Nutritional Aspects of Pediatric Gastrointestinal Diseases.

In the last decade, the role of nutritional management in pediatric gastrointestinal diseases has gained increasing popularity. Disease-specific diets have been introduced as conventional treatments by international guidelines. Patients tend to more willingly accept food-based therapies than drugs because of their relatively "harmless" nature. Apart from a diet's therapeutic role, nutritional support is crucial in maintaining growth and improving clinical outcomes in pediatric patients. Despite the absence of classical "side effects", however, it should be emphasized that any dietary modification might have negative consequences on children's growth and development. Hence, expert supervision is always advised, in order to support adequate nutritional requirements. Unfortunately, the media provide an inaccurate perception of the role of diet for gastrointestinal diseases, leading to misconceptions by patients or their caregivers that tends to overestimate the beneficial role of diets and underestimate the potential adverse effects. Moreover, not only patients, but also healthcare professionals, have a number of misconceptions about the nutritional benefits of diet modification on gastrointestinal diseases. The aim of this review is to highlight the role of diet in pediatric gastrointestinal diseases, to detect misconceptions and to give a practical guide for physicians on the basis of current scientific evidence.

Emphysematous gastritis after metastatic malignant melanoma: a radiological surprise.

Malignant melanoma is cancer of the skin which commonly metastasises to the stomach. There have been no reported cases of emphysematous gastritis secondary to metastasis of malignant melanomas, to date. However, a 61-year-old woman with metastatic malignant melanoma of the left great toe presented to us with symptoms of severe left hypochondrium pain associated with high-grade fever, gross abdominal distension and recurrent vomiting. Two months earlier, metastasis was observed to have spread to the stomach and inguinal lymph nodes. At this stage, the patient opted for traditional medication instead of definitive surgery and chemotherapy. Radiological imaging revealed an emphysematous change to the stomach which was radiologically consistent with gastric malignant melanoma. Unfortunately, the patient succumbed to this rare condition.

Review article: treatment options for functional dyspepsia.

BACKGROUND: Functional dyspepsia, consisting of epigastric pain syndrome and postprandial distress syndrome, is a prevalent functional gastrointestinal disorder. To date, only limited treatment options are available and conflicting results in terms of efficacy have been reported. Consequently, nonpharmacological treatment options are increasingly being explored for functional dyspepsia. AIM: To provide an overview of current pharmacological and nonpharmacological treatment options for functional dyspepsia. METHODS: A literature search was conducted on Pubmed and other sources to identify relevant studies. RESULTS: Acid suppressive therapy reduced symptoms in 30%-70% of the patients, with higher benefit in epigastric pain syndrome and superior effectiveness for proton pump inhibitors compared to H2 -antagonists. Prokinetic agents, primarily used to treat postprandial distress syndrome, showed variable efficiency: 59%-81% responder rate for dopamine receptor antagonists, 32%-91% for serotonin-4-receptor agonists and 31%-80% for muscarinic receptor antagonists. H Pylori eradication, recommended in infected patients, was effective in 24%-82%. Refractory symptoms are addressed with neuromodulators. However, their efficacy in functional dyspepsia remains incompletely elucidated, available data showing symptom reduction in 27%-71% of the patients. Regarding herbal agents, peppermint oil reduced symptoms in 66%-91%, rikkunshito in 29%-34% and iberogast in 20%-95%. Lastly, acupuncture, cognitive behavioural therapy and hypnotherapy may help to provide symptom control, but research on their efficacy remains sparse. CONCLUSIONS: None of the available therapies is effective in the majority of patients without being associated with major side effects. Developing new treatment options is challenging due to the heterogeneity of functional dyspepsia, the lack of readily identified target mechanisms and the poor association between pathophysiological disturbances and symptoms.

Eosinophilic Gastrointestinal Disorders.

Eosinophilic gastrointestinal disorders (EGID) are a group of disorders characterized by pathologic eosinophilic infiltration of the esophagus, stomach, small intestine, or colon leading to organ dysfunction and clinical symptoms (J Pediatr Gastroenterol Nutr; Spergel et al., 52: 300-306, 2011). These disorders include eosinophilic esophagitis (EoE), eosinophilic gastritis (EG), eosinophilic gastroenteritis (EGE), eosinophilic enteritis (EE), and eosinophilic colitis (EC). Symptoms are dependent not only on the location (organ) as well as extent (layer invasion of the bowel wall). Common symptoms of EoE include dysphagia and food impaction in adults and heartburn, abdominal pain, and vomiting in children. Common symptoms of the other EGIDs include abdominal pain, nausea, vomiting, early satiety, diarrhea, and weight loss. These disorders are considered immune-mediated chronic inflammatory disorders with strong links to food allergen triggers. Treatment strategies focus on either medical or dietary therapy. These options include not only controlling symptoms and bowel inflammation but also on identifying potential food triggers. This chapter will focus on the clinical presentation, pathophysiology, and treatment of these increasingly recognized disorders.

