Objective — to compare the indices of importance of the digestive system pathologyin the military men of the Armed Forces of Ukraineduring the 10-year follow-up(years 2004 — 2013).
Materials and methods. Investigation has been held for the ten-year incidence of the digestive system pathology in the military men of the Armed Forces of Ukraine (AFU) based on annual reports of the medical service military units. The conventional methods were used for statistical processing.
Results. It has been established that, over the investigated period, the indices of primary morbidity with the digestive diseases among military men of compulsory service in the AFU increased in more than 1.2 times. At the same time, these indices decreased in more than 3 times in the army officers, and in more than 2.7 times in the contract soldiers.
Conclusions. As a whole, the primary morbidity of the digestive system diseases among military men of the Armed Forces of Ukraine significantly decreased in more than 1.5 times (р < 0.05).

Keywords: diseases of the digestive system, the military men, the Armed Forces of Ukraine, morbidity.

Objective — to determine the location and nature of pain, inherent to each type of bowel syndrome (IBS), its intensity, irradiation, connection with the onset, reduction or disappearance.
Materials and methods. Examinations involved 164 patients, distributed into four groups: the first group consisted of 53 (32.3 %) IBS patients with constipation (IBS-C) and included 11 men and 42 women), the second group included 57 (34.8 %) subjects with IBS and diarrhea (IBS-D) (17 men and 40 women), the third group involved 30 (18.3 %) patients with non-specific IBS variant (IBS-NV) (12 men and 18 women), the fourth comprised of 12 (13.0 %) IBS subjects with mixed variant (IBS-MV) (10 men and 9 women). Women was the majority of all patients 78 (72.8 %). The patients were selected in accordance with Rome Criteria III (2006).
Results. It has been established that the pain localization and nature, it’ intensity degree differ depending on the clinical IBS variant: form mild discomfort in case of IBS-C and IBS-MV (p < 0.05) to the strongly expressed painful sensation at IBS-D and IBS-NV (p < 0.05). The presence of pain significantly affects the quality of life of the patients. At IBS-C, pain was more often localized in the right iliac and umbilical area (р < 0.05), it was predominantly of burning and aching in nature (р < 0.05). At IBS-D, the sensation of pain was more often localized in umbilical area and all over the abdomen (р < 0.05) and was stabbing in nature. At IBS-NV and IBS-MV, pain was mainly (р < 0.05) localized in the lower abdomen, but was of different nature: (burning and aching at NV and stabbing at MV). At the IBS-MV, pain more often irradiated in the right iliac and umbilical area and upper abdomen (p < 0.05), and at IBS-NV in the umbilical area. The pain eliminated after defecation in patients with IBS-C (77.4 %) and IBS-D (61.4 %). The spontaneous pain relief took place in the patients with IBS-D (21.1 %) and IBS-MV (85.7 %), and after the spasmolytics intake in patients with IBS-D (71.9 %, р < 0.01). The pain enhancement before and after defecation and after the emotional load were on observed in patients of all groups (p < 0.05). At IBS-C, the pain sensations increased at the physical load (p < 0.05).
Conclusions. Тhe obtained results will promote the improvement of approaches to the treatment of patients by means of the proper therapy choice for each of IBS variants.

Keywords: irritable bowel syndrome, abdomen pain, bloating, constipation, diarrhea.

