In 2019, a retrospective analysis of medical records for 10 previous years (2019-2009) was conducted for 426 patients with confirmed malignant neoplasm (MN) of the stomach registered in 125 outpatient and polyclinic medical and preventive treatment facilities in 12 cities of the Russian Federation. The average age of patients at the time of diagnosis was 61.9 years, the life expectancy after diagnosis being 2.2 years. In 67.4% of patients the diagnosis was made at stages III and IV of the disease. All patients had a history of any upper digestive tract pathology. The record of H. pylori c examination was detected in 16.9% of patients, all of them with positive results. In 64,3% of esophagogastroduodenoscopy (EGDS) protocols there were visible changes in the gastric mucosa. Dynamic EGDS control was performed irregularly. During the whole period of observation, an average of 2.5 biopsies per patient were taken during EGDS. In the clinical diagnosis of “chronic gastritis” morphological examination was performed in 70.0% of patients. Classical “warning signs” were registered on the average 2.4 years before the diagnosis of gastric cancer. Dyspepsia syndrome was registered 4.6 years before cancer verification. The correlation between dyspepsia and the timing of cancer diagnosis was confirmed. Thus, the dyspepsia syndrome can be categorized as “early warning signs”. For the diagnosis of gastric adenocarcinoma, 3D correlation analysis showed a correlation between the number of biopsy samples taken, the number of “warning signs” and the number of years lived after the diagnosis of malignant neoplasms.

The article presents the results of the analysis of clinical features of gastroenterological manifestations of a new coronavirus infection (COVID-19) caused by the pathogen SARS-CoV-2. Taking into account the stage-by-stage system assessment of the experience of treating 1,180 patients in a multi-specialty hospital transformed into an infectious hospital, the most characteristic clinical manifestations of digestive damage by SARS-CoV-2 coronavirus are described. The article focuses on verification of changes in the digestive system, both at the stage of primary examination, and during etiotropic (in combination with hydroxychloroquine and azithromycin, interferon-alpha drugs), pathogenetic (in combination with corticosteroids, heparin drugs, according to indications - an interleukin-6 inhibitor) and symptomatic (antipyretics, antiemetics and antitussive drugs) therapy, carried out in accordance with Temporary guidelines of the Ministry of health of the Russian Federation “Prevention, diagnosis and treatment of new coronavirus infection Covid-19”. Directions for the development of algorithms for clinical and laboratory, instrumental and radiological diagnostics of changes in the digestive system in patients with COVID-19 are justified.

The aim of the work is to study and describe modern concepts of functional gastrointestinal disorders. The modern Roman classification of FGIR is given, their relationship with emotions and pathological anxiety of a person is described. A comparative analysis of clinical cases of outpatient visits to an outpatient gastroenterologist for the corresponding periods from December 2019 to December 2020 is carried out. An example of such disorders in a patient is given.

Modern research indicates a possible synergistic effect of bacterial-protozoal infestations in the pathology of the upper gastrointestinal tract, among which special attention is paid to the problem of giardiasis. Other parasitic agents, in particular Blastocystis spp, are also gaining some significance. The aim is to study the prevalence of H. pylori and protozoal infestations in chronic gastroduodenal diseases and the influence on the indicators of enzymatic digestion. Materials and methods. We examined 244 patients (130 adults and 114 children) with clinical manifestations with abdominal pain and dyspeptic syndromes. All patients were examined by immunochromatographic test for the qualitative detection of H. pylori in the feces, coprological and protozoological methods. Results. In the group of patients with chronic gastroduodenal diseases, the H. pylori antigen in the feces was detected in 116 (47.5%) patients. During protozoooscopic examination of feces, the detection rate of Lamblia intestinalis was 22.9%, in Blastocystis spp. - 13.1%, Entamoeba coli 10.2%, Entamoeba spp. 9.4%. Protozoan invasion was detected in the groups of H. pylori + and H. pylori - patients: infection of Lamblia intestinalis was diagnosed in 27.6% and 18.8% of cases respectively (p<0.05), in Blastocystis spp. - in 16.4% and 10.2% cases (p<0.05). There were no significant differences in the frequency of detection of non-pathogenic amoebas in these groups of patients. Mixed infection with H. pylori and pathogenic protozoa, along with increased manifestations of gastrogenic, ileocecal, enteral and acholian syndrome, signs of pancreatogenic and distal-colitic syndromes were detected. Monoinfection Lamblia intestinalis, signs of enteral, ileocecal, and acholia with signs of ileocecal syndromes were detected, and when monoinfection Blastocystis spp. signs of enteral and ileocecal syndromes were revealed. Conclusions. It is shown that intestinal protozoan and bacterial-protozoan mixed infection (H. pylori + L. intestinalis; H. pylori + Blastocystis spp.) can have a negative effect on enzyme digestion and are important etiopathogenetic factors of diseases of the upper gastrointestinal tract.

