Experience and prospects for the use of combination enterosorbents in the practice of gastroenterologists

Enterosorption as a therapeutic method has a long experience of application in medicine, is recognized as a component of detoxification and pathogenetic therapy for diseases of the gastrointestinal tract, intestinal infections, antibiotic-associated diarrhea, allergic diseases in children and adults. In clinical trials and in real-world practice, the positive effects of enterosorption have been noted: binding of toxic products, bacterial toxins, microorganisms and their fragments, products of impaired intestinal metabolism and inflammation, xenobiotics, etc. A large number of enterosorbents of various origins with different mechanisms of action and application points have been proposed. The article examines the main mechanisms of action of enterosorbents, taking into account their nature, presents a classification of modern enterosorbents, and analyzes the results of the use of enterosorption in diseases of the gastrointestinal tract and associated diseases/conditions. The review focuses on complex enterosorbents with components of various origins, which allows us to summarize the positive effects of the components, providing a comprehensive effect and reducing the risks of side effects. The combination of microcrystalline cellulose and silicon dioxide (White charcoal Extra) has been analyzed in detail, and such a combination has extensive experience in gastroenterological pathology. The results of the combined enterosorbent application are presented, including randomized clinical trials and clinical observations of the last 15 years. The positive effect of the combination of microcrystalline cellulose and silicon dioxide on both objective and subjective manifestations of intestinal, liver, and pancreatic diseases, as well as on laboratory markers, has been shown. The acceleration of relief of pathological symptoms was noted with the introduction of the combination in question into treatment regimens, prolongation of remission in chronic diseases, and an impact on the quality of life of patients. The prospects of using a combination of microcrystalline cellulose and silicon dioxide in the practice of a gastroenterologist are outlined.

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