Objective — to study the state of endothelial function of young patients with gastroesophageal reflux disease (GERD) with concomitant arterial hypertension and without comorbidity.
Materials and methods. The study involved two groups of patients. The first consisted of 55 students with non-erosive GERD with concomitant I stage arterial hypertension, 1 — 2 degree of severity. The second group included 38 students with non-erosive form of GERD without comorbidity. The control group consisted of 20 healthy age- and sex-matched subjects. All participants were evaluated the blood levels of endothelin-1 and NO2, the aggression of gastric juice, antioxidant protection of mucosal barrier and assessment of quality of life.
Results. Both groups of patients demonstrated significant reduction in quality of life scores compared to the control group. However, in patients with GERD without comorbidity indices role physical functioning scales (34.1 ± 2.8 points) and pain intensity scale (29.8 ± 2.9 points) were lower than in patients with concomitant arterial hypertension (42.9 ± 3.4 and 47.6 ± 3.2 points, respectively). The difference between them was statistically significant (p < 0.001). Performance level of general health scales, physical and social functioning were lover in GERD patients without comorbidity, but the difference between them was not statistically significant. The considerable endothelial dysfunction was reveled in patients of both groups: in the group of GERD patients without comorbidity, the mean ET-1 level (8.46 ± 0.65 mmol/l) was significantly (p < 0.001) higher than normal (4.37 ± 0.64 mmol/l) and significantly higher (p < 0.05) than in patients with GERD with concomitant arterial hypertension (6.49 ± 0.54 mmol/l). The level of NO2 (1.29 ± 0.05 g/ml) in GERD patients with concomitant hypertension was significantly (p < 0.001) lower than normal (2.32 ± 0.07 g/ml) and significantly lower than the average of the groups of patients GERD without comorbidity (1.51 ± 0.04 g/ml). The indices of the quality of life were even more reduced, providing the evidence of the endothelial dysfunction. In GERD patients with AH comorbidity, the significant reduction of the protective properties of gastroduodenal mucosal barrier was established. This was defined by the lower level of SH-groups (up to 824.5 ± 41.2 vs. 1076 ± 40.1 mcmol/l in patients without comorbidity, at a rate of 1281.5 ± 38.4), as well as higher level of TBA-active products (up to 14.7 ± 0.71 mcmol/l vs. 10.5 ± 0.58 mcmol/l in patients with GERD without comorbidity at a rate of 3.8 ± 0.29 mcmol/l). The clear correlation was established between these indices.
Conclusions. The established changes and close correlation (r = 0.9 — 0.96) between the indices of quality of life and imbalance in the system of the investigated parameters of the endothelial function testified about stress as one of the possible trigger factors of the onset of GERD and concomitant AH. This stress as result of the low life level, by means of stimulating of the increased expression of the highly active substance in blood, with a high probability can be revealed at the concomitant pathology by the decreased NO2 level and with less probability by the increased ET-1 levels. At GERD without concomitant AH, stress is revealed mostly by the increased ET-1 levels, and in less degree in the reduced NO2 level, that results in the increased aggression of the gastric juice, and attenuation of the protective properties of the gastric mucosa (the main factors of GERD formation).

Keywords: gatroesophageal reflux disease, arterial hypertension, young person, the quality of life, endothelium.

Abdominal pain is one of the main symptoms of the irritable bowel syndrome. In the most cases, the pain is accompanied with the disturbances of intestine emptying. Currently, the preparations of predominantly antispasmodic action are used for pain relief. Trimebutine is one of the effective agents with a complex and unique mechanism of action: this is an agonist of peripheral µ, κ and δ opiate receptors. In Ukraine, the trimebutine preparation Trimspa (Macleods) is used as tablets of 200 mg, 30 pcs in a package. This preparation modulates intestinal motility by means of affecting various types of opioid receptors, thus providing favorable effects at both hypokinetic disturbance of intestinal motility and hyperkinetic forms of the functional pathology. Trimspa reduces the visceral hypersensitivity, demonstrating a pronounced analgesic effect. The universality of Trimspa, rapid onset of therapeutic effect, the almost complete absence of side effects gives the ground to recommend its extensive use in the gastrointestinal practice.

Keywords: irritable bowel syndrome, gastrointestinal motility, trimebutine, Trimspa.

Objective — to evaluate the efficacy of Laktiale in the dynamics of complex therapy of paediatric patients with chronic Helicobacter pylori-associated gastrointestinal disorders by means of the hydrogen breath test with lactulose (HBTL).
Materials and methods. The observations were performed on 66 children in ages of 11 to 16 years in the course of eradication therapy, that included simbiotik Laktiale. The paediatric patients were allocated into two groups, matched by age, sex, nosology, and HBTL results. The first group included 34 patients who received ­Laktiale starting from the 1st day of triple antihelicobacter therapy; the second group involved 32 subjects, to whom symbiotic was administered after the above mentioned therapy on the 8th day of treatment. The total course of Lactiale administration in the groups lasted 30 days. The program of investigation included HBTL on three stages of therapy: before the treatment administration, on the 14-th and 30-th days after its start.
Results. On the 30-th day of Lactiale administration, the normalization of the HBTL results was registered in 55.6 — 68.4 % of children with the bacterial excessive growth syndrome, and in 41.7 — 58.3 % of subjects with the prolongation of the orocecal transit time. In the group of children, to whom symbiotic was administered simultaneously with the eradication therapy, the normalization of the indices was observed in the greater number of subjects and in the shorter terms.

