspring health, the characteristics of the gut microbiota in children of various ages born to mothers with obesity have not been well studied. Objective. To determine the features of gut microbiome in preschool and school-age children born to mothers with obesity. Materials and Methods. The study was conducted at the City Polyclinic No. 56, DPO 48, St. Petersburg. It involved 55 children (aged 5-6 and 14-16 years), divided into groups based on the presence of maternal obesity before and during pregnancy (Group 1 - maternal obesity; Group 2 - controls). All children underwent anthropometric measurements and blood testing for microbial biomarkers using gas chromatography-mass spectrometry (G.A. Osipov’s method). Statistical analysis was performed using StatTech v. 4.10.4. Results. Children in Group 1 more frequently had obesity or overweight (46.6% vs. 8.0%, p<0.001). They showed higher levels of Actinomyces spp (p<0.001), Alcaligenes spp (p<0.001), Clostridium coccoides (p=0.035), Clostridium propionicum (p=0.002), Clostridium ramosum (p=0.004), Nocardia asteroids (p=0.002), Pseudonocardia spp (p<0.001), Ruminococcus spp (p<0.001), Staphylococcus spp (p=0.006), and Streptococcus mutans (p=0.036). Plasmalogen levels were higher in the control group (p=0.002), while total endotoxin levels were higher in Group 1 (p<0.001). Conclusion. Children born to mothers with obesity have a distinct gut microbiome.

Objectives. To evaluate the effectiveness of treatment of acute adhesive intestinal obstruction in a comparative aspect, taking into account the possibilities of modern minimally invasive surgery. Materials and methods. Among those operated on were 62 men aged 20 to 78 years and 65 women aged 21 to 80 years. To evaluate the results of patient treatment, we identified two groups. The main group included 63 patients who were scheduled for laparoscopic adhesiolysis for acute adhesive small intestinal obstruction, and the second control group included 65 patients who underwent open surgery, of whom 6 (9.2%) patients underwent mini-access surgery. All patients underwent laboratory, X-ray, ultrasound and CT examinations to confirm the diagnosis. Risk adjustment for comparing different treatment groups was performed using the ASA score and the P-POSSUM scale before surgery. Results. The duration of hospitalization was reduced (6.1 days in the main group versus 9.7 days in the control group) and the duration of operations (71 minutes versus 107 minutes). After taking into account concomitant diseases and surgical factors, patients who underwent laparoscopic adhesiolysis were less likely to develop serious complications (OR = 0.6; 95% CI 0.48-0.75; p < 0.001) and postoperative complications (OR = 0.21; 95% CI 0.14-0.31; p < 0.0001). Mortality was 3.2% in the laparoscopic group compared with 7.7% in the open group (OR = 0.54; 95% CI 0.31-0.75; p = 0.025). Conclusion. Laparoscopy is a safe and effective method of dissection of adhesions in most patients with postoperative adhesions. This method makes it possible to reduce the length of hospital stay without significantly affecting the incidence of complications and mortality.

Constipation is a common condition in older adults, significantly impacting quality of life and healthcare costs. Morbidity and even mortality are reported in frail older adults. Although constipation is not a physiological consequence of normal aging, decreased mobility, medication use, comorbidities, and rectal sensory-motor dysfunction may contribute to its increased prevalence in the elderly. In older adults, there is typically more than one etiologic mechanism, requiring a multifactorial approach to treatment. Most patients respond to diet and lifestyle modifications, supported by bowel training. For those who do not respond to conservative treatment, the approach should be individualized, taking into account all comorbidities. In this case, lactulose, which possesses both osmotic laxative properties and pronounced prebiotic properties, may be the drug of choice for patients with comorbidities. Lactulose’s safety in patients with comorbidities is due to its metabolic neutrality and lack of effect on the cytochrome P450 system, which minimizes the risk of adverse drug interactions in patients receiving polypharmacy for cardiovascular, endocrine, and other chronic diseases.

The aim of this review is to assess the proposed mechanisms of pathogenesis underlying the maintenance of UC activity in liver recipients, as well as the efficacy and safety of drugs proposed for the treatment of UC in this group of patients. Materials and methods. A literature review concerning the topic of inflammatory bowel diseases in liver recipients was conducted. Results. Inflammatory bowel diseases (IBD) are often associated with liver diseases such as primary sclerosing cholangitis (PSC), autoimmune hepatitis (AIH), and primary biliary cholangitis (PBC). Up to 80% of patients with PSC have concomitant IBD. Conversely, only 5% of patients with IBD have PSC. The most common IBD variants are ulcerative colitis (UC), which occurs in 50-80% of patients with PSC, and Crohn’s disease (CD), which occurs in 20% of cases of PSC. Patients with PSC and UC have specific clinical features and are classified as a separate IBD phenotype, distinct from patients with UC alone. Liver transplantation (LT) remains the only radical treatment for advanced stages of chronic diffuse liver diseases. After TP, all recipients receive maintenance immunosuppressive therapy (IST). The drugs used for IST lead to a change in the course of UC in this group of patients. According to current clinical guidelines, the drugs.

