Функциональная диспепсия является актуальной проблемой современной гастроэнтерологии, ее манифестации способствуют нарушения образа жизни и питания. Однако комплексной оценки влияния нарушений пищевого поведения, распределения жировой ткани и уровня регулирующих аппетит гормонов на выраженность гастроэнтерологической симптоматики у лиц с разными вариантами функциональной диспепсии не проводилось. Цель работы -уточнить влияние пищевого поведения, концентраций грелина и лептина в крови на клиническую симптоматику при разных типах функциональной диспепсии.
Diabetes mellitus holds one of the leading positions among the current problems of modern medicine. Despite the obvious success in studying diabetes in the last decades, its prevalence has become pandemic. In spite of the use of modern methods of therapy, a rather high frequency of diabetes mellitus complications from various organs and systems, the pathological changes in which largely determine the course of the disease and patient’s quality of life remains. Issues of eating disorders and their correction play an important role in the complex therapy of patients with diabetes mellitus. Objective: determination of the characteristics and relationship of eating disorders with gastroenterological symptoms and glucose levels in patients with chronic gastritis in type 2 diabetes. Materials and methods: dynamic study of the eating behavior and quality of life in 66 patients with chronic gastritis in type 2 diabetes mellitus was conducted using GSRS, SF-36 and DEBQ questionnaires. The level of glucose on an empty stomach and after eating was also measured, the frequency of self-measurement of glucose level and the presence of diabetes mellitus complications were determined. Results: the identified correlation relationships suggest that gastrointestinal symptoms characteristic of chronic gastritis with type 2 diabetes mellitus worsen the physical and psychological components of health, which provokes a breakdown and a violation of the diet in this category of patients. Conclusion: chronic gastritis in patients with type 2 diabetes mellitus aggravates the prognosis of diabetes and exacerbates eating disorders, which requires observation of an endocrinologist, as well as a gastroenterologist and psychotherapist in the management of such patients.
Purpose of the study: to clarify the effect of the concentration of motilin in the blood on the clinical symptoms of functional dyspepsia. Materials and methods. A prospective examination of 90 people aged 22,3±0,17 years was carried out, divided into 3 groups: patients with postprandial distress syndrome (PDS), patients with epigastric pain syndrome (EPS), practically healthy. All subjects were questioned according to the GSRS questionnaire, and the concentration of motilin in their blood was determined before and after the drinking test. Statistical processing included the calculation of mean values, their errors, Student’s t-test, Pearson’s correlation test, factor analysis. Results. In patients with PDS, the intensity of abdominal pain (2,47±0,38 points) does not differ from healthy ones (2,19±0,22 points), in patients with EPS it is higher (4,33±0,51 points). Dyspeptic syndrome is more typical for patients with PDS (2,07±0,12 points) than for EPS (1,10±0,04 points). The concentration of motilin in the blood on an empty stomach with PDS (9605,47±167,64 pg/ml) is higher than with EPS (8780,67±232,27 pg/ml). After the drinking test, the level of motilin in the blood of patients with EPS increased to 9367,33±145,78 pg/ml, the PDS decreased to 9323,33±239,04 pg/ml. With PDS, the severity of reflux syndrome directly correlates with the concentration of motilin in the blood. In EPS, the initial level of motilin correlates inversely with the severity of reflux syndrome, constipation syndrome, and the volume of water drunk. After the drinking test, there is an inverse correlation between the level of motilin and the severity of diarrheal and dyspeptic syndromes, and a direct correlation with the intensity of abdominal pain. The initial level of motilin in the blood brings the greatest factor load into the “factor of motor disorders”. Conclusion. The initial level of motilin and its dynamics during water load play an essential role in the formation of the clinical picture of functional dyspepsia.
Objective: to study the mechanism of action of low-mineralized sulfate-chloride-sodium mineral water on the clinical picture and motor function of the stomach in patients with epigastric pain syndrome using the regulatory peptide motilin as an example. Materials and methods: 113 people of both sexes were examined, the average age was 22.3±0.21 years. The observation group (57 people) included individuals with functional dyspepsia in the variant of epigastric pain syndrome, the comparison group included practically healthy individuals (56 people). The questionnaire method was used according to the Gastrointestinal Symptom Rating Scale questionnaire; ELISA method for determining the concentration of motilin in the blood. Mineral water in a volume of 200 ml was taken once by both groups of patients, patients with EPS additionally received a course. Results: in persons with epigastric pain syndrome, abdominal pain prevails. The course intake of mineral water provides a positive clinical trend, confirmed by a decrease in the syndromes of lesions of the upper gastrointestinal tract. A single and course intake of mineral water provides a stable increase in the level of motilin in functional dyspepsia. Conclusion: patients suffering from functional dyspepsia in the variant of epigastric pain syndrome have persistent disorders of motilin secretion compared with healthy individuals. Stimulation of the stomach on a drinking test model showed inadequacy of changes in the level of this hormone. Both a single and a course intake of low-mineralized sulfate-chloride-sodium mineral water contributes to an increase in the concentration of motilin, which should be considered as a physical adaptogenic factor leading to a stable ordering of the body’s functional relationships.