Keywords: gastroduodenal pathology, hydrogen breath test, eradication therapy, symbiotic.

The authors gave considerations of the issues of the relationship between the bowel disease and diseases of internal organs (lungs, cardiovascular system, skin), as well as the basic mechanisms of pathogenesis of diverticular disease of the colon, ulcerative colitis and Crohn’s disease, irritable bowel syndrome. The role of the drug as Zafakol as colonprotector, normalizing mucus education and function of goblet cells, reducing permeability of the mucosa and having cancer-preventive action, as well as pre- and probiotics in the treatment of colon diseases is shown.

Keywords: Zafakol, colon, butyrate, irritable bowel syndrome, inflammatory bowel disease.

Objective — to study the peculiarities of the intestinal pathology and modern capabilities of preparation to the endoscopic investigations in patients of Poltava region.
Materials and methods. The analysis involved 6034 results of endoscopicy in patients who were examined in Poltava Regional Clinical Hospital in the period of 2010 to 2014 years. The mean age of the patients was (52.6 ± 9.2) years. Endoscopic changes were revealed in 3074 (50.9 %) patients. Among the types of intestinal pathology, subtypes of the irritable bowel syndrome (IBS) prevailed in 1009 (32.8 %) subjects. The inflammatory intestinal diseases were established in 356 (11.6 %) cases, the neoplasms in 811 (26.4 %) patients, among the rest, the benign endothelial tumors dominated in 640 (20.8 %) cases. The preparation of patients to endoscopy was performed in accordance with the standard technical, and isoosmotic solution of polyethylene glycol (Endofalk) was used for 395 patients.
Results. Over the investigation period, the incidence of the revealed patients with IBS subtypes and endoscopic inflammatory changes in the colon mucosa (р < 0.01). Moreover, the increased incidence of Krohn disease (р < 0.05), and polyps and pseudopolyposis against the background of non-specific ulcerative colitis (р < 0.01). In the endoscopic picture of the patients with inflammatory intestinal diseases the left-sided lesions, predominantly of the 2nd degree of activity, were observed significantly more often. The study defined the increased number of the revealed adenomatous polyps, including the big-sized ones, as well as the left-sided colon cancer. The Endofalk application during the preparation to endoscopic investigation resulted was well tolerated, and the degree of preparation in 331 (83.8 %) patients was assessed as an optimal.
Conclusions. In Poltava region, the trend to the increased number of intestinal diseases has been defined over the analyzed period. The colon departments were affected mostly often. The incidence of exposure of both inflammatory and functional pathology increased. The significant increase of the number of polypoid neoplasms have been defined in patients with the inflammatory changes of colon mucosa. The multiple polyps and neoplasia prone to large polyps (more than 2 sm) were revealed mostly often. Endofalk can be recommended for the widespread application during the preparation to endoscopic investigation as one of the most optimal in terms of tolerability and qualitative colon cleanse and ease of use.

Keywords: intestinal pathology, endoscopic investigations, Endofalk.

The nonsteroidal anti-inflammatory drugs (NSAIDs) are widely administered for the treatment of the musculoskeletal system disorders as well as for the purpose of antiplatelet therapy. However, their use is associated with the development of side-effects, most serious of which is considered to damage the mucosa of the gastrointestinal tract, including the development of ulcers and gastrointestinal bleeding. Prevention of the NSAID-induced gastropathy is connected with the correct assessment of the risk factors of NSAID-induced complications andrational use of the preventive measures, the proton pump inhibitors are the most advisable agents.

Keywords: NSAID-induced gastropathy, ulcers, gastrointestinal bleeding, Helicobacter pylori, proton pump inhibitors, pantoprazole, Ulsepan.