Perianal fistulas are a severe complication of Crohn’s disease, significantly reducing patients’ quality of life. Despite the use of immunosuppressive and biological therapy, as well as modern surgical techniques, many patients fail to achieve sustained and long-term remission. In the last decade, cell-based therapies aimed at correcting the local inflammatory response and stimulating regenerative processes have attracted the attention of researchers. This review summarizes current data on the efficacy, safety, and potential of autologous and allogeneic cell products for the treatment of perianal fistulas in Crohn’s disease.

In recent years, much attention has been paid by researchers to dietary interventions and lifestyle changes as areas of therapy for patients suffering from functional gastrointestinal disorders. The largest number of clinical studies are aimed at studying the effectiveness of various restrictive dietary regimes in the treatment of functional gastrointestinal disorders - the low-FODMAP diet, the gluten-free diet and the Mediterranean diet. The purpose of the review is to analyze the results of modern clinical studies examining the effectiveness of using various restrictive types of nutrition in the treatment of functional gastrointestinal disorders in children. Currently, there are few studies on the effectiveness of using various restrictive diets among pediatric patients. Limited evidence suggests that low-FODMAP and the Mediterranean diet may be promising treatments for functional gastrointestinal disorders, especially in patients with irritable bowel syndrome, but more research is needed on this issue. The study of the effectiveness of using various restrictive types of nutrition in children suffering from functional gastrointestinal disorders is a promising and little-studied area of research today.

Aim: To investigate the associations between plasma levels of surfactant proteins SP-A and SP-D and characteristics of carbohydrate and lipid metabolism. Materials and Methods: A cross-sectional observational study included 174 residents of Novosibirsk aged 45 to 69 years. All participants underwent fasting blood tests to measure glucose, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and serum levels of surfactant proteins SP-A and SP-D using enzyme-linked immunosorbent assay (ELISA). Results: In the overall study, an inverse correlation was found between SP-A and hyperglycemia meeting the criteria for diabetes mellitus (r = -0.204; p = 0.007). This suggests that elevated blood glucose levels may negatively affect SP-A concentration, potentially impairing lung function in patients with hyperglycemia. In individuals with hyperglycemia (glucose ≥ 7 mmol/L), inverse associations were also observed between SP-A and key lipid metabolism parameters: TG (r = -0.441; p = 0.035), LDL-C (r = -0.501; p = 0.015), and the TyG index (r = -0.455; p = 0.029). Conclusion: This based study in Novosibirsk revealed significant associations between the level of pulmonary surfactant protein SP-A and indicators of carbohydrate and lipid metabolism. These findings open new avenues for further research into the role of surfactant proteins in the pathogenesis of metabolic diseases, as well as for developing strategies to prevent and treat complications associated with hyperglycemia and dyslipidemia.

A clinical case of a 67-year-old female patient with short bowel syndrome and severe intestinal failure complicated by liver dysfunction with cytolytic syndrome is presented. Long-term combination therapy with hepatoprotectors and an individualized parenteral nutrition regimen allowed for stabilization of the patient’s condition and, ultimately, the discontinuation of parenteral nutrition. Supportive therapy includes enteral nutrition and direct-acting anticoagulants.

In this study, we describe a 12-year-old girl suffering from ulcerative colitis with total intestinal mucosal involvement. The aim of our study is to clarify the etiology of the disease using molecular genetics testing. Methods. Whole-genome sequencing was performed using the DNBSEQ-T7RS platform. We used the CADD, PROVEAN and other predictive programs to determine potential clinical significance of the identified variants. Results. The pathogenic missense variant c.583C>T, p.Arg195Cys in the HMBS gene, associated with acute intermittent porphyria, and a rare variant of unknown significance.c.437G>A, p.Arg146Gln in the TTC7A gene, which is associated with intestinal and immune disorders of varying severity were detected. Conclusions. An unexpected combination of ulcerative colitis with a mutation in the HMBS gene associated with an autosomal dominant acute porphyria which in rare cases is combined with inflammatory bowel diseases, has been identified.

A clinical case of diagnosis of pyoderma gangrenosum in a patient with ulcerative colitis is presented. The presence of rashes on the skin of the lower limb, the lack of effect of antibacterial therapy, the phenomenon of pathergy served as the reason for the diagnosis of pyoderma gangrenosum as an extraintestinal manifestation of ulcerative colitis. This observation demonstrates the need to inform doctors of various specialties about extraintestinal, including skin, manifestations of inflammatory bowel diseases in order to choose the optimal tactics for managing patients.