Pediatric Collagenous Gastritis and Colitis: A Case Series and Review of the Literature.

INTRODUCTION: Collagenous gastritis is a rare disease characterized by the subepithelial deposition of collagen bands. Two phenotypes of the disease have been described: a pediatric-onset and an adult-onset type. The adult-onset form is associated with collagenous colitis and autoimmune disorders. No effective treatment has been identified to date. OBJECTIVE: We aim to describe the clinical features and outcomes of patients in our cohort and provide a summary of published pediatric cases with collagenous gastritis and colitis reported to date to gather information that will contribute to improved knowledge of this rare condition. METHODS: A retrospective chart review of all patients with collagenous gastritis and/or colitis who were treated at the Royal Children's Hospital, Melbourne, was performed. A literature review was also conducted. RESULTS: A total of 12 cases of collagenous gastritis were reviewed. Three of 12 (25%) patients had associated collagenous colitis. The most common clinical presentation was iron deficiency anemia. Nine (75%) patients were followed up, and repeat endoscopies were performed in 8 (67%). Iron deficiency anemia resolved in all patients on oral iron supplementation. Histologic improvement was only identified in one patient with the adult phenotype who had been treated with oral corticosteroids and azathioprine. CONCLUSIONS: Collagenous gastritis is a rare condition in children. A small proportion of children develop features of the "'adult" phenotype at a very young age. Patients with collagenous gastritis require long-term follow-up and monitoring of their disease. Further randomized clinical trials are needed to establish an effective therapeutic strategy.

Blood flow differences in cun-kou (radial) artery and anterior tibial artery: normal people vs patients with chronic gastritis.

OBJECTIVE: To explore the blood flow differences in cun-kou (radial) artery and anterior tibial artery between normal people and patients with chronic gastritis. METHODS: Using doppler ultrasonography, blood flow charts [peak systolic velocity (VP), maximum blood flow velocity in diastole (VD), mean blood flow velocity (VM), pulse index (PI), resistance index (RI), blood vessel diameter (D), vessel volume (SV), circulation blood flow periodic time (ET)] measured by at cun-kou (radial) artery and anterior tibial artery in normal group (n = 30) and chronic gastritis group (n = 30) in department of ultrasound, Beijing Anzhen hospital, capital medical university. RESULTS: In the doppler flow charts of the normal group, there were statistically significant differences in VD, VM, D, RI, SV, ET between cun-kou artery and anterior tibial artery (P < 0.05), and there were more statistically significant differences in PI between cun-kou artery and anterior tibial artery (P < 0.01). In the comparison of doppler flow charts in the chronic gastritis group, there were statistically significant differences in VD, VM, D, RI, SV, ET between cun-kou artery and anterior tibial artery (P < 0.05), and there were more statistically significant differences in PI between cun-kou artery and anterior tibial artery (P < 0.01). In the comparison of doppler flow charts between normal group and chronic gastritis group, there were statistically significant differences in SV, ET between normal group and chronic gastritis group (P < 0.05), and there were more statistically significant differences in PI between normal group and chronic gastritis group (P < 0.01). CONCLUSION: Based on the differences in doppler flow charts between the normal group and the chronic gastritis group, the doppler flow charts of cun-kou artery and anterior tibial artery were not only proved to be significantly different, but also provided quantitative objective indexes for the study of cun-kou artery and anterior tibial artery doppler flow charts of normal people and chronic gastritis patients. This study also proves that the doppler flow chart of the anterior tibial pulse is of great significance for the diagnosis of chronic gastritis.

[THE CORRECTION OF TROPHIC DISORDERS IN CHILDREN OF CHRONIC GASTRODUODENITIS WITH METHOD LOW-FREQUENCY LIGHT-MAGNETOTHERAPY].

