[Role of vascular disorders in the pathogenesis of ulcerative colitis and its complications].

Mucous membrane circulatory disorders in ulcerative colitis (UC) are accompanied by significant capillary plethora with endothelial nuclear swelling in the capillaries and minor veins. Some cases show the development of secondary endophlebitis with thrombi occurring in individual veins. Occasionally, there is deep vein thrombosis in the leg with pulmonary embolism. Portal vein thromboembolism is very rarely observed during autopsy. The development of extensive deep mucous membrane ulcers gives rise to destruction of the vessels of the submucous plexis and its recurrent branchlets feeding the circular muscle layer. Impaired microcirculation is confirmed by the presence of myocytic dystrophic or necrotic changes. There are large transmural ischemic necroses in the area of toxic dilatation. Connective tissue foci develop in chronic UC at the site of ischemic necroses. Long longitudinal ulcers seen in nonspecific UC and Crohn's disease are likely to be ischemic, the course of which is long contraction of tenia with vein compression.

[State of the mouth cavity in patients with inflammatory intestinal diseases].

The article presents the results of the dental examination of 75 patients with ulcerative colitis and Crohn's disease with mild and medium-to-severe clinical course. Absolutely all of the patients had intensive dental caries and inflammatory diseases of the paradontium that exceeded the average statistical level for Moscow both in terms of incidence and severity. As many as 20-60% of patients suffering from inflammatory intestinal diseases also had such disorders of the mouth cavity mucous membrane as angular cheilitis, labial fissures, glossitis or aphthous stomatitis. The reduction of the alveolar bony tissue was usually found in cases of gingivitis and paradontosis. It was demonstrated that the treatment of this type of pathologies as well as preventive measures can essentially reduce the mouth cavity disease incidence for this group of patients and improve their life quality.

[Treatment of the irritable bowel syndrome from the point of conclusive medicine].

For many years the irritable bowel syndrome therapy was based only on an empirical approach. A lot of information has appeared for this period, which allows making a judgment about the efficacy of either of the ways of the functional bowel disorders treatment. A part of them was not approved in the course of clinical testing. At the same time, new high-performance ways of treatment appeared. This article presents an analytical survey of the irritable bowel syndrome pharmacotherapy. It also shows the role of diet, spasmolysants, psychotherapy, tricyclic antidepressants, serotonin reuptake inhibitors, HT3 antagonists and HT4 agonists.

[Chronic constipations in elderly people]. / Khronicheskie zapory u pozhilykh.

Chronic constipations in elderly people proved to be an important medical and social problem due to their high prevalence and serious complications caused by the very disease and administration of stimulating laxatives. They include as follows: anorectic incontinence, large intestine obstruction, stercoral ulcers, laxative dependence and bowels toxic affection (Cathartic colon). Morphological and physiological prerequisites of chronic constipation and anorectic incontinence occurrence are examined in this review. Drugs and tactics for monitoring constipations depending on their severity, dominance of transit and evacuation disturbances, occurrence of anorectic incontinence are described. Characteristics of laxatives and intestinal motility regulators, range of side effects as well as experience of their application in elderly patients with functional constipations and irritable bowel syndrome are presented.

[Clinical-functional and morphological changes in the large intestine in patients with chronic abdominal ischemia]. / Kliniko-funktsional'nye i morfologicheskie izmeneninia tolstoi kishki u bol'nykh s khronicheskoi abdominal'noi ishemiei

The article presents a study of clinical variants of ischemic lesions of the large intestine (ILLI) in patients with the chronic abdominal ischemia (CAI) syndrome. There was an examination of 42 patients with putative ILLI, who had a cardiovascular pathology at the background, which led to significant hemodynamic disorders of the blood flow in unpaired visceral branches of the abdominal aorta. The authors performed a complex diagnostics of ILLI including anamnestic and clinical data, laboratory and morphological assessment of the large intestine and vessels providing its blood supply. Based on the data collected, other functional and organic diseases of the large intestine (LI) were excluded. It was revealed that the final result of ILLI differed depending on the ischemia degree--from reversible functional disorders to high-grade organic lesions of the LI. Each clinical variant of ILLI has its own clinical manifestations as well as functional, organic and morphological peculiarities of changes in the LI revealed by a laboratory and histological examination of the LI.