COMPARATIVE RESEARCH OF EFFICACY OF MONOTHERAPY WITH UDCA AND THE COMBINATION OF UDCA GIMEKROMONOM C IN PATIENTS WITH BILIARY SLUDGE2 STAGES.

Aim of research: Evaluate clinical advantages of combined therapy using Ursodeoxycholic acid (UDCA) with spasmolytic of patients with second stage biliary sludge (BS) - in a form of echo-heterogeneous bile containing clots. MATERIALS AND METHODS: 42 patients with 2nd stage BS were examined. 1st group (21 patients) was treated by UDCA monotherapy, 2,d group (21 patients) received combined therapy: UDCA with Hymecromone for 4 weeks. 4 week later, clinical and echographical assessment of the therapy provided was conducted. RESULTS: patients who received the combined therapy had more expressed decrease of pain syndrome in the right hypochondrium than those who received the monotherapy. During the study of gallbladder contraction function (GCF) any reliable evidence of its change wasn't found in both groups, thus the combined therapy (UDCA + Hymecromone) does not increase GCF. According to ultrasonography, an improvement of gallbladder content (transition from the 2nd stage BS to the 1st and reduction of an amount and size of clots and suspension) was observed in 81% patients from the Ist group (UDCA), and in 95% patients from the 2nd group (UDCA + Hymecromone). CONCLUSION: research data show increased effectiveness of treatment of patients with 2nd stage BS while using the combi- nation of UDCA and Hymecromone.

[Efficacy of rifaximine in small intestinal bacterial overgrowth syndrome in patients after cholecystectomy].

AIM: To define frequency of onset of small intestinal bacterial overgrowth syndrome (SIBOGS) in patients with postcholecystectomy syndrome (PCS); to substantiate necessity of microflora correction and assess efficacy of rifaximine in the doses 800 and 1200 mg/day. MATERIAL AND METHODS: A breath hydrogen test (BHT) was made in 82 PCS patients. Rifaximine was given to 40 SIBOGS patients: 20 of them received the drug in a dose 800 mg/day and 20--in a dose 1200 mg/day for 7 days. The efficacy was estimated by attenuation of the clinical symptoms and parameters of BHT. RESULTS: SIBOGS was detected in 73% of PCS patients. This was an indication for antibacterial treatment. Rifaximine in a dose 800 mg/day failed to attenuate pain and to eliminate dyspeptic syndromes in some patients, BHT in them was not normal. Administration of rifaximine in a dose 1200 mg/day normalized BHT in 90% patients and eliminated clinical symptoms in most of the patients. CONCLUSION: Rifaximine in a dose 1200 mg/day vs 800 mg/day in PCS patients with SIBOGS is more effective as it eliminates clinical symptoms and normalizes BHT.

[Rifaximin application in the overgrowth bacterial syndrome in the small intestine in patients after cholecystectomy].

UNLABELLED: The aim of the work was to determine the frequency of the overgrowth bacterial syndrome (OBS) in the small intestine in patients with postcholecystectomical syndrome (PHES) justify the need for correction of the microflora and to assess the effectiveness of rifaximin at a dose of 800 and 1200 mg/day. MATERIALS AND METHODS: With the help of the hydrogen breath test were examined 92 patients with PHES. 40 patients with OBS were treated with rifaximin, 20 of them received the drug at a dose of 800 mg and 20-1200 mg/day for 7 days. Effectiveness was determined by the dynamics of clinical symptoms and indicators of the hydrogen breath test. RESULTS AND DISCUSSION: OBS was detected in 76% of the patients with PHES, which justifies the holding of antibiotic therapy. Lack of acceleration of peristalsis of small intestine as a cause of diarrhea was confirmed by the study of the electromotive activity of the small intestine, which revealed no differences from the norm. In some patients on therapy at a dose of rifaximin 800 mg/day uncropped pain and dyspeptic symptoms and was not accompanied by normalization of the hydrogen breath test. In the treatment of rifaximin at a dose of 1200 mg/day was showed normalization of the hydrogen breath test parameters in 90% of patients and relief of clinical symptoms in most patients. CONCLUSION: Rifaximin at a dose of 1200 mg/day compared with a dose of 800 mg/day in patients with PHES associated with bacterial overgrowth in the small intestine, had a more pronounced clinical effect, as evidenced by positive dynamics in the form of relief of clinical symptoms and normalization of the hydrogen breath test.

[Rationale for the allocation of clinical variants of the postcholecystectomical syndrome associated with bacterial overgrowth in the small intestine].

The article presents the literature data concerning the pathogenesis and clinical manifestations as postcholecystectomical syndrome and syndrome of bacterial overgrowth in the small intestine (ARIS). Was provided information on the microflora of the small intestine and factors affecting its formation. It is shown that the main clinical manifestations of ARIS influenced by intestinal motility disorders, the processes of intestinal digestion and absorption. Are also given own results, which allowed to justify the selection of a clinical variant postcholecystectomical syndrome associated with bacterial overgrowth in the small intestine.

[Efficacy of rifaksimin in excessive bacterial growth syndrome after cholecystectomy].

UNLABELLED: OBJECTIVE. To determine the frequency of the syndrome of excessive bacterial growth in patients with cholecystectomy and PL, justify the need for correction of intestinal microflora and to assess the effectiveness of rifaksimin decontamination. MATERIAL AND METHODS: The study involved 35 patients with gallstone disease (GSD) (3 men, 32 women, average age--59 +/- 9 years) and 50 patients who underwent cholecystectomy at the cholecystolithiasis (4 men, 46 women, average age--60 +/- 9 years). Inclusion criteria were the complaints that are characteristic for the syndrome of excessive bacterial growth in the small intestine (EBG). All the patients underwent clinical, laboratory and instrumental examinations and hydrogen breath test. In identifying the EBG was a rifaksimin treatment at a dose of 800 mg/day for 7 days. Treatment efficacy was determined by the dynamics of clinical symptoms and indicators of the hydrogen breath test at the 8 th and 30th day of observation. RESULTS AND DISCUSSION: Patients who was underwent cholecystectomy, EBG was detected in 58%, and among patients with gallstone disease--in 28%. The rifaksimin treatment to 8 th day was declining intensity of clinical symptoms correlated with the dynamics of the hydrogen breath test. On day 30 the majority of patients clinical symptoms of EBD disappeared (from 56 to 75% depending on the symptoms), but in some patients it persisted, despite the reduction in their severity. These data also correlated with the dynamics of the hydrogen breath test. CONCLUSION: At cholecystolithiasis and in patients with removal of the gallbladder detected EBG in 28 and 52% respectively, which requires corrective therapy. The rifaksimin therapy have positive dynamics in relieving clinical symptoms and the decline in the hydrogen breath test. However, some patients with therapy at a dose of 800 mg/day uncropped pain and dyspeptic symptoms and hadn't accompanied by normalization of pH test.

[Syndrome of excessive bacterial growth in small intestine: etiology, pathogenesis, clinical manifestations].

In survey presented literature data about etiology, pathogenesis and clinical course of the syndrome of excess intestinal bacterial growth. Is produced information about intestinal microflora and its unfavorable changes in various environmental influences. Is showed that main clinical findings of the syndrome are formed by influence of disturbances of motility, intestinal digestion and absorption.

[The role of the congenital duodenum abnormality in development of the upper gastrointestinal tract and the biliary system diseases].

In article clinical observation of the patient of 17 years with developmental anomaly of a duodenum-megabulbus, transferred in the early neonatal period operative treatment concerning congenital impassability of a duodenum in connection with its atresia, and generated after diseases of upper gastrointestinal and biliary tract is presented.