The results of a survey of school children with chronic gastroduodenitis when applying at an early period the medical rehabilitation with method low-frequency light-magnetotherapy. During treatment of hospital was evaluated vegetative-trophic status with methods of cardiointervalography and thermovision functional tests. In normalizes clinical parameters was correction in dynamics of the vegetative status in children, it confirms the effectiveness of the therapy. It is proved, that the use of low-frequency light-magnetotherapy has a positive effect on the vegetative--trophic provision an organism and normalizes the vegetative dysfunction.

Symptom clustering in chronic gastritis based on spectral clustering.

OBJECTIVE: Apply spectral clustering to analyze the patterns of symptoms in patients with chronic gastritis (CG). METHODS: Based on 919 CG subjects, we applied mutual information feature selection to choose the positively correlated symptoms with each pattern. Then, we used the Shi and Malik spectral clustering algorithm to select the top 20 correlated symptoms. RESULTS: We ascertained the results of six patterns. There were three categories for the pattern of accumulation of damp heat in the spleen-stomach (0.00332). There were six categories for the pattern of dampness obstructing the spleen-stomach (0.02466). There were two categories for the pattern of spleen-stomach Qi deficiency (0.013 89). There were three categories for the pattern of spleen-stomach deficiency cold (0.009 15). There were five categories for the pattern of liver-Qi stagnation (0.01910). There were four categories for the pattern of stagnant heat in the liver-stomach (0.00585). CONCLUSION: Most of the spectral clustering results of the symptoms of CG patterns were in accordance with clinical experience and Traditional Chinese Medicine theory. Most categories suggested the nature and/or location of the disease.

Proximal collagenous gastroenteritides: clinical management. A systematic review.

AIM: While collagenous colitis represents the most common form of the collagenous gastroenteritides, the collagenous entities affecting the proximal part of the gastrointestinal tract are much less recognized and possibly overlooked. The aim was to summarize the latest information through a systematic review of collagenous gastritis, collagenous sprue, and a combination thereof. METHOD: The search yielded 117 studies which were suitable for inclusion in the systematic review. Excluding repeated cases, 89 case reports and 28 case series were reported, whereas no prospective studies with or without control groups were identified. Further, no randomized, controlled trials were identified. The total number of patients with proximal collagenous gastroenteritides reported was 330. RESULTS: An overview of clinical presentations, prognosis, pathophysiology and histopathology, as well as management of these disorders is presented. The prognosis of both collagenous gastritis and sprue seems not to be as dismal as considered previously. Data point to involvement of immune or autoimmune mechanisms potentially driven by luminal antigens initiating the fibroinflammatory condition. CONCLUSIONS: To reach the diagnosis it is recommended that biopsies are obtained during gastroduodenoscopies. Therapies with anti-secretory strategies, glucocorticoids, and in some cases iron supplementation are suggested, although rational treatment options from randomized, controlled trials do not exist for these rare or even overlooked disorders.

Effect of moxibustion treatment on cell apoptosis and expressions of heat shock protein and second mitochondrial activator of caspase in acute gastric mucosal lesion of rats.

OBJECTIVE: To investigate the effect of moxibustion-acupoint treatment with acupoints of Zusanli (ST 36) and Zhongwan (RN 12) on cell apoptosis and the expressions of heat shock protein (HSP) 60, HSP70 and second mitochondrial activator of caspase (Smac) in rat models of acute gastric mucosal lesion (AGML), and explore the mechanisms underlying protection of gastric mucosal lesion. METHODS: Twenty-four Sprague Dawley rats were divided into 3 groups, blank controlled group (group A), controlled-point group (group B) and acupoint group (group C), 8 for each. After 8-day moxibustion treatment in group B and C, gastric lavage of anhydrous ethanol was used to created AGML in all three groups. The Guth method was employed to measure the ulcer index (UI) of gastric mucosal lesion and immunohistochemistry used to measure apoptosis with apoptosis index (AI) and examine the expressions of HSP60, HSP70 and Smac. RESULTS: Compared with group A, the expressions of UI, AI, Smac and HSP60 were markedly elevated in group B (P < 0.05 or P < 0.01). However the expression of HSP70 showed no obvious change (P > 0.05); the expressions of UI, HSP60 and HSP70 were markedly elevated in group C (P < 0.01) while those of AI and Smac became obviously suppressed (P < 0.01). Compared with group B, the expressions of UI, AI and Smac decreased significantly in group C (P < 0.01) while those of HSP60 and HSP70 increased markedly (P < 0.01), and the expressions of HSP60 and HSP70 were considerably up-regulated (P < 0.01). CONCLUSION: The moxibustion treatment could alleviate the gastric mucosal lesion caused by anhydrous ethanol, induce the over-expressions of HSP60 and HSP70, and down-regulate the expression of Smac, which could suppress cell apoptosis.

