Diet therapy, in most cases, is the first stage of treatment of diseases of the gastrointestinal tract. Especially, this question remains relevant in patients suffering from functional gastrointestinal disorders. The irritable bowel syndrome is one of the most common of functional gastrointestinal tract disorders in the population. The Rome criteria IV are basic recommendations for the diagnosis and treatment of functional gastrointestinal disorders in patients of different ages. The diet with a reduced content of fermentable oligosaccharides (fructans and galactans), di- (lactose), monosaccharides (fructose) and polyols (FODMAP) is recommended by current international consensus for patients of different ages with irritable bowel syndrome. The article presents current findings on the low-FODMAP diet effect on the clinical manifestations of irritable bowel syndrome. The elimination of various foods in the diet of patients with different clinical variants of irritable bowel syndrome according to the low-FODMAP diet scheme leads to a decrease in gassing and normalization of contractile activity of the intestine. It significantly reduces the frequency of exacerbations of the disease and improves the quality of life of such patients. A number of clinical studies using the low-FODMAP diet in adult patients and children with irritable bowel syndrome are presented. It is concluded that further clinical studies to study the effectiveness of the low-FODMAP diet in patients with irritable bowel syndrome are needed. Especially this issue remains relevant in pediatric practice.
Summary. The irritable bowel syndrome is one of the most common of functional gastrointestinal tract disorders in the population. The Rome criteria IV are basic recommendations for the diagnosis and treatment of functional gastrointestinal disorders in patients of different ages. At the present time, the therapy of most diseases requires special attention not only from the treating physician, but also from the patient. In turn, in the treatment of children, the monitoring of compliance with the treatment is carried out not by the patient, but by his parents who control the regimen of taking medications. The aim of the study was to determine the level of parental compliance and factors affecting it in the treatment of children with irritable bowel syndrome. It was established that the level of parental compliance to the treatment of irritable bowel syndrome for their children is low, which may lead to a decrease in the effectiveness of the treatment. It was found that only in less than 1/3 of the patients the parents are fully compliant with respect to the therapy received by their child. The main causes that influence the adherence of parents to the treatment of their child with irritable bowel syndrome are revealed. Establishment of interpersonal relationships in the “doctor-patient-parent” system, working with parents, aimed at explaining the essence of the disease (in some cases, the mechanisms of its formation), the consequences of the disease, treatment tactics are an important stage in the therapy of a sick child.
At the present time, the therapy of most diseases requires special attention not only from the treating physician, but also from the patient. In turn, in the treatment of children, the monitoring of compliance with the treatment is carried out not by the patient, but by his parents who control the regimen of taking medications. The aim of the study was to determine the efficiency of traditional anti-H. pylori regimen in the treatment of chronic gastroduodenal pathology in children with various level of parental compliance. 80 children of school age suffering from peptic ulcer disease duodenal ulcer associated with H. pylori from families with different levels of parental compliance were examined. The traditional anti-H. pylori therapy scheme containing omeprazole, clarithromycin lasting 14 days was prescribed for all children with chronic gastroduodenal pathology. It is established that strict adherence to the regimen and duration of administration of prescribed drugs allows achieving a high level of eradication of H. pylori even with the use of the traditional anti-Helicobacter pylori. Conducting a “compliance training” before starting therapy is an important factor that increases the level of parental compliance in patients with inflammatory-destructive diseases of the stomach and duodenum. Establishment of interpersonal relationships in the “doctor-patient-parent” system, working with parents, aimed at explaining the essence of the disease, the consequences of the disease, treatment tactics are an important stage in the therapy of a sick child.
The effectiveness of the treatment of chronic gastroduodenal pathology associated with Helicobacter pylori infection consists not only in the successful eradication of the pathogenic microorganism, but also in eliminating dyspeptic and abdominal pain syndrome, as the main clinical criteria for this pathology. Among the main reasons that affect the successful outcome of therapy, it can be distinguished strict adherence to the prescribed drug regimens. The aim of the work was to assess the effect of parental adherence to their child suffering from chronic gastroduodenal pathology, treatment on the patient's quality of life. 80 children of high school age suffering from chronic gastroduodenal pathology associated with Helicobacter pylori were examined. Anti-Helicobacter therapy using clarithromycin, amoxicillin, omeprazole for 14 days was held in all patients. The training of parental compliance in relation to ongoing therapy for their child was conducted before therapy in patients of the comparison group. The special questionnaire developed by us was used to assess the level of parental compliance. In addition, in all patients, the quality of life indices were studied using the SF-36 questionnaire at baseline and one month after the start of therapy. It was revealed that in children with chronic gastroduodenal pathology the initial indicators on all scales of quality of life were significantly lower compared to the children of the control group. It was found that the greater compliance of parents to their child's prescribed therapy leads not only to the successful eradication of Helicobacter pylori infection, but also to positive dynamics, both physical and psychological aspects of health.
The problem of vitamin D deficiency is one of the most actual today, because, according to the results of numerous studies, its deficiency is registered in half the worlds population. The article presents the results of a study on the level of vitamin D in children of first year of life, suffering from cows milk proteins allergy, as well as in children who have formed a secondary food tolerance to this allergen. In the article was evaluated the effectiveness of the additional use of vitamin D against the background of the therapeutic dairy-free diet use. It was found that the 57.1 4.8% children of first year of life with cows milk proteins allergy have vitamin D insufficiency. Normal vitamin D level was found in only 36.2 4.7% of patients. In turn, vitamin D deficiency was found in 6.7 2.4% children, suffering from cows milk proteins allergy. It was found that the additional daily intake of vitamin D on the background of the use of therapeutic dairy-free diet may reduce the time of development of food tolerance to cows milk proteins and achieve the formation of secondary food tolerance for the three years in 92.0 3.8% of children with cows milk proteins allergy. It was found, that the use of only therapeutic dairy-free diet allows to achieve the formation of secondary food tolerance only in 76.0 6.0% children (p 0.05). The normal level of vitamin D were established in 97.6 1.7 % children, formed a secondary food tolerance to cows milk proteins.
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