medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-299medsovet-7833Research ArticleГАСТРОЭНТЕРОЛОГИЯGASTROENTEROLOGYСиндром раздраженного кишечника у детей и кишечная микробиота: патогенетические аспекты и клинические рекомендацииIrritable bowel syndrome in children and intestinal microbiota: pathogenetic aspects and clinical guidelineshttps://orcid.org/0000-0002-1228-443XБельмерС. В.BelmerS. V.

Бельмер Сергей Викторович, доктор медицинских наук, профессор кафедры госпитальной педиатрии №2 педиатрического факультета

117997, Москва, ул. Островитянова, д. 1

Sergey V. Belmer, Dr. Sci. (Med.), Professor of the Department of Hospital Pediatrics No. 2 of the Pediatrics Faculty

1, Ostrovityanov St., Moscow, 117997

belmersv@mail.ruРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian Federation202301112023017Педиатрия143148Copyright © Бельмер С.В., 20232023Бельмер С.В.Belmer S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7833

Синдром раздраженного кишечника (СРК) – одно из наиболее распространенных функциональных состояний среди детей и взрослых. В основе СРК, как и других функциональных расстройств органов пищеварения лежит нарушение взаимодействия между мозгом, кишечником и кишечной микрофлорой – так называемой оси «мозг – кишечник – микробиота». Микробиоте в последние годы придается особое значение не только в постинфекционном СРК, но и при классическом, стресс-индуцируемом. Кишечная микрофлора определяет состояние энтеральной нервной системы, висцеральную чувствительность, моторику кишечника. Кроме того, кишечная микробиота через вырабатываемые ею трансмиттеры взаимодействует с центральной нервной системой (ЦНС), которая также влияет на кишечную моторику и состояние микрофлоры. Обновленные рекомендации по диагностике и лечению СРК у детей российского Общества детских гастроэнтерологов, гепатологов, нутрициологов в разделе лечения включают психотерапевтическую коррекцию, диетотерапию и медикаментозную терапию. Доказанной эффективностью обладают корректоры моторики кишечника (тримебутин), пробиотики и спазмолитики. Показана эффективность и безопасность применения Lactobacillus rhamnosus GG, L. acidophilus LA­5, B. infantis, B. ani­ malis, L. plantarum, L. casei, L. bulgaricus, Bifidobacterium lactis BВ­12, B. breve, B. longum, S. thermophilus, Saccharomyces boulardii CNCM I­745 при СРК у детей. При этом целесообразно применение мультиштаммовых пробиотиков. Таким образом, кишечная микробиота принимает непосредственное участие в патогенезе СРК, а необходимость применения пробиотиков в составе комплексной терапии не вызывает сомнений. Их эффективность доказана во многих серьезных исследованиях, что послужило поводом для их включения в отечественные и зарубежные рекомендации по лечению СРК у детей и взрослых.

Irritable bowel syndrome (IBS) is one of the most common functional conditions among children and adults. At the basis of IBS, as well as other functional disorders of the digestive system, is the disorder of brain-gut-microbiota axis. In recent years, the latter has been given particular importance not only in post-infectious IBS, but also in classic stress-induced IBS. The intestinal microflora determines the state of the enteric nervous system, visceral sensitivity, intestinal motility. In addition, the intestinal microbiota interacts through the transmitters it produces with the central nervous system, which also affects intestinal motility and the state of the microflora. Updated guidelines for the diagnosis and treatment of IBS in children of the Russian Society of Pediatric Gastroenterologists, Hepatologists and Nutritionists in the treatment section include psychotherapeutic correction, diet therapy and drug therapy. Correctors of intestinal motility (trimebutine), probiotics and antispasmodics have proven effectiveness. The efficacy and safety of use in IBS in children Lactobacillus rhamnosus GG, L. acidophilus LA­5, B. infantis, B. animalis, L. plantarum, L. casei, L. bulgaricus, Bifidobacterium lactis BВ­12, B. breve, B. longum, S. thermophilus, Saccharomyces boulardii CNCM I­745. In this case, it is advisable to use multi-strain probiotics. Thus, the intestinal microbiota is directly involved in the pathogenesis of IBS, and the need for the use of probiotics as part of complex therapy is beyond doubt. Their effectiveness has been proven in many serious studies, which was the reason for their inclusion in practical recommendations for the treatment of IBS in children and adults.

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The authors declare that there are no conflicts of interest present.