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CLINICAL GASTROENTEROLOGY

    1. Federal state budgetary educational institution of higher education “Volgograd state medical University” of the Ministry of health of the Russian Federation, 400131, Russian Federation, Volgograd, Pavshikh Bortsov Sq., 1

    Keywords: nonspecifi c ulcer colitis, diagnostics, treatment

    Abstract: Nonspecific ulcer colitis remains one and most complex problems in gastroenterology today. The chronic nonspecific diffusion inflammatory canker of slime and submucosal layer of a direct and large intestine is the cornerstone of this pathology that causes the clinical picture which is shown in the form of abdominal pains, tenezm, obstipation, intestinal bleedings, a frequent liquid chair with impurity of blood and pus. Also nonspecific ulcer colitis can be shown by various abenteric manifestations that causes certain difficulties in early diagnosis and treatments of this disease. Article narrates about the main strong points for the general practitioners and gastroenterologists facing this disease.

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      7. Travis S.P., Dinesen L. Remission in trials of ulcerative colitis: what does it mean? Pract. Gastroenterol. 2010;30:17-20.
      8. Masevich C. G., Sitkin S. I. Sovremennaya farmakoterapiya khronicheskikh vospalitel’nykh zabolevanij kishechnika [Modern pharmacotherapy of chronic inflammatory diseases of intestines]. Aqua Vitae, 2001, no. 1, pp. 37-41. (In Russ.)
      9. Blagodarnogo L. А, Shelygina Yu. А. Spravochnik po koloproktologii [Reference book on coloproctology]. Litterra, 2012, pp. 460-522. (In Russ.)
      10. Khalif I. L., Loranskaya I. D. Vospalitel’nye zabolevaniya kishechnika (nespetsificheskij yazvennyj kolit i bolezn’ Krona): klinika, diagnostika i lechenie [Inflammatory diseases of intestines (nonspecific ulcer colitis and disease Krone): clinic, diagnostics and treatment]. Moscow, Miklosh Publ., 2004. 88 p. (In Russ.)
      11. Shifrin O. S. Sovremennye podkhody k lecheniyu bol’nykh nespetsificheskim yazvennym kolitom [Modern approaches to treatment of patients with nonspecific ulcer colitis]. Consilium-medicum, 2002, vol. 4, no. 6, pp. 24-29. (In Russ.)
      12. Khalif I. L. Printsipy lecheniya yazvennogo kolita (rekomendatsii rossijskoj gruppy po izucheniyu vospalitel’nykh zabolevanij kishechnika) [Principles of treatment of ulcer colitis (recommendation of the Russian group on studying of inflammatory diseases of intestines)]. Koloproktologiya, 2006, no. 2, pp. 31-33. (In Russ.)
      13. Khalif I. L. Lechebnaya taktika pri yazvennom kolite [Medical tactics at ulcer colitis]. Rossijskij zhurnal gastroehnterologii, gepatologii, koloproktologii, 2006, vol. 16, no. 3, pp.58-62. (In Russ.)
      14. Belousova E. A. Iazvennyi kolit i bolezn’ Krona [Ulcer colitis and Crohn’s disease]. Moscow, Triada Publ., 2002. 128 p. (In Russ.)
      15. Belousova E. A., Nikitina N. V., Tsodikov O. M. Lechenie yazvennogo kolita legkogo i srednetyazhelogo techeniya [Treatment of ulcer colitis of an easy and medium-weight current]. Farmateka, 2013, no. 2, pp. 42-46. (In Russ.)
     


    Full text is published :
    Lugovkina A. A., Rudakova L. O., Kryukova N. A., Bessonov A. A., Skvortsov V. V. Features of diagnostics and treatment of nonspecifi c ulcer colitis. Experimental and Clinical Gastroenterology. 2019;164(4): 10–16. (In Russ.) DOI: 10.31146/1682-8658-ecg-164-4-10-16
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    1. Multidisciplinary medical center of the Bank of Russia, Moscow 117593, Russia

    Keywords: NSAID-colopathy, ulcerative colitis, colonoscopy, inflammation

    Abstract: The aim: to focus on a relatively new and little-studied pathology of the colon-NSAID-colopathy, to show the similarities and differences in the clinical and endoscopic picture with ulcerative colitis.
    Materials and methods: comparison, based on the data available in the literature and own observations, using methods of endoscopic diagnosis, pathology of the colon with a similar clinical picture.
    Results: on the basis of the obtained and systematized data, key differences were formed, formulated in the form of a table for a more visual and rapid perception of information and recommendations for the differential diagnosis of NSAID-colopathy and ulcerative colitis were given.
    Conclusion: understanding the specifics and differential diagnosis of inflammatory diseases of the colon improves the quality of therapy of these pathologies.

