The human gastrointestinal tract is one of the largest in area — points of contact between the internal environment of the host and environmental factors.

The most important functional element of this interaction is the microbial — tissue complex of the gastrointestinal tract, and its permeability is defined as a key option in the implementation of the mechanisms of adaptation and homeostasis.

The microbiota is represented in various interpretations by the main four domains (archaea, bacteria or eubacteria, eukaryotes and viruses). The combination of these domains into the Biota taxon suggests the need to use the term biota-tissue complex, which more fully reflects the sophisticated interactions of all microbial-tissue complexes of the body.

Metabolic syndrome is associated with current diseases, such as obesity, diabetes, hypertension, which are accompanied by changes in the intestinal microbiota and the functioning of the immune and neuro-humoral systems of the body. Without detracting from the role of heredity and environmental factors, the intestinal microbiota makes a significant contribution to the development of metabolic disorders and obesity by modulating cascading enzymatic reactions of the macroorganism, interacting with receptors directly and/or using its own metabolites and signaling molecules.

The purpose of study was to analyze the literature data obtained in the study of the role of the intestinal microbiota in the development of metabolic syndrome (MS).

Results: A review of current literature on the role of intestinal microbiota in the development of metabolic syndrome is presented. The features of the mucosal microflora of the colon, the role of bacterial films, epithelial lining of the intestinal mucosa in the formation of the intestinal microbial-tissue complex as the leading links of metabolic disorders are discussed. The article presents data on the variability of short-chain fatty acids, bacterial genome in the development of obesity and type 2 diabetes.

Metabolic syndrome and non-alcoholic fatty liver disease, as its hepatic manifestation, are extremely relevant and socially significant health problems today. The article presents new data on the problem of the pathogenesis of non-alcoholic fatty liver disease from the perspective of the influence of bile acids on the state of carbohydrate and lipid metabolism, the functioning of adipose tissue, the composition and function of the intestinal microbial-tissue complex. Bile acids are ligand-binding domains involved in the activation of many receptors. The role of endogenous fructose, uric acid, chronic kidney disease, platelet dysfunction in the development of the disease is highlighted, the directions of therapeutic action are determined. An increase in oxidative stress, a violation of the intestinal microbial-tissue complex, dyslipidemia, and excessive platelet activation form a “vicious circle” that promotes the progression of liver and kidney diseases.

The purpose of the study was to determine the frequency and nature of manifestations of left ventricular diastolic dysfunction in patients with non-alcoholic fatty liver disease with the background of metabolic syndrome (MS).

Characteristics of patients and research methods: To solve this problem, 227 patients with MS (130 men and 97 women) were examined. The study was conducted in two phases. At the first stage, all patients with MS are divided into two groups: patients with NAFLD — 205 people and 22 — without liver damage. At the next stage, a group of NAFLD patients with left ventricular DD (n=136) (66.34%) (the main group) and patients with no DD (n=69) (33.66%) (the comparison group) were identified.

Results of the study: the results of diagnostics, clinical and laboratory manifestations of left ventricular diastolic dysfunction in 136 patients with NAFLD on the background of metabolic syndrome are Presented. Significant factors of development and progression of diastolic dysfunction were identified, which include increased body weight and adipose tissue, insulin resistance, dyslipidemia, hyperuricemia, activity and stage of liver damage. According to the data of structural and functional changes in the myocardium, the role of diastolic dysfunction in the development of chronic heart failure in patients with NAFLD with manifestations of metabolic syndrome has been established.

Conclusion: it was Found that the development of left ventricular diastolic dysfunction in patients with NAFLD is due to the morphofunctional state of the liver.

The goal was to determine the effect of ursodeoxycholic acid (UDCA) in non-alcoholic steatohepatitis (NASH) with impaired glycemic control.

Materials and methods. 67 patients NASH were examined: prediabetes — 38 (56.7%), type 2 diabetes mellitus 29 (43.3%), men — 39 (58.2%), women — 28 (41.8%), age — 45.1 ± 10.2 years. The UDCA dose was 9.4 ± 2.0 mg / kg / day during 59.7 ± 77.6 weeks. Fragments of cytokeratin-18 (FCK-18) (TPS ELISA, Biotech, Sweden), TNF-α (Human TNFα Platinum ELISA, eBioscience, Austria), IL-6 (“Interleukin-6-IFA-Best”, Vector-Best, Russia), insulin (“Insulin TEST System”, Monobind Inc., USA), HOMA-IR were determined.

