The article provides a systematic review of modern literary data on the basics of gastric acid secretion. It describes the ionic transport systems of the parietal cell involved in the hydrochloric acid synthesis. The molecular structure of H +, K + -ATPhase (proton pump) is discussed. The article characterizes various ways of regulation of gastric acid secretion (neural, hormonal and paracrine) and intracellular signal transduction processes of a parietal cell.

Functional dyspepsia (FD) is the widespread syndrome the pain or sensation of a burning sensation in epigastriums, feeling of early saturation and overflow in an anticardium can be which implications, becoming perceptible during last 3 months which have arisen not less than 6 months prior to statement of the diagnosis and which it is impossible to explain organic diseases. According to the Roman diagnostic criteria of IV revision, diagnosis FD is put by process of elimination with organic diseases of the top department of a gastroenteric tract (a peptic ulcer, a chronic gastritis, gastroesophageal reflux illness). Traditionally and quite soundly it is considered that FD concerns group of psychosomatic diseases, however in its pathogenesis the big role is taken away to local motor disturbances (an antroduodenal dyscoordination owing to a disbalance of intestinal neuromediators and gastrointestinal hormones), and also to behavior factors (an alimentary stereotype, alcohol and a tobacco smoking) and to a chronic lesion of intramural nervous plexuses of a digestive tube by toxins of a pathological intestinal microflora. FD considerably reduces quality of life of patients that demands its timely revealing and treatment.

The article presents a systematized review of the literature data on the role of adequate acid suppression in the treatment of Helicobacter pylori-associated diseases. The increased pH levels in the stomach correlate with the efficacy of eradication therapy. Thus, minimal inhibitory concentrations of amoxicillin, clarithromycin and metronidazole decrease at higher pH levels, increasing the Helicobacter pylori sensitivity to these antibacterial drugs. In addition, the increased pH levels in the stomach contribute to the stability of some antibacterial agents, which increases the likelihood of eradication success.

The article presents a current algorithm for treating patients with functional dyspepsia, which is based on the clinical guidelines of the Rome IV Revision (2016), the Russian Gastroenterological Association (2017), and the American and Canadian Associations of Gastroenterologists (2017). It provides evaluation of the options for eradication of Helicobacter pylori infection as one of the stages of management of patients with this functional disorder. It also discusses the strategy for differentiated use of proton pump inhibitors and prokinetics for various variants of functional dyspepsia.

Proton pump inhibitors (PPI) remain a key element in the management of acid-dependent diseases. The antisecretory drug administration schedule should take into account the nature of the disease and the research data reflected in relevant international consensus. The patient’s adherence to the PPI intake has a significant impact on the results of management of acid-dependent diseases. The benefit of PPI intake significantly exceeds the potential harm that is low or very low. To date, there is no conclusive evidence of the adverse effects of the prolonged use of PPI, however, if there is no indication for the PPI intake, it is not recommended to use high doses of the drug. The pharmacodynamic effect of different PPIs doesn’t differ significantly, however, according to experts’ opinion based on meta-analysis, esomeprazole has some advantage over other drugs.

The flexible dosage form combined with the increased maintenance of a therapeutic dextensoprazole concentration in plasma with a modified release and prolonged inhibition of acid secretion after administration of the drug suggests that dexlansoprozole has several advantages for patients with acid-dependent diseases. The pharmacokinetic profile of dexlansoprazole is characterized by two Tmax peaks in 1–2 and 4–5 hours after administrating the drug and ensures a stable concentration of it in the blood. The efficacy of dexlansoprozole in the treatment of various forms of gastroesophageal reflux disease has been confirmed by several randomized controlled clinical trials.

The article presents contemporary views on the hepatic encephalopathy pathogenesis, as well as a brief overview of the therapy methods. It provides a review of the evidence-base for the efficacy of L-ornithine L-aspartate preparations. Clinical findings support the positive effect of intravenous administration of Ornilatex in patients with clinically significant manifestations of hepatic encephalopathy.

The incidence of non-alcoholic fatty liver disease (NAFLD) in the Russian Federation is increasing rapidly in proportion to the increase in the number of patients with obesity, hypertension, dyslipidemia, diabetes mellitus, et al. The incipient and often asymptomatic disease progresses, which forms the basis for numerous threatening complications. What modern therapeutic tools to reduce the degree of liver disease activity and prevent the development of complications do the gastroenterologists have? We are talking about this with the Honoured Doctor of the Russian Federation, the leading researcher of the Department of Endocrine and Metabolic Disorders of the Moscow Clinical Research and Practical Center, Doctor of Medicine, Professor Larisa Arsentievna Zvenigorodskaya.

Non-alcoholic fatty liver disease (NAFLD) becomes gradually the most frequent liver disease in the world. Expert teams in the USA, Western Europe, and Russia give pride of place within the NAFLD treatment regime to lifestyle modification including the optimization of physical activity, diet and, as a consequence, the BMI reduction. However, it is often difficult for the practitioner to motivate the patients to change their lifestyle and eating habits. Due to this, it is extremely important to use a pharmacologic therapy aimed at weight loss, reducing insulin resistance and repopulating the severely damaged liver parenchyma. By now ursodeoxycholic acid drugs (Ursosan) have been proved to be highly effective in treating NAFLD in clinical practice, having a significant impact on several pathogenetic mechanisms of this disease.

The review article reflects a contemporary view of irritable bowel syndrome (IBS) based on the Rome IV Criteria (2016). The paper studies the matters of definition, classification, features of the clinical picture and diagnostic criteria for IBS. It outlines the real-time findings of the pharmacotherapy of IBS from the perspective of evidence-based medicine.