Aim. On the basis of the complex analysis, to evaluate the efficiency of eradication therapy at patients with stable stenocardia with a combination of chronic gastritis. Material and methods. 46 patients with stable stenocardia with a combination of chronic H. pylori-associated gastritis were included in the open prospective clinical study. Two groups of patients were formed during the study. Patients of group I (n = 25) received eradication therapy in accordance with antibiotic sensitivity of H. pylori strains, patients of group II (n = 21) - without antibiotic sensitivity. In all patients before and after treatment were performed: evaluation of clinical status, laboratory indicators, EGDS with biopsy sampling, diagnosis of H. pylori. Results. The effectiveness of eradication therapy was 86.9%, at the same time, 96% -in group I and 76.2% - in group II. It is established: stabilization of clinical status of patients, improvement of morphological and endoscopic picture of gastroduodenal zone, improvement of laboratory indices. Conclusions. The inclusion of antibiotic-sensitive erication therapy in the algorithm of treatment of patients with stable stenocardia in combination with chronic gastritis allows to achieve high effectiveness of killing the infection Helicobacter pylori. At the same time stabilizes clinical status of patients, laboratory indices, has a positive effect on morphological and endoscopic picture of gastroduodenal zone, preventing progression of metaplastic changes.

Purpose of research. Assessment of the population prevalence of Helicobacter pylori infection and the effectiveness of eradication therapy by analyzing the results of the¹³C-urease breath test (¹³C-UBT) of surveyed patients who applied for the test to the nationwide network of medical offices of the INVITRO laboratory in 2019-2020. Materials and methods.¹³C-UBT was performed using¹³C-UREA TEST kits and IR spectrometer IRIS° - Doc, Kibion AB, Sweden. A brief questionnaire was used when applying to clarify the purpose of the request, prior medication or gastric surgery. The evaluation of the prevalence of helicobacteriosis among those who applied for screening, and the effectiveness of eradication among those who applied for therapy control, was carried out by comparison of the specified point of the examination and the results of the¹³C-UBT test, based on a selected information from the laboratory database for 2019-2020 years (n=42843). Statistical calculations of quantitative results of¹³C-UBT performed using Excel, MS programs. Results. Primary screening of H. pylori infection was the goal of the examination for 69% (n=26,127), and eradication control for 31% (n=16,716) of the surveyed persons. According to the results of¹³C-UBT, using the threshold of positive results of 4.5% and the gray zone of 3.0-4.5%, among the primary screening subjects, 39% had a positive result, 3% - doubtful, others negative. In the group of patients who applied for eradication control, 40% of the subjects completed the full course of treatment. Among those who completed the course of treatment, the infection according to the results of¹³C-UBT remained in 15%, and for the group as a whole in 17% of patients. Conclusions. Among patients who applied to a large network laboratory for initial examination, the detection rate of H. pylori infection was 39%, which probably reflects the approximate current level of prevalence of this infection in the Russian Federation. According to the results of testing for treatment control, the effectiveness of eradication therapy was 80-82%.

Hereditary predisposition is one of the aetiopathogenetic factors in the development of gastric ulcer and duodenal ulcer. The analysis of literature materials allows us to identify a number of candidate genes that play a role in the formation of peptic ulcer: PSCA, ABO, IL1β, IL1RN, TNFα, HSP70-1, GSR, TLR4, TLR2, TLR9, MMP-1, MMP-3, MMP- 9, TIMP-3, PGC, MIF, MPO, COX-1. Considering that most of the studies were carried out abroad, the results differ depending on the ethnic characteristics of the studied groups, sometimes they are contradictory, and the works of domestic scientists on this problem are rare, further study of the role of polymorphic variants of candidate genes in the formation of gastric ulcer and duodenal ulcer is necessary.