Results. There was a decrease in the levels of FCK-18 — from 238.1 ± 93.7 to 170.7 ± 79.2 U / l (p <0.05), ALT — 61.3 ± 19.0 to 38.9 ± 19.1 U / l (p <0.05), glucose 5.9 ± 1.3 to 5.5 ± 0.7 mmol / l (p <0.05), insulin 21.9 ± 18.2 to 13.7 ± 9.7 MkU / l, HOMA-IR — 5.8 ± 2.2 to 3.1 ± 0.8 (p <0.05), cholesterol — 6.2 ± 0.9 to 5.3 ± 0.3 mmol / l, LDL — 3.9 ± 0.9 to 3.2 ± 0.6 mmol / l (p <0.05), TNF-α 6.3 ± 1.5 to 5.4 ± 2.1 pg / ml (p <0.05), IL-6–7.1 ± 3.4 to 4, 1 ± 3.2 pg / ml (p <0.05).

Conclusion. UDCA had pleiotropic effects in NASH with impaired glycemic control, reducing cellular apoptosis, necrosis, inflammation, improving insulin sensitivity and lipid homeostasis.

The aim was to investigate features of manometric pattern of type II achalasia.

Materials and methods: High-resolution esophgeal manometry (HRM) was performed in 250 patients with achalasia. In 154 cases patients underwent peroral esophageal myotomy (POEM).

Results: We found that poor results after POEM showed patients with high preoperative esophageal pressurization (>80 mm Hg). The poorest result after POEM we observed in patient with short additional increase of panesophageal pressure (up to 95 mm Hg) withing the contour of panesophageal pressurization.

Evidence is presented for a significantly wider spread of the first two stages (mild and moderate) Colorectal Bradyarrhythmia Syndrome (CBS) compared with the third (severe — constipation) stage of this syndrome. Surveyed more than 2,500 medical professionals by the method of chronoenterographia. It was found that the incidence of mild CBS (about 60% of cases) and moderate stage of this syndrome (about 30% of cases) is almost an order of magnitude higher than the incidence of severe stage (about 10% of cases) of CBS. SCB has been shown to increase the risk of obesity by almost 3 times. It is shown that CBS contributes to a decrease in well-being, activity and mood, as well as a decrease in the quality of life. Screening for CBS and normalizing the circadian bowel rhythm with psyllium (mucofalc) in individuals who consider themselves healthy may contribute to early prevention of the risk of the metabolic syndrome.

There is ample evidence that insulin resistance, hyperinsulinemia, and obesity are at the heart of the development of non-alcoholic fatty liver disease (NAFLD). The disease is now considered as the hepatic component of metabolic syndrome (MS).

64 children with NAFLD were assessed for metabolic syndrome stigma. An analysis was also made on the state of the problem according to the literature on the general links of the pathogenesis of these conditions, methods of diagnosis and treatment of NAFLD.

All components of MS are observed with different frequencies in patients with NAFD. This disease, together with type 2 diabetes mellitus, becomes very common diseases in childhood. The incidence of NAFLD in children is constantly growing, it has begun to occur in infants, an outcome in cirrhosis of the liver is possible within childhood, although the prognosis for NAFLD remains definitely uncertain. Weight loss with a low glycemic index diet, regular exercise, and other lifestyle changes are the mainstay of NAFLD treatment, but not yet very effective for various reasons. In these conditions, it is necessary to increase the role of primary prevention of MS and NAFLD.

In recent years, non-alcoholic fatty liver disease (NAFLD) has been associated with metabolic syndrome (MetS) and is considered as one of its components. The mortality rate of patients with NAFLD is due not so much to the progression of liver damage as to cardiovascular complications. This review summarizes current data on possible pathophysiological mechanisms linking NAFLD and cardiovascular diseases. The article analyzes the clinical effects of NAFLD on the heart and blood vessels: atherosclerosis, myocardial remodeling, rhythm and conduction disorders, and chronic heart failure.