Atividade antiulcerogênica do extrato aquoso da Bryophyllum pinnatum (Lam. ) Kurz / Antiulcerogenic activity of aqueous extract from Bryophyllum pinnatum (Lam. ) Kurz

Bryophyllum pinnatum (Lam.) Kurz pertence a família Crassulaceae e é conhecida vulgarmente como coirama, folha-da-fortuna, ou folha-do-ar, sendo usada popularmente como antifúngico, no tratamento da hipertensão, em úlceras e em inflamações. O presente estudo objetivou analisar a atividade antiulcerogênica do extrato aquoso das folhas de Bryophyllum pinnatum (Lam.) Kurz em modelo de úlcera gástrica induzida por indometacina em Rattus norvegicus, machos (150 a 250 g) com idade de 70 dias. Os animais receberam por via oral: água, extrato aquoso de Bryophyllum pinnatum (Lam.) Kurz (1 e 2 g Kg-1 ) ou ranitidina (60 mg Kg-1 ), fármaco com ação gastroprotetora conhecida que atua bloqueando os receptores de histamina H2. Após uma hora dos tratamentos, todos animais receberam indometacina via intraperitoneal. Os resultados demonstraram que o extrato aquoso da Bryophyllum pinnatum (Lam.) Kurz possui ação gastroprotetora; na dose de 1 g Kg-1 inibiu 45,49% o índice de ulceração induzido pela indometacina, e, na dose de 2 g Kg-1, inibiu 49,50%. Sugere-se o envolvimento de vários mecanismos na ação gastroprotetora dessa planta e não somente uma possível participação das prostaglandinas nesse efeito. Estudos futuros com diferentes modelos de indução de úlcera gástrica tornam-se necessários para melhor avaliar a atividade antiulcerogênica do extrato aquoso de Bryophyllum pinnatum (Lam.) Kurz.

Bryophyllum pinnatum (Lam.) Kurz belongs to the family Crassulaceae, is popularly known as "coirama", "folha-da-fortuna", or "folha-do-ar" and has been commonly used as antifungal, in the treatment of hypertension, ulcers and inflammation. The present study aimed to analyze the antiulcerogenic activity of aqueous extract from the leaves of Bryophyllum pinnatum (Lam.) Kurz using indomethacin-induced gastric ulcer models in Rattus norvegicus, males (150-250 g) aged 70 days old. The animals received by the oral route: water, aqueous extract from Bryophyllum pinnatum (Lam.) Kurz (1 and 2 g Kg-1) or ranitidine (60 mg Kg-1), a drug with known gastroprotective action, blocking histamine H2-receptors. After one hour of treatments, all animals received indomethacin by the intraperitoneal route. Results demonstrated that the aqueous extract from Bryophyllum pinnatum (Lam.) Kurz has gastroprotective action; at 1g kg-1 it inhibited 45.49% of the indomethacin-induced ulcer index, while at 2g Kg-1 it inhibited 49.50%. Several mechanisms of actions are suggested to be involved in the gastroprotective action of this plant, besides the possible participation of prostaglandins in this effect. Further studies using different gastric ulcer-induction models are needed to better evaluate the antiulcerogenic activity of aqueous extract from Bryophyllum pinnatum (Lam.) Kurz.

[Clinical observation on therapeutic effects of mild moxibustion in superficial gastritis patients with spleen-stomach deficiency-cold pattern].