The acute intestinal diseases section worked as part of the 10th All-Russian Congress on Infectious Diseases with international participation, where Antonina A. Ploskireva, MD, Member of the National Scientific Society of Infectious Diseases, presented a report on the topic of the day Antibacterial Therapy for Acute Intestinal Infections and announced the results of a study of the efficacy and safety of antibiotic therapy in acute intestinal infections conducted in the Central Research Institute of Epidemiology of the Federal Service on Surveillance for Consumer rights protection and human well-being.

This article on irritable bowel syndrome (IBS) focuses on the definition, epidemiology and pathophysiology as a means of understanding optimal treatment strategies, considered more standard and new methods of treating IBS.

Infections and Allergies section was organized within the framework of the 10th Annual All-Russian Infectious Diseases Congress with International Participation «Infectious Diseases in the Modern World: Evolution, Current and Future Threats» (Moscow, February 26–27, 2018) with support from Pharmamed. The section was held under the chairmanship of the Corresponding Member of the Russian Academy of Sciences, MD, Professor of the Department of  Paediatric Diseases of I.M. Sechenov First Moscow State Medical University И.М. Alexander Vasilievich Gorelov, and Head of the Department of   Paediatric Infectious Diseases with Postgraduate Education Course of V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University, MD, Professor Galina Petrovna Martynova. The speakers participating in the section have summarized recent data on human microbiote, dysbiosis and food allergy in children and presented new evidence-based data from the clinical studies on the use of multi-strain, emphasizing the high efficacy of British next-generation Bac-Set probiotics.

The article presents the results of a pilot prospective randomized study aimed at evaluating the efficacy and safety of rebamipide (Rebagit, PRO.MED.CS Praha a.s., Czech Republic) as part of the triple therapy for helicobacter pylori (H. Pylori) eradication. 54 patients with H. pylori-associated gastric ulcer/duodenal ulcer were enrolled to the study. All patients were randomized to two therapeutic groups depending on the eradication therapy to be received. Group 1 received the standard triple therapy, Group 2 received the standard triple therapy plus rebamipide. The efficacy of H. pylori eradication in Group 1 amounted to 78,2% (ITT), 81,8% (PP), and in Group 2 to 83,8% (ITT), 86,6% (PP). Odd ratio of efficient eradication with the use of rebamipide as part of standard triple therapy for helicobacter pylori eradication was 1,44 (95 CI: 0,36–5,72). The side effect rates between the groups were comparable

The article is devoted to the study of the efficacy of the flexible spectral imaging color enhancement (FICE) in the visual assessment of the polyp morphology. A group of 166 patients had undergone screening colonoscopy, which showed polyps of different sizes and histological structure in different parts of the intestine. The accuracy of the visual assessment of the polyp type performed using FICE was compared with the histological examination results. 255 polyps in various parts of the colon were identified in 166 patients. Comparative analysis of the results of visual assessment and histological examination of the identified polyps showed that the diagnoses agreed in 190 (74.5%) cases, and preliminary diagnoses proved to be erroneous in 65 (25.5%) cases. The size of the polyp was found to be inversely correlated with the number of erroneous diagnoses, i.e. the smaller the size of the polyp, the greater the probability of error. The erroneous diagnosis was made most frequently in the cases of small and smallest tubular adenomas and hyperplastic polyps, which were taken as serrated one (p <0.05 – significant differences), and also in the case of small and smallest hyperplastic polyps, which were taken as tubular ones (p < 0.05). Based on the results of evaluation of the FICE informativeness in the visual assessment of colon polyps, the method has been shown to have high diagnostic accuracy with respect to tubular, serrated and hyperplastic polyps equal to 83.1, 81.2, 83.9%, respectively. The study showed the high efficacy of flexible spectral imaging colour enhancement in recognizing the morphological structure of epithelial neoplasms, which can be used as a screening method for the preliminary classification of colonic epithelial neoplasia.

The paper presents the results of a clinical study in 25 patients with the established diagnosis of acute pancreatitis, who were in inpatient treatment at the State Budgetary Healthcare Institution “Republican Clinical Hospital No. 4” divided into groups depending on the sex and the acute pancreatitis form. In the course of the study, it was established that liver damage and microcirculation disturbances were observed against the background of pancreas damage and fermentation. It is manifested by changes in the blood flow in the hepatic veins and significant hemodynamics disorders in the portal vein. The degree of changes manifestation depends on the aetiological factor and the intensity of the inflammation in the pancreas. The changes are less significant in the edematic form of acute pancreatitis, and they return to normal rather quickly. In acute pancreatitis of alcoholic genesis, the changes in hemodynamics in the portal system are more persistent and profound, which persist throughout the observation period. It has also been established that ultrasonic dopplerography is a safe, rapid and relatively simple noninvasive and sufficiently informative method for detecting hemodynamic disturbances in the portal vein system and hepatic veins in acute pancreatitis.

Esophageal high-resolution manometry is a modern method of diagnosis performed worldwide as the gold standard for assessing esophageal motility. The Chicago classification is applied to interpret the manometric findings. It provides a standardized approach to the analysis and classification of motility disorders, which facilitates a diagnosis of esophageal motility disorders and helps select a tactic for treatment. There are four major categories of motility disorders: 1. Disorders with esophagogastric junction outflow obstruction (types I, II, III achalasia, esophagogastric junction outflow obstruction). 2. Major disorders of peristalsis (distal esophageal spasm, jackhammer esophagus, absent contractility). 3. Minor disorders of peristalsis (ineffective motility, fragmented peristalsis) 4. Normal esophageal motility. Only primary esophageal motility disorders are addressed in the Chicago Classification. Motility disorders of the upper esophageal sphincter, motility abnormalities after surgical esophagus interventions do not have classification criteria. However, in the future the Chicago classification is expected to be improved and expanded to cover these disorders.