Currently, a large number of studies have been published supplementing our knowledge of sarcopenia and its effect on the development of metabolic disorders, including the formation of NAFLD. This data allows a new look at the pharmacological and non-pharmacological approaches to the treatment of NAFLD, based on basic physiological processes, including the biological axis of the muscle — the liver. This provides a compelling rationale for studying skeletal muscle as the main therapeutic target for NAFLD and metabolic syndrome.

In recent years, in the pathogenesis of metabolic syndrome (MS), great importance has been attached to non-alcoholic fatty liver disease (NAFLD) and violation of the intestinal microbial-tissue complex. This review summarizes current data on possible pathophysiological mechanisms that link NAFLD, pregnancy, and intestinal microbiota disorders. The clinical consequences of NAFLD influence on pregnancy and development of obstetric complications and adverse perinatal outcomes are analyzed.

The aim. The aim of our study was to analyze the available data from literature sources concerning the issues of etiology, pathogenesis, clinic, diagnosis and features of treatment of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic fatty pancreatic disease (NAFPD).

Materials and methods. We conducted a retrospective analysis of foreign literature sources that contain up-to-date information about the state of the problem of NAFLD and NAFPD.

Results. NAFLD and NAFPD develop against the background of metabolic syndrome (MS), systemic insulin resistance, oxidative stress, changes in lipid metabolism. The natural course of NAFPD is associated with high risk of MS progression, occurrence of NAFLD, arterial hypertension, type 2 diabetes mellitus, exocrine pancreatic insufficiency, acute and chronic pancreatitis, pancreas cancer. Correction of the components of MS can reduce the severity of NAFLD and NAFPD; enzyme replacement therapy can improve the function of β-cells in pancreas steatosis.

Conclusion. The alternatives of the pharmacological treatment of NAFLD and NAFPD continue to be actively explored. We emphasize the need of including medications containing pancreatic enzymes in the treatment of NAFLD.

The review provides an analysis of the available data on the clinical efficacy of fecal transplantation in various diseases. Promising areas of this type of therapy are identified, as well as unresolved issues regarding both the methodology itself and the evaluation of effectiveness.

The implementation of the target setting for the treatment of inflammatory bowel diseases — the achievement of clinical and endoscopic remission in each case, even taking into account biological therapy drugs, is not always achievable. It is obvious that patients with ulcerative colitis and Crohn’s disease are genetically heterogeneous in nature, which is manifested by the formation of various clinical and genetic phenotypes and various profiles of altered intestinal microbiota. Modern dietetics and nutritionology can be the most important fine-tuning tool in this chain of events and significantly increase the effectiveness of the therapy, equally contributing to both normalization of the intestinal microbial community and providing mechanisms for regulating gene expression (epigenetic effect).

This review presents literature data on the role of the gastric tract in the processes of intoxication and detoxification of endoand exobiotics. The factors that promote the absorption and metabolism of toxic products in the gastrointestinal tract are described. The causes of intoxication and the mechanisms of two-phase detoxification with the participation of phase I enzymes of the biotransformation of xenobiotics in the intestine, in particular cytochrome P-450 isoenzymes, are described in detail. The predominance of the cytochrome P-450 isoenzyme CYP3A4 in the intestine was shown, and among the enzymes of phase II of biotransformation in the intestinal wall, the most important are UDP-glucuronyltransferase and sulfotransferase. The data on the ways of correction of intoxication with the use of a detoxification complex of dietary nutrition are presented. Clinical studies have shown that a specialized program provides antioxidant protection and the work of enzymes of the I and II stages of the metabolism of toxins, a decrease in the absorption and excretion of metabolic products, can significantly reduce the intoxication of the body, which is extremely necessary during the treatment and rehabilitation of diseases of the gastrointestinal tract and other organs and systems. rehabilitation of the body. It was found that the use of products of detox nutritional program LEOVIT DETOX led to a significant decrease in the concentration of urea and creatinine, which indicates an accelerated elimination of toxins and metabolic products formed in the body. A decrease in the concentration in the blood of the main enzymes characterizing the detoxification activity of the liver ALT, AST, GGT was also established.