Обоснование. Функциональные заболевания желудочно-кишечного тракта являются актуальной проблемой современной гастроэнтерологии в связи с ростом их частоты и значительным влиянием на качество жизни пациентов. В числе факторов, способствующих их манифестации, рассматриваются особенности образа жизни и питания. Однако, влияние нарушений пищевого поведения и распределения жировой ткани на выраженность гастроэнтерологической симптоматики у лиц с разным уровнем физической активности требует уточнения. Цель: уточнить влияние пищевого поведения, распределения жира и физической активности на симптомы функциональных гастроинтестинальных расстройств. Материалы и методы. Обследовано 60 человек без органических заболеваний желудочно-кишечного тракта в возрасте 22,7±0,19 года. Сформированы 2 группы по 30 человек: регулярно занимающиеся физическими упражнениями и не занимающиеся физическими упражнениями. Проведено анкетирование по опросникам GSRS, DEBQ, определены антропометрические данные. Статистическая обработка включала вычисление средних величин, их ошибок, t-критерий Стьюдента, критерий корреляции Пирсона, факторный анализ. Результаты. Регулярно занимающиеся физическими упражнениями имеют более низкие показатели количества подкожной и висцеральной жировой ткани, чем не занимающиеся. В группе физически активных выявлено наличие обратной зависимости между синдромом запоров и количеством висцерального жира. У не занимающихся физическими упражнениями обнаружена прямая зависимость между количеством висцерального жира и рефлюкс-синдромом, экстернальным типом пищевого поведения. В фактор «риск гастроэнтерологической патологии» вошли: общий балл по опроснику GSRS, эмоциогенный и экстернальный типы пищевого поведения, окружность бедер и соотношение объем талии/объем бедер. Заключение. Для минимизации симптомов функциональных гастроинтестинальных расстройств необходимо оптимальное количество висцерального жира, его уменьшение усугубляет синдром запоров, а увеличение – рефлюкс-синдром. Регулярные физические упражнения позволяют сбалансировать особенности пищевого поведения и оптимизировать количество жировой ткани в организме.
Aim. The present article studies the effect of balneotherapy with Uvinskaya mineral water on the microbial spectrum of urine in patients with type 2 diabetes.Materials and methods. The study was carried out at the Endocrinology Department of the First Republican Clinical Hospital (Izhevsk). A total of 56 patients with type 2 diabetes participated in the study, which involved collecting medical history and complaint data of patients along with performing general and system-based examination, urinalysis, urine culture prior to and following the course of therapy, as well as kidney ultrasound aimed at excluding the presence of calculi. Urine cultures (morning sample) were plated onto 5% blood agar, as well as Endo’s medium for detecting bacteria from the Enterobacteriaceae family using the Gould method. Urine cultures were incubated for 24, 72 and 144 hours at a temperature of 37 °C. The significance of differences was determined using the t-test for independent and paired samples.Results. Changes in urinalysis were observed in all examined patients, which included changes characteristic of urinary tract infections: a large number of bacteria per field of view; a large amount of mucus; the presence of leukocytes in urine; alkaline pH shift; as well as disorders typical of diabetes mellitus (glycosuria, proteinuria). E. coli predominated in urine cultures. Following a 30-day therapy with Uvinskaya mineral water, the number of bacteria and leukocytes, as well as the amount of mucus, detected in the urine reduced significantly, which indicates urinary tract sanation. Positive dynamics among patients who underwent balneotherapy treatment is confirmed by the Student’s t-test (p < 0.05). In addition, no urinary sanation was observed in the group of patients who did not receive balneotherapy.Conclusion. Drawing on the study results, the authors recommend using Uvinskaya natural mineral water in the combined treatment of patients with type 2 diabetes for urinary tract rehabilitation.
The pathology of the gastrointestinal tract occupies one of the leading places in the structure of the general morbidity of the population. Despite modern diagnostic methods, their prevalence is constantly increasing. Among the diseases of the gastroenterological profile, the most common are chronic pancreatitis, gastric ulcer and duodenal ulcer, hepatitis and cirrhosis of the liver, as well as chronic intestinal diseases. Purpose. To assess the possibilities of the GSRS questionnaire as a method for differential diagnosis of diseases of various organs of the gastrointestinal tract. Materials and methods. A study of the symptoms of 91 patients with gastrointestinal diseases was carried out using a specific GSRS questionnaire. Also, to verify the diagnoses, laboratory (complete and biochemical blood tests, complete feces and urine analyzes) and endoscopic (EGDS and video colonoscopy) research methods were carried out. Results. In the course of the study, the patients were divided into three groups according to the main diagnosis. It was noted that all groups were significantly different in terms of abdominal pain syndrome (AP) and reflux syndrome (RS), as well as the overall score of the GSRS questionnaire. Laboratory data were consistent with the clinical picture of the disease. Conclusion. Shows the importance of using the GSRS questionnaire as a method of approximate differential diagnosis of diseases of various parts of the gastrointestinal tract. The necessity of its joint use with laboratory – instrumental methods in the examination of patients is noted. Thus, an integrated approach will improve the efficiency of the quality of primary health care provided.
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