The article presents modern views on etiology, pathogenesis and classification of dyspepsia syndrome, taking into account the recommendations of the Kyoto consensus, 2015. The efficacy of empirical treatment strategies in young patients with dyspepsia syndrome has been defined. It has beenproved that the successful eradication of H. pylori allows control of the disease symptoms in 78.6 % of patients.In H. pylori-negative patients the use of pantoprazole (Nolpaza) at a dose of 20 mg per day resulted in the disappearance of symptoms of dyspepsia in 80.7 %of cases.

Keywords: dyspepsia syndrome, eradication of H. pylori, pantoprazole.

Gastroesophageal reflux disease (GERD) takes one of the first places in prevalence among chronic diseases. With every year GERD morbidity constantly increases, especially in subjects of 40 years old and more, and this fact also is connected to concomitant diseases. Moreover, the quality of life of GERD patients is reduced. In patients with non-erosive GERD prevalence of dyspepsia symptoms and the combination of GERD and functional dyspepsia are observed more often. Also in such patients there is weaker response to proton pomp inhibitors (IPP) therapy as compared to erosive esophagitis. The role of kinetic disorders, refluxate composition and acid pocket in the lack of effectiveness of PPI therapy in patients with GERD has been shown. The necessity of the combination therapy of patients with GERD based on the using IPPs, alginates and prokinetic with considering all the components of the pathogenesis of the disease and its comorbidities has been grounded.

Keywords: gastroesophageal reflux disease, pathogenesis, dyspepsia, acid pocket, treatment, proton pomp inhibitors, alginates, Gaviscon.

Materials and methods. The efficacy of Eslidine in patients with non-alcoholic fatty liver disease (NAFLD) of various genesis has been studied in the open-labelled, randomized, comparative study with parallel groups. The study involved 60 patients (37 men, 23 women) aged 25 to 60 years with NAFLD examined.The NAFLD was diagnosed on the basis of ultrasonographicdetection of liver steatosis and mild hepatomegaly in patients with obesity (BMI > 30 kg/m2, 42 patients in total) and/or type 2 diabetes (18 patients), with negative serological markers of viral hepatitis B, C, D and autoimmune hepatitis, alcohol abuse and lack of receiving hepatotoxic medications. The diagnosis of non-alcoholic steatohepatitis NASH (28 patients) was additionally establishedbased on the persistent hypertransaminasemia with predominantly increased ALT, and ratio of ALT/AST higher than 1.0.
Results. While the course of hepatic steatosis was benignin the most cases, NASH was characterized byhepatocytes’ damage, liverinflammation and fibrosis, that can result in cirrhosis, liver failure and hepatocellular cancer.Eslidineproved to be an effective, safe and pathogenetically substantiated hepatoprotective agent, which provided the significant clinical and biochemical (reduction of steatosis, hepatomegaly, hyperenzymemia) and cholesterol-lowering effects at NAFLD.
Conclusions. The scheme of NASH treatment should include the course of Eslidine, combined with long-term (continuous) exposure to risk factors of NAFLD.

Keywords: non-alcoholic fatty liver disease, Eslidine, efficacy, safety.

Objective — investigation of clinical efficiency of Hepanaze for patients with biliary insufficiency (BІ) against thebackground of primary dysfunction of the gallbladder (GB) for hypokinetic type and hypertonicity of Oddi sphincter.
Materials and methods. The observation was performed for 36 persons (12 men and 24 women) with primary biliary tract disorders. Patients were medicated Hepanaze with 1 cap. 3 times a day with meals for 4 weeks. A survey of patients was conducted before and after the observation period. During the study of the clinical efficiency of Hepanaze the following indicators were evaluated: dynamics of complaints,coprogram for presence of fatty acids and neutral fat, urinalysis parameters for the salt composition, data of biliary system and kidneys ultrasound investigation, considering the presence of urinary diathesis.
Results. Condition of patients, medicated with Hepanaze, characterized with positive dynamics of clinical picture (reduction of pain, abdominal discomfort, bloating absence, normalization of stool). Results were accompanied by significant improvements in biliary motility determined by dynamic ultrasound. Output volume of GB fasting significantly decreased from 55.2 ± 8.4 to 30.2 ± 4.3 ml (p < 0.01).and contraction rate increased from 42.46 ± 3.9 to 64.82 ± 6.8 % (p < 0.01) that indicates the recovery of contractile ability of GB. Positive dynamics was detected