Objective. To analyze the peculiarities of eating behavior and diet of medical students, to reveal the relationship between dietary habits and gastrointestinal symptoms. Materials and methods. A one-step anonymous survey of 996 students of 1-6 grades of the Chita State Medical Academy was carried out. The author’s questionnaire contained 53 questions concerning the peculiarities of the diet, the quality of the consumed products, as well as aimed at identifying gastrointestinal symptoms and hereditary factors in students. Statistical processing was carried out using the Statistica 10.0 program, correlation analysis was carried out using gamma correlation. Results. Only 40% of the respondents eat regularly at least 3 times a day. Almost 80% of students periodically skip meals at lunchtime, replacing it with a “snack on the run”: 45% 1-2 times a week, 24.8% 3-4 times a week, 9.4% daily during the school week. A positive correlation was found between the frequency of “snacking while running” per week with the frequency of pain (p = 0.0000001) and symptoms of gastric dyspepsia (p = 0.0000001). Only 57% of the respondents have breakfast. Abdominal pain 1-2 times a month and less was in 37.6% of respondents, 1-2 times a week - 26%, 3-4 times a week and more often - 7.4% and only 22% did not complain of pain in a stomach. Conclusion. Most of students have eating disorders that include inadequate breakfast, snack instead of lunch, lunch-dinner, and eating after 22:00. The relationship between the frequencies of eating disorders, fast food consumption, chips with gastrointestinal symptoms was revealed.

Purpose of the study. To study calcium-phosphorus metabolism in patients with peptic ulcer (PU) in comparison with bone mineral density (BMD), its age and gender aspects. Materials and methods. 216 people with ulcer were in remission and 154 people without ulcer history and erosive-ulcerative changes during fibrogastroduodenoscopy (FGDS) were examined. All patients underwent clinical and endoscopic studies, dichromatic X-ray densitometry with the calculation of the T-test of the femoral neck (FN) and the lumbar spine (LS). Calcium and blood phosphorus have been studied. Results. In patients with PU compared with patients without this pathology there was a significant decrease of BMD. In 32% of patients with PU osteoporosis (OP) was diagnosed and in 34% of patients - osteopenia. In the group of persons who had no PU osteoporosis was found in 18%, osteopenia in 26% of cases. In both groups women prevailed. Blood calcium was significantly higher in patients with PU as compared to those examined without an ulcer history. A significant increase of calcium was observed in individuals with a comorbid course of PU and OP. Conclusion. The data obtained show that the study of blood calcium can serve as a simple criterion for diagnosing disorders of BMD and, if its values are high, conduct a more detailed examination of patients with PU for early detection of OP and the possibility of its treatment.

Research goal - to examine the effectiveness of active-individualized tactics in treatment of chronic gastric and duodenal ulcers. Material and methods. Analysis of treatment of 251 patients with chronic gastric and duodenal ulcer bleeding was conducted. Duodenal ulcer bleeding was present in 202 cases (80,5%), gastric ulcers were the reason of bleeding in 49 cases (19,5%). Treatment conducted according to principles of active-individualized tactics. Results. The provided characteristics and the acquired results were presented according to the fundamental components of active-individualized tactics in treatment of gastric and duodenal ulcers. Diagnostic and treatment abilities of endoscopy were determined, an unique scale of bleeding relapse risk was presented, the time limits and main indications for surgery were explained,, the role of bleeding relapse was emphasized as crucial in forming the main results of treatment of patients with bleeding gastric and duodenal ulcers. Conclusion. At present time, active-individualized tactics should be used for treatment of gastric and duodenal ulcer bleeding.