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    Full text is published :
    Belova G. V., Solovev E. A. Diff erential diagnosis of colopathy induced by nonsteroidal antiinfl ammatory drugs (NSAID-colopapthy) and ulcerative colitis. Experimental and Clinical Gastroenterology. 2019;164(4): 17–20. (In Russ.) DOI: 10.31146/1682-8658-ecg-164-4-17-20
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    1. RUDN University, Moscow, Russia
    2. Skobelkin state scientifi c center of laser medicine, Moscow, Russia
    3. Branch № 2 «Medical Rehabilitation Centre of the Ministry of Economic Development of Russia», Moscow, Russia

    Keywords: endoscopy, colon, screening colonoscopy, autofluorescence, polyps, dysplasia, early cancer

    Abstract: Objective: to determine the dependence of autofluorescent staining of epithelial colon lesions, depending on the histomorphological structure.
    Material and Methods: Video colonoscopy using autofluorescence was performed in 1674 patients. The patients’ age was 58±13.9, men were 761 (45.5%), women 913 (54.5%). Epithelial lesions were detected in 269 patients (16%). Endoscopic examinations were carried out according to a standard procedure using Olympus video colonoscopes, GF-260. Results: It was established that the presence of AF staining in the purple color of the epithelial colon lesions, as a marker of dysplasia, can serve as an additional criterion in the complex indications for their endoscopic removal.
    Conclusion: The developed method of using autofluorescent endoscopy is simple to perform and allows obtaining data that have a differential value on the presence of dysplastic changes in the epithelial colon lesions.

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    Knyazev М. V., Duvanskiy V. A., Belkov A. V. Possible autofl uorescent diagnostics of epithelial structures in the colon. Experimental and Clinical Gastroenterology. 2019;164(4): 21–26. (In Russ.) DOI: 10.31146/1682-8658-ecg-164-4-21-26
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    1. Federal State Budgetary Educational Institution of Higher Education “National Research Ogarev Mordovia State University”, Saransk 430005, Republic of Mordovia, Russia

    Keywords: Remaxol, chronic periodontitis, gastropathy, lipid metabolism

    Abstract: Two groups of patients with chronic severe periodontitis and gastropathy: І (comparison group, n = 26) - under standard therapy; ІІ group (studied group, n = 22) - Remaxol is included in the standard treatment regimen. On admission and after 10 days of treatment, we studied the structural and functional state of periodontal tissues with the calculation of clinical indices, performed fibrogastroduodenoscopy with a biopsy of the gastric mucosa, followed by determination of lipid composition in its tissues and red blood cells, determined the content of H. Pylori, pepsinogen I and II, immunoglobulin A and E, malonic dialdehyde and diene conjugates, the activity of phosphalipase A2 and catalase. Chronic periodontitis was established to be accompanied by significant structural and functional lesions of the stomach (gastritis, erosion, ulcers). The role of membrane-destabilizing phenomena in epithelial cells of the gastric mucosa has been proved in the pathogenesis of gastropathy. Oxidative stress and phospholipase activity are involved in the development of these phenomena. The use of Remaxol in the treatment leads to a decrease in inflammatory necrotic processes in the mouth and stomach. The effectiveness of the drug is largely due to its ability to reduce membrane-destabilizing processes by decreasing the activity of lipoperoxidation and phospholipase A2, as well as reducing the acidity of gastric juice.

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    Vlasova T. I., Kondyurova E. V., Davydkin V. I., Vlasov A. P., Sheyranov N. S., Vasilyev V. V., Mitina E. A., Sinyavina K. M. Pathogenetic base for a new approach in the treatment of diseases of the digestive system upper departments. Experimental and Clinical Gastroenterology. 2019;164(4): 27–32. (In Russ.) DOI: 10.31146/1682-8658-ecg-164-4-27-32
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    1. Practical and Clinical Research Center of Diagnostics and Telemedicine Technologies, Department of Healthcare of Moscow, 109029, 28–1, Srednyaya Kalitnikovskaya str., Moscow, Russia
    2. Federal State Autonomous Educational Institution of Higher Education “I. M. Sechenov First Moscow State Medical University” of the Ministry of Health of the Russian Federation (Sechenov University), 119991, 8–2, Trubetskaya str., Moscow, Russia
    3. Lomonosov Moscow State University, Faculty of Fundamental Medicine, 119192, 27/1, Lomonosovsky Ave., Moscow, Russia

    Keywords: osteoporosis, QCT, gastric cancer, pancreatic cancer, gastrectomy, pancreatoduodenal resection, malabsorption