The aim of the study was to evaluate the detoxification effectiveness of the preventive nutrition Program and individual detoxification products LEOVIT DETOX, designed to affect all stages of Exo — and endobiotic metabolism.

Materials and methods. Detoxification nutrition LEOVIT DETOX includes: specialized food product of dietary preventive nutrition “Complex nutrition program DETOX”, detoxifying jelly and bars — specialized food products of dietary preventive nutrition for detoxification of the body. The DETOX nutrition program is designed for 15 days and contains 30 products. The dynamics of biochemical parameters of liver and kidney function disorders (AST, ALT, GGT, urea, creatinine), blood lipid spectrum (by total cholesterol), fasting blood glucose level, and products of lipid peroxidation in blood serum were measured.

Results. The use of specialized food products of dietary prophylactic nutrition “, a Comprehensive nutrition program DETOX” leads to a significant decrease in the concentration of urea and creatinine, AST, ALT, GGT, cholesterol, glucose, diene conjugate, ketodienes of CARBONYLS and increased total oxidative activity of blood serum were examined.

Conclusion. The use of a specialized food product of dietary preventive nutrition “Complex nutrition program DETOX” provides effective detoxification of the body in diseases of the gastro-intestinal system.

Aim. Conduct a review of studies characterizing the role of herpesvirus infections in the pathogenesis of inflammatory bowel disease (IBD).

Introduction. The study of the role of herpes virus infections in the pathogenesis of inflammatory bowel disease (IBD) is currently of considerable interest to researchers from different countries.

Result. The results of studies on the significance of human herpes viruses (HHV) in inflammatory bowel diseases (IBD) ulcerative colitis (UC) and Crohn’s disease (CD), their effect on the course of these diseases, and refractory treatment of UC and CD in the presence of HHV are presented.
It is shown that most researchers unanimously conclude that the main attention should be paid to Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human herpes simplex virus type 6 (HHV-6), which are found in the mucous membrane of the colon in patients with IBD and affect both the course of the disease and the effectiveness of the treatment. Attention is focused on the fact that it is necessary to differentiate colitis due to HHV and IBD, proceeding against the background of HHV reactivation, since approaches to the treatment of these conditions are different.

Conclusion. Requires targeted research on the role of human herpes viruses in the pathogenesis of IBD.

The purpose of the review was to study the data of the modern literature on the effect of diet on the skin condition and the course of some dermatological diseases. Recent studies have shown a strong link between diet and a number of dermatological conditions. Food allergies and Western eating patterns can dramatically alter microbiome composition and intestinal permeability. In conditions of disturbed microbial balance and changes in the barrier function of the intestine, the penetration of immunogenic molecules into the systemic circulation, including food antigens, bacterial toxins and pathogens, which can accumulate in the skin, disrupt the epidermal barrier and contribute to chronic inflammation, increase. However, in children with atopic dermatitis, elimination diets did not show a significant advantage in reducing the severity of the disease; on the contrary, adverse events associated with malnutrition, lack of vitamins and minerals were more often recorded. Despite the fact that dietary intervention is an important aspect of the treatment and prevention of a wide range of dermatological diseases, many questions remain open today.

The combination of inflammatory bowel diseases with lesions of the spine and joints is an topical problem for modern medicine. A case of combination of ulcerative colitis and sacroiliitis is presented. The patient is recommended the therapy of genetically engineered biologic drugs.

The article describes the historical and linguistic origins of the main anatomical terms associated with the digestive system: mouth, lip, tongue, parotid gland, tooth, palate, fauces, uvula, pharynx, esophagus, intestine and parts of small and large intestine, pancreas, liver, gallbladder, duct. Not only their morphemic structure and derivational (including from the point of view of etymology) characteristics, but also the historical context of the appearance of certain terms are considered. The names of the anatomical formations are given in sequential order, that is, from the initial sections of the digestive system to the final. Preference is given to anatomical terms in Latin, but the most important Greekisms are also considered.