The article continues the tradition of writing scientific reviews concerning achievements in the field of pediatric gastroenterology, laid down by the leaders of Russian pediatrics and neonatology - A. V. Mazurin, N. G. Zernov, B. G. Apostolov, A. A. Baranov, V. F. Uchaykin, G. V. Rimarchuk, Yu. G. Mukhina, P. L. Shcherbakov, S. V. Belmer, I. Yu. Melnikova and others. The article discusses the origins, development and successes of modern Russian pediatric gastroenterology. Important in the diagnosis of diseases of the digestive system in children, beginning at an early age (up to 3 years), along with laboratory methods, have played methods of medical intrascopy. The main achievements in the study of diseases of the esophagus, stomach, intestines, hepatobiliary system, pancreas are analyzed. Prospects for the development of pediatric gastroenterology as an independent area of pediatrics are being advanced.

Constipation among children is an extremely widespread state. They arise at any age and may pose major challenges, disrupting the child’s health with the risk of complications, regressing the quality of life of both the child and his family members. Having arisen once, constipation among children can recur, require repeated and prolonged treatment. For children, functional constipation is the most common. According to international recommendations, it is not necessary to resort to complicated methods for its diagnosis, wherein the treatment and prevention of constipation in children requires a fairly strict adherence to diet, motor activity and drug therapy. The evidence base on the use of certain foods for constipation is expanding. The relationship between constipation and intestinal microbiota disturbance was revealed, providing a theoretical basis for the microbial treatment of chronic constipation. Among the wide variety of laxatives traditionally prescribed for constipation in children’s practice, safe and effective use is proven with the use of polyethylene glycol (macrogol) and lactulose.

The aim of the work. To establish the features of clinical manifestations and pathomorphology of gastric mucosa in Hp - associated chronic gastritis in adolescents, depending on the genetic characteristics of Hp. Patients and methods. In 133 adolescents with Hp-associated gastritis, polymerase chain reaction was used to determine the presence of pathogenicity factors in the HP genome. Results. In 60,9% of cases, highly pathogenic strains of Helicobacter pylori containing genes Cag (A, C, E, F, H, M, T), UreB, UreI, VacAs1, IceA, BabA, hpaA, AlpB and OipA are detected. Conclusion. The presence of highly pathogenic strains of Hp does not affect the clinical manifestations of gastritis, but is associated with high rates of contamination, increased inflammation, the appearance of signs of atrophy of the gastric mucosa.

Hereditary spherocytosis (Minkowski-Shoffar disease) - protein-dependent mebranopathy, leading to the destruction of red blood cells, is one of the causes of gallstone disease. The purpose of this work: to acquaint doctors of various specialties with a possible complication of hereditary spherocytosis in the form of cholelithiasis. The article briefly presents etiopathogenesis, clinical features, diagnosis and treatment of this disease. Two clinical cases of cholelithiasis with hereditary hemolytic microspherocytic anemia of Minkowski-Shoffar are described. Results. In the cases presented, there was a severe course of hereditary spherocytosis with hemolytic crises. A detailed picture of suprahepatic jaundice due to microspherocytosis, a decrease in the osmotic resistance of red blood cells, was accompanied by anemia, an increased content of reticulocytes, an increase in the level of indirect bilirubin. The formation of large amounts of thick bile created the conditions for the formation of stones in the gallbladder. Patients had surgical treatment of gallstone disease. Conclusion: pediatricians, family doctors, hematologists need to remember about the possible complication of hereditary spherocytosis in the form of gallstone disease for forehanded diagnosis and treatment.

The aim is to analyze the activities of nurses in the offices of a healthy child in children’s policlinics in Moscow to optimize counseling and improve the quality of preventive work. Materials and methods. The data of official statistics and statistical reports of the office of a healthy child clinic. The method of statistical analysis of data for the study period, analysis of medical services and quantitative method of SWOT-analysis of 75 parents of children who visited the office of a healthy child. Results and discussion. Analysis of the office of a healthy child clinic revealed additional opportunities for the organization of primary prevention of gastroenterological diseases. It was found that the leading position on perenatal counselling is given to the nurse, and nurses with higher medical education have the advantage. It is advisable to revise the regulatory framework for the functioning of the Cabinet of healthy child and provide modern equipment, the introduction of modern methods of organization of work taking into account the training/retraining of nurses with higher education. In the course of advisory and educational work, a nurse with higher education uses the accumulated psychological and pedagogical skills, and parents receive professional information on the development of young children, which ultimately ensures the introduction of new health-saving technologies into practice. Conclusion. The results of the situational analysis of the activities of a nurse in a healthy child’s office allow us to optimize the process of counseling the speed of decision-making to improve the quality of preventive work in a children’s policlinic.

In the genesis of the development of chronic liver and liver diseases in childhood insufficiency, the leading place belongs to hereditary liver diseases. Timely diagnosis allows you to identify this pathology at an early age and choose the right treatment tactics, and improve the prognosis. The article presents a modern view of diseases such as alpha 1-antitrypsin deficiency, neonatal hemochromatosis, erythropoietic protoporphyria, cystic fibrosis. The treatment of such diseases should be comprehensive, based on the principle of an interdisciplinary approach.