    Abstract: Objective. Analyze the relationship between the surgical treatment of the upper gastrointestinal tract (GIT) and the decrease in bone mineral density (BMD) by comparison with reference age data and the control group. Methods. The medical data of 20 patients were analyzed with various types of surgical interventions on the upper GI tract (main group): 8 patients underwent various types of pancreatoduodenal resections, 11 - stomach resections, including two according to Billroth II, one patient underwent antral stenting. The patients’ age ranged from 53 to 84 years old, the median one being 70 years old, 13 men and 7 women. Measurements of lumbar spine BMD by the method of asynchronous CT densitometry were carried out using native images of the abdominal cavity, without contrast enhancement. The control group consisted of 35 patients who underwent an abdominal scan, without cancer pathology and without indications of a decrease in BMD. The age in the control group ranged from 43 to 86 years old, the median one being 65 years old, 22 men and 13 women. A multifactorial regression model was built to analyze the influencing factors on BMD. Results. A statistically significant dependence of the IPC on three factors was revealed: sex (p = 0.015), age (p = 0.001), and the presence of surgery. It was shown that among the main group of patients, the value of BMD was lower on average by 12.3 mg/ml as compared with the control group (p = 0.027), this corresponds to a decrease Zscore -0,35 SD. Conclusion. A statistically significant decrease BMD in patients after surgical treatment of the upper GIT, relative to the control group. It can be assumed that the emerging malabsorption syndrome is one of the prerequisites for the development of osteoporosis or osteopenia. Asynchronous CT densitometry is an effective method for monitoring bone mineral density, which provides additional information regarding BMD in patients under examination.

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    Petraikin A. V., Soloviev A. V., Chesnokova A. O., Petryaykin F. A., Nisovtsova L. A., Sergunova K. A., Akhmad E. S., Semenov D. S., Vladzymyrskyy A. V., Morozov S. P. Asynchronous quantitative computed tomography (QCT) in assessing the impact of the upper gastrointestinal tract on bone mineral density. Experimental and Clinical Gastroenterology. 2019;164(4): 33–39. (In Russ.) DOI: 10.31146/1682-8658-ecg-164-4-33-39
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    1. Orenburg State Medical University (OrSMU), 460000 Orenburg, Russia

    Keywords: gastro-esophageal junction, gastroesophageal refl ux disease, Helicobacter pylori, preneaplastic changes, Barrett’s esophagus

    Abstract: Objective: to improve the diagnosis of gastroesophageal reflux disease and its complications.
    Materials and methods: clinical and endoscopic studies were performed on 1052 patients, 110 of them healthy, 722 - with gastric ulcer and duodenal ulcer, after Billroth II stomach resection, with a hiatus hernia, gallstone disease, etc., 210 children. Studied 100 macropreparations of the esophageal-gastric junction and 70 longitudinal histotopograms from patients who died from diseases not related to diseases of the gastrointestinal tract, histotopograms of 10 cases with esophageal adenocarcinoma and esophageal-gastric junction.
    Results: The location of the Z-line is individually variable, the range is limited to two levels: up to 40 mm above and 18 mm below the outlet of the cardia. The presence of a mucous membrane with a cylindrical epithelium in the distal esophagus is a variant of the norm. In the area of the Z-line in 70% of cases there is a duplication at a distance of 10 mm, consisting of a mucous membrane with a stratified squamous epithelium, covering the mucous membrane with the gastric epithelium. High Helicobacter infection of the mucous membrane with gastric epithelium was detected, its pre-neoplastic changes in adults (17.2%), in children (10.9%) and Barrett’s esophagus are often found in mild degrees of esophagitis, and there are also indirect signs of HP in the esophagus.
    Conclusions: The presence of a mucous membrane with a cylindrical epithelium in the esophagus up to 40 mm above the outlet of the cardia is a variant of the norm. In the area of the Z - line there is in 70% of cases duplication at a distance of 10 cm, consisting of a mucous membrane with a stratified squamous epithelium, under which there is a mucous membrane with a gastric epithelium, and a step biopsy is required to diagnose changes in it. The presence of HP in the mucous membrane of gastro-esophageal junction has indirect endoscopic signs, contributes to the development of pre-neoplastic changes of the mucous membrane, which in most cases are found in mild degrees of esophagitis, which requires antihelicobacter therapy.

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    Dronova O. B., Kagan I. I., Tretyakov A. A., Mironchev A. O. Discussion issues of gastroesophageal refl ux disease based on clinical and endoscopic studies. Experimental and Clinical Gastroenterology. 2019;164(4): 40–45. (In Russ.) DOI: 10.31146/1682-8658-ecg-164-4-40-45
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