Relevance. Pathology of non-infectious genesis is currently playing a leading role in the structure of overall morbidity of the population. The incidence of inflammatory bowel diseases increases all over the world. The severity of inflammatory bowel diseases complicates the presence of comorbid pathology, metabolic disorders, which lead to disability and the risk of premature death. Currently available diagnostic measures allow to detect disorders at the stage of clinical manifestations. There are several factors causing the development of pathological changes at the early stage including the peculiarities of intestinal microbiome formation and the predominance of certain microorganism clusters with the subsequent formation of a biotype, which may allow diagnosing the disease at a latent stage.Aim: To evaluate the role of the intestinal microbiota in the formation of inflammatory bowel diseases and metabolic disorders according to the data of national and foreign literature.Material and Methods. The review of literature on this topic was carried out based on the analysis of data obtained from the publications indexed in PubMed, Web of Science, Scopus, Google Academy, and eLibrary.ru databases over the past 10 years.Results. Data on the role of intestinal microbiota in the development of changes in patients with inflammatory bowel diseases and metabolic disorders (obesity, impaired glucose tolerance, and diabetes mellitus) were revealed. New potential mechanisms for the development of type 2 diabetes mellitus were identified, and the features of the generic composition of the flora in patients with comorbid pathology were described.Conclusion. The obtained results suggest that further research is required to improve understanding of this pathology and to create the methods for correcting the gut microbiota in case of abnormal findings.
Rationale. Currently, there is an increase in cancer among the elderly. Despite the obvious advances in health care related to the diagnosis of the disease and its treatment, oncopathology occupies a high position in the structure of the overall morbidity. Description of the clinical case. Patient T., 62 years old, came to the therapist with complaints of constant pulling pains in the lower abdomen, stool disorder - alternating constipation and diarrhea, presence of blood in the stool over the past 6 months, weight loss by 8 kg over the past 4 months. She was examined independently two years ago, when for the first time there were disorders of the gastrointestinal tract (GIT), which she associated with constant stressful situations at work. According to the study results, no significant deviations were found. The patient also underwent 16s-RNA sequencing of the intestinal microbiome, which revealed significant changes in many clusters of bacteria (a decrease in the quantitative composition of Lactobacterium, Bifidobacterium, Akkermansia, Faecalibacterium, which is the main representative of the normal intestinal flora, which may indicate a decrease in the protective barrier function of the mucosa, an increase in Fusobacterium, as well as other representatives of the pathogenic flora). During the period of treatment at the present time, within the framework of laboratory and instrumental examination, the diagnosis was confirmed - Malignant formation of the colon (colorectal cancer). T3M0N1. A repeated study of the intestinal microbiota was carried out, according to the results of which an increase in Fusobacterium up to 7.5% was observed, a sharp decrease in the representatives of the normoflora (1%)). Conclusion. Changes in various bacterial clusters of the intestinal microbiota can serve as an early marker for the verification of malignant neoplasms of the large intestine. Determining the amount of Fusobacterium in the intestinal microbiome can be an indicator of the first diagnostic line, which helps to identify the pathological process at the stage of precancer, take timely therapeutic measures, improve the quality of life and increase its duration.
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