Schedules of regular medical checkups for children with ulcerative colitis and Crohn’s disease by paediatricians and medical specialists, of laboratory and instrumental examinations are offered, a complex of prophylactic, therapeutic and rehabilitation measures is described. Key aspects of the programme are its complex character, continuity, division into stages and use of modern diagnostic methods. Problems of diet therapy, medication and many other aspects of the follow-up of children with ulcerative colitis and Crohn’s disease are discussed. Criteria of the effectiveness of the programme are: the absence of exacerbations and omplications of diseases, normal physical and sexual development of a child, improvement of the quality of the patient’s life.

The aim was investigate some features of diagnosis of cholelithiasis in children. Materials and methods: The study was completed with 75 patients in the Clinic of pediatric surgery of the BSMU, Russia, Ufa in 1997-2017. The mean age of the patients was 11.2±3.8 (3-18) years. 44 (58.7%) patients were females. Results: The original method (X-ray Tomography with cholekinentic) was preferred and received results were decisive for surgery. Identified sclerotic changes (>40 H) and gallstone density (>100H) were indications for cholecystectomy.

The main methods of diagnostics newborn intestinal obstruction (NIO) is radiological. Ultrasonography (US) plays a supporting role when carrying out differential diagnostics. Purpose: to estimate possibilities of diagnostics and treatment of children with NIO and its complications with use special interventional methods of US. Methods: Retrospective study of results of the treatment children with NIO operated in the Arkhangelsk children’s hospital in 1998-2012 was conducted, in 62 the protocol of investigation included special US methods. Two groups were compared: 1st (n=44) for the purpose of diagnostics of NIO and its reasons special US methods (US of the stomach with contrasting by fluid, hydrocolonic sonography (HS)) and X-RAY carried out, 2^nd (n=44) were only radiological investigations. In both groups timeliness of establishment of the diagnosis and a postoperative lethality were estimated. Results: All types of NIO and their complications had direct signs (visualization of the atresia, volvulus, exudate at peritonitis, violation of a passage in underlying departments of a gastrointestinal tract) and indirect US signs allowing to make a conclusion about obstruction reason. In the 1st group the diagnosis of NIO was significantly more often made in time (p <0,001), statistically significantly was less often observed lethal outcome, than in patients of the 2nd group (p <0,001).

The objective: To study the features of carnitine and amino acid metabolism in young athletes. Materials and methods: 131 children (I-II health groups) aged 12 to 17 years 11 months were examined. The main group is 94 young athletes. Control group - 37 children who do not engage in sports. Determination of the level of free and bound carnitine, amino acids by tandem chromatography-mass spectrometry. According to the results of the examination of two groups of children, the content of free carnitine is significantly higher in young athletes (p <0.05). Significant differences exist in the free / bound carnitine index. This figure is significantly higher among athletes (p <0.05). The reliability of differences in the content of methionine was noted at p <0.001. Conclusion indicate the presence of a number of features of carnitine status and amino acid metabolism in young athletes. It can be assumed that the obtained data reflect a more efficient cellular energy in children involved in sports.

The gut microbiota has attracted increasing attention during the last several years as a key player in the pathophysiology of chronic disease. Microbiome is considered to be the link between metabolic disorders, obesity, insulin resistance, dyslipidemia, diabetes, hypertension and cardiovascular diseases. Recent findings have related the intestinal microbiota to a plethora of pathological conditions, including type 2 diabetes, obesity, cholelithiasis and nonalcoholic steatohepatitis. This review presents potential mechanisms for the development of these diseases in response to changes in the gut microbiota. They involve increased gut permeability, low-grade inflammation and autoantibodies. Many studies contradict each other, which confirms the need for further scientific research in this area.

A case of the drug-induced liver injury (DILI) development is presented on the background of the self-treatment with an antiparasitic drug Albendazole in an 11 years-old girl with several risk factors for the drug-induced liver injury (history of a drug reaction, carbohydrate and fat metabolism disturbance, female gender, and adolescence). The disease was diagnosed using the the CIOMS/RUCAM scale. The drug was withdrawn and the pathogenetic therapy was established (fluids, hepatoprotective drugs) with the resolution of the drug-induced hepatitis.

Cystic fibrosis is a hereditary disease that affects the quality of life of patients without proper treatment. It has been established that allergic diseases have become a global public health problem. Due to a variety of clinical manifestations that affect the development, health and quality of life, it is difficult to diagnose. Due to the high incidence of allergic problems, there is the problem of interrelationship of hereditary genetic diseases - cystic fibrosis and spectral sensitization of children suffering from morbidity in order to improve the algorithms, improve the condition and quality of life of patients, due to the appointment of proper diet therapy.

In the article, the authors present brief information about gastric ulcer and duodenal ulcer, its epidemiology, diagnostic capabilities, approaches to the treatment and prevention of complications. In addition, there are data on the diagnosis and verification of symptomatic gastroduodenal ulcers. Using the example of a clinical case of a complicated symptomatic ulcer in a child, the authors describe the difficulties encountered at the stages of diagnosis, treatment, and follow-up at high risk of complications.

The final version of the draft protocol for the diagnosis and treatment of Crohn’s disease in children, developed by experts of the Russian Society of Pediatric Gastroenterology, Hepatology and Nutrition, is presented in the article. This project has been repeatedly discussed by pediatric gastroenterologists - specialists in the study of IBD in children during round tables at the XXV-th and XXVI-th Congres of Pediatric Gastroenterologists of Russia and, after final approval, will be presented in the form of clinical recommendations.