The growth of cognitive impairment (CI) in clinical practice makes us search for their new pathogenetic mechanisms, among which the effect of intestinal microbiota on the brain is currently being actively studied. The mechanisms of interaction of the axis “brain - microbiota” have not been completely studied. The aim of this study was to confirm the possible effect on the brain of the neurotoxin ammonia, which rises in the blood due to the syndrome of excessive bacterial growth (SIBO). Materials and methods: The article presents data from a clinical observation, which included an examination of 70 patients of the gastrocenter in Perm with dyspepsia syndrome, who studied changes in the intestinal microbiota, the level of ammonia of capillary blood, and cognitive impairment, and conducted a correlation analysis. Results: According to the results of a statistical analysis of the obtained data, we did not find any significant changes or significant correlations between the studied parameters. However, the identified tendency in the connection “SIBO - hyperammonemia - cognitive impairment” suggests that the presence of SIBO can aggravate the severity of not only existing gastroenterological manifestations, but also be a risk factor for hyperammonemia, as well as contribute to the formation of impaired human cognitive functions.

This narrative review summarizes a selection of clinically-important novel gastrointestinal developments, presented and discussed at the virtual Gastro Update Europe. The selected topics, fully referenced, reflect what the distinguished faculty considered of vital importance to be communicated to the astute busy gastro-hep clinician who is eager to stay abreast of important novel developments. Whenever appropriate a personal comment or addition was added to further raise the educational value of this review. Given its narrative character, statements and conclusions are largely expert opinion-based, and referencing within this summary is limited to the included slide images.

The article highlights the problem of improving the rational treatment of campylobacteriosis. Probiotics are present in treatment regimens along with antibiotics, which have the advantage that they do not violate intestinal microbiocenosis and provide the ability to correct dysbiotic conditions. As well as antimicrobial agents, probiotics have different effects on the growth of pathogenic microorganisms. Campylobacter spp. probiotics in the in vitro system. The article studies the anticampylobacter activity of probiotic cultures of Enterococcus faecium L3, Lactobacillus plantarum 8 R-A3, a mixture of Lactobacillus acidophilus and Saccharomyces boulardii by two-layer agar and droplet method. Analysis of the antagonistic activity of chemically synthesized bacteriocins. The high sensitivity of Campylobacter spp was presented. to probiotics having lactobacilli and enterococci, as well as their metabolites (including bacteriocins). The strain-specific activity of probiotics and its dependence on their ability to produce bacteriocins were found. The results and data of other researchers indicate the need for individual selection of probiotics for the treatment of campylobacteriosis, the feasibility of analyzing the bacteriocinogenicity of the strains and testing their effect on the growth of clinical isolates.

Crohn’s disease is a chronic inflammatory disease of the gastrointestinal tract in which patients should receive continuous, lifelong therapy. Particular attention should be paid to their nutritional status. The characteristics of the diet traditionally recommended for Crohn’s disease often lead to a decrease in the consumption of essential nutrients by patients. Therefore, an important role belongs to nutritional support with specialized mixtures, the effectiveness of which has been proven, both for the induction of remission, and for optimizing the parameters of physical development and puberty, bone mineralization. Nutritional support should be carried out in the case of a newly diagnosed disease in the form of complete enteral nutrition, and subsequently - in remission, exacerbation, in the pre- and postoperative periods, as an addition to the standard diet. Of particular interest is the CDED ModuLife program, which is based on a combination of enteral nutrition with specially selected foods, aimed at reducing the activity of intestinal inflammation in CD.

Long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency (LCHAD) is a hereditary disease referred to the group of disorders of mitochondrial β-oxidation of fatty acids with autosomal recessive inheritance. The main symptoms include hypoglycemia, hepatic steatosis, cardiomyopathy, cardiac arrhythmias, progressive muscle hypotension. We present a case of successful diagnosis and treatment of a long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency (LCHAD) with the use of 100% medium chain triglycerides’ oil product. The importance of the possibly earliest verification of the diagnosis and initiation of diet therapy using medium-chain triglyceride oils is emphasized, which allows to reduce the disease manifestations and determines the need to include diseases of mitochondrial fatty acids β-oxidation into the neonatal screening program.

Fluid collection around pancreas is one of the most frequent remote complications of acute pancreatitis which often requires drainage. Drainage can be performed either surgically (with creation of cyst-jeuinal anastamosis), transcutaneously or endoscopically. In endoscopic methods endosonogrophic assisted drainage (EUS-guided drainage) with placement of metal self-expanding stents is widely used. Hot Axios is one the latest state-of the-art innovative stents used for draining of different types fluid collections including infected cysts. This clinical case demonstrates successful drainage of fluid collection under endosonographic guidance.