[Pharmacotherapy of inflammatory bowel diseases: efficacy performance and safety management].

Treatment of inflammatory bowel diseases IBD (Crohns disease, ulcerative colitis) is aimed at achieving clinical, endoscopic and histological remission, minimizing surgical complications, and ensuring a normal quality of life. However, the use of medical treatment is potentially associated with various adverse events, among which infectious complications, malignant neoplasms, as well as myelotoxicity, hepatotoxicity, skin lesions and others. The risk of side effects depends on the type of drug therapy (5-aminosalicylates, thiopurines, biologicals, etc.), the duration of treatment, the presence of extra-intestinal manifestations, etc. The article provides an overview of data on both the effectiveness and frequency of various side effects of the main classes of drugs in IBD, presents methods of investigation which can predict the effectiveness and development of side effects, the implementation of which can be considered as a variant of personalized therapy in IBD.

FUNCTIONAL FOODS ARE CRITICAL COMPONENTS OF TREATMENT OF METABOLIC DISORDERS IN CELIAC DISEASE.

AIM: To evaluate the effectiveness of Native-complex functional food to correct nutritional disorders and to normalize gastrointestinal motor activity in celiac disease (CD). METHODS: 20 CD patients with constipation and metabolic disorders were included in the study (age 31.8?9.5 years, male to female ratio 1:5.3). The diagnosis of CD was confirmed by clinical and anamnestic data, endoscopy, histopathology of duodenal biopsy specimens, HLA-DQ2 and HLA-DQS typing. All patients received Native-complex Fucus jelly (Kelp jelly) within 2 months. RESULTS: At the beginning of the study45% of patients had stools corresponding to the Bristol Stool Form ScaleType 1,40% of patients had Type 2 stools and 15% of patient had Type 3 stools. 15 patients (75%) showed a decrease in fat mass and 13 patients (65%) showed a decrease in fat-free mass indicated by bloimpedance measurement. All patients had low values of total bacterial counts and increased abundance of pathobionts including fungi and viruses in fecal microbiota. Supple- mentary nutrition significantly improved symptoms, intestinal circadian rhythms and stool consistency in CD patients. At the end of the study 70% of patients had daily bowel movements, 30% of patients had stools every other day. The average stool frequency was 5,95 ? 1,80 per week. 80% of patients had Type 4 or Type 5 stools,20% of patients had Type 3 stools according to the Bristol Scale. Supplementary nutrition significantly improved gut microbiota profile. CONCLUSION: Long-term gluten-free diet in celiac disease leads to a decrease in dietary fiber and polysaccharides consumption and promotes intestinal dysbiosis. Functional foods improve symptoms; stool consistency and gut microbiota profile in adult celiac patients on gluten-free diet.

[Connective tissue dysplasia in patients with celiac desease as a problem of violation of adaptation reserve islands of the body].

Clinically significant dysplasia of connective tissue in patients with celiac disease is often responsible for various visceral disorders. Different disturbances of motor and evacuation functions are often determined in this patients (gastroesophageal reflux, duodenogastral reflux, spastic and hyperkinetic dyskinesia). The clinical course of the celiac disease, associated with connective tissue dysplasia, is characterized by asthenovegetative syndrome, reduced tolerance to physical activity, general weakness, fatigue and emotional instability. These data should be considered in choosing a treatment.

[FEATURES OF FUNCTIONAL DISORDERS GASTRODUODENOBILIARY SYSTEM IN PATIENTS WITH CELIAC DISEASE].

The disturbances in synchronous functioning of gastroduodenal and biliary system and in their consequent interaction underlies functional disorders of the digestive tract. Motor and evacuation functioning of the gastrointestinal tract depends on the bile flow to the duodenum, which influences on digestive processes. Functional disorders of the biliary tract, contributing disturbances of the gastrointestinal motor activity, cause gastrointestinal symptoms. The cause of biliary dysfunctions often are gallbladder anomalies, which are accompanied by disturbances in drainage system of bile flow, development of the pathological refluxes, inflammation and formation of the biliary sludge. The progression of the biliary system deflux dysfunction leads to motor and evacuation dysfunction of the gut. According to the numerous data, gall bladder anomalies, which underlies functional disorders in bile deflux, are common in patients with coeliac disease. The results, obtained in the conducted research, revealed hypertonic hyperkinetic motor disorders of the upper part of the gastrointestinal tract and inflammation changes of the gastroduodenal zone in patients with coeliac disease with fixed bend in the gallbladder neck, necking and different deformation of the gallbladder, which are the visceral signs of undifferentiated connective tissue dysplasia. Disorders in every component of the digestive tract upper part motor activity lead to the corresponding clinical manifestations.