OBJECTIVE: To observe the curative effect of different duration of mild moxibustion in superficial gastritis patients with deficiency cold pattern of spleen and stomach. METHODS: A total of 84 superficial gastritis patients were randomly divided into moxibustion-20 min group, moxibustion-40 min group and medication (Ranitidine) group, with 28 cases in each group. Mild moxibustion was applied to bilateral Zusanli (ST 36) and Zhongwan (CV 12, odd days), Pishu (BL 20) and Weishu (BL 21, even-numbered days) for 20 min and 40 min respectively, once daily for 20 days. The symptom integrative score of superficial gastritis patients and the therapeutic effects were assessed according to "The Scoring Table for Symptoms and Signs of Gastrointestinal Disorders of Chinese Medicine", etc. RESULTS: Following 20 days' treatment, of the three 28 gastrititis patients in the medication, moxibustion-20 min and moxibustion-40 min groups, 0, 1, and 0 cases were cured, 5, 7 and 12 experienced marked improvement in their symptoms, 15, 16 and 12 had an improvement, and 8, 4 and 4 were invalid, with the effective rates being 71.4%, 85.7% and 85.7%, respectively. After one month's follow up, of the three 28 cases in the medication, moxibustion-20 min and moxibustion-40 min groups, 0, 4 and 0 cases were cured, 4, 8, and 13 experienced marked improvement, 15, 16 and 13 had an improvement, 9, 0 and 2 were ineffective, with the effective rates being 67.9%, 100% and 92.9%, respectively. Self-comparison of each group showed that the integrative scores of symptoms were all decreased significantly after the treatment and one-month's follow up in the three groups (P < 0.01). The effective rates of both moxibustion-20 min and -40 min were significantly higher than that of the medication group after one month's follow up (P < 0.01, P < 0.05). The therapeutic effect of moxibustion-20 min group was significantly superior to that of the medication group in lowering the integrative score of symptoms after one month's follow up (P < 0.01). No significant differences were found among the three groups in the therapeutic effects and in reducing integrative scores of symptoms after 20 days' treatment (P > 0.05). CONCLUSION: Mild moxibustion is significantly superior to medication in long-term therapeutic effects in the treatment of superficial gastritis patients with spleen-stomach deficiency-cold pattern.

[Effect of acupuncture with Ling gui Ba fa as main for treatment of chronic superficial gastritis of liver-stomach disharmony type].

OBJECTIVE: To verify the therapeutic effect of acupuncture with Ling gui Ba fa (method for picking eight points linked with extraordinary meridians according to time) for treatment of chronic superficial gastritis (CSG) of liver-stomach disharmony type. METHODS: Sixty cases were randomly divided into an observation group and a control group, 30 cases in each group. The observation group was treated with Ling gui Ba fa and acupuncture at Neiguan (PC 6) and Taichong (LR 3); the control group was treated with routine acupuncture at Zusanli (ST 36), Zhongwan (CV 12), Taichong (LR 3), Neiguan (PC 6), Ganshu (BL 18) and Weishu (BL 21), 3 times a week, 10 times constituted one course. After two courses of treatment, the clinical and gastroscopy effects were evaluated. RESULTS: The clinical curative rate of 66.7% (20/30) in observation group was superior to that of 26.7% (8/30) in control group (P < 0.01); the gastroscopy curative rate of 66.7% (20/30) in observation group was superior to that of 23.3% (7/30) in control group (P < 0.01). CONCLUSION: The clinical effect and gastroscopy examination of the acupuncture with Ling gui Ba fa are superior to those of routine point selection for treatment of CSG of liver-stomach disharmony type.

Study on the drug selection law for treatment of chronic gastritis with spleen deficiency and stomach dryness by complex system entropy cluster.

OBJECTIVE: To study on Prof. GAO Zhong-ying's drug selection law for treatment of chronic gastritis with data mining technique. METHODS: The 407 medical records of chronic gastritis treated by Prof. GAO Zhong-ying were collected and the study on these drugs in the recipes was carried out with data mining method. Among them, the recipe composed of one drug was studied with frequency statistical method, correlativity between drug pairs with improved mutual information, correlativity among multi-drugs with complex system entropy cluster technique. RESULTS: In treatment of chronic gastritis by Prof. GAO Zhong-ying there were 30 drugs with a higher use frequency of over 38 times, 94 commonly-used drug pairs with correlation coefficient of over 0.05, 11 commonly-used drug core combinations. CONCLUSION: The results attained with data mining technique for studying experience of famous and old TCM physicians conform to the clinical practice and the method is of an important significance for summarization of famous and old TCM physicians' experiences.

Gastrin, inflammation, and carcinogenesis.

PURPOSE OF REVIEW: Chronic infection of the gastric mucosa with Helicobacter pylori has long been recognized as a significant risk factor for gastric cancer, and indeed, this model represents the prototypical inflammation-associated cancer. In this review, we present the latest clinical and experimental evidence showing that gastrin peptides and their receptors [the cholecystokinin (CCK2) receptors] potentiate the progression of gastric cancer and other gastrointestinal malignancies in the presence of inflammation. RECENT FINDINGS: We highlight the feed-forward mechanisms by which gastrin and CCK2 receptor expression are upregulated during inflammation and in gastrointestinal cancers, summarize gastrin's proinflammatory role by inducing the production of cyclooxgenase-2 (COX-2) and interleukin-8 (IL-8), and relate evidence suggesting that gastrin and their receptors modulate the function of immune cells and fibroblasts following cellular stress, injury, repair, as well as during cancer progression. SUMMARY: We discuss trends for future studies directed toward the elucidation of gastrin peptides' role in regulating intercellular molecular signaling mechanisms between local and circulating immune cells, fibroblasts, epithelial cells, and other cell types in the microenvironments of inflammation-related cancers. Elucidation of the molecular and cellular pathways that relate inflammation with cancer may provide additional opportunities to develop complementary therapies that target the inflammatory microenvironment of the cancer.

Clinical effects of the method for warming the middle-jiao and strengthening the spleen on gastric mucosa repair in chronic gastritis patients.

OBJECTIVE: To observe clinical effects of the method for warming the middle-jiao and strengthening the spleen on gastric mucosa repair in chronic gastritis patients. METHODS: The 42 cases of the treatment group were orally adiministered Yiweikang Capsule; while the other 25 cases in the control group were orally given Wenweishu Capsule. Both the groups were observed for 2 months. RESULTS: The total effective rate in the treatment group was obviously higher than that of the control group (P < 0.05), with statistical significance shown by the TCM symptom score, gastroscopic examination and the HP test (P < 0.05 or P < 0.01). CONCLUSIONS: Yiweikang Capsule is an effective medicine for chronic gastritis.

[Effect of treatment with non-alcoholic beverages of patients with gastritis and hyposecretion]. / Otsenka effektivnosti primeneniia bezalkogol'nykh napitkov u bol'nykh gastritom s ponizhennoi sekretsiei.

A positive effect of use of non-alcoholic drink "Shirinskaia high-vitaminized treatment-board Water" in complex treatment of chronic gastritis with hyposecretion was revealed.

[Exogenous psychosis induced by cobalamin-deficiency]. / Exogene Psychose durch Vitamin-B12-Mangel.

The case of a 69 years old female patient is reported, who developed paranoid behaviour due to cobalamin-deficiency without megaloblastosis based on a chronic gastric atrophy. The psychosis showed complete remission after vitamin B 12 supplementation. The discussion leads to the question, whether or not chronic use of tricyclic antidepressants may be one cause of atrophic gastritis. Furthermore, differentialdiagnostic reflections consider the role of cobalamine and folate in the synthesis of monoamine neurotransmitters in the brain.

Hemorrhagic gastritis from topical isopropanol exposure.

OBJECTIVE: To report the occurrence of hemorrhagic gastritis after topical isopropanol application in an infant. CASE SUMMARY: A 2-year-old Hispanic boy developed coffee-ground emesis during emergency department evaluation for lethargy and fever. After an initial inconclusive workup for sepsis, further history revealed an isopropanol rubdown for fever reduction. Isopropanol concentrations and acetone metabolites were elevated, the patient recovered with supportive therapy, and other causes for hemorrhagic gastritis were excluded. DISCUSSION: Isopropanol sponge bathing is commonly used as a home remedy for infants with fever. Topical absorption of isopropanol has previously been reported to cause mental status changes, ketosis, and metabolic acidosis. We report a case of hemorrhagic gastritis as a complication of topical isopropanol absorption in a febrile infant. An objective causality assessment revealed that the adverse event was probably caused by the isopropanol. Previous reports of pediatric isopropanol poisoning and its management are discussed. CONCLUSIONS: Severe morbidity from topical isopropanol exposure may occur in young children.

[Dynamics of the morphofunctional status of digestive organs in patients with chronic gastroduodenitis during monotherapy with sulfate sodium-calcium mineral water]. / Dinamika morfofunktsional'nogo sostoianiia organov pishchevareniia u bol'nykh khronicheskim gastroduodenitom pri monoterapii sul'fatnoi natrievo-kal'tsievoi mineral'noi vodoi.

The authors describe morphofunctional changes in gastroduodenal tract in patients with chronic gastroduodenitis. Some of them have previously undergone laparoscopic cholecystectomy for cholelithiasis. Balneotherapy with mineral water "Uvinskaya" has a good effect in the above disease and therefore is recommended for prevention and treatment of patients with chronic gastroduodenitis as well as for prevention of repeated cholelithiasis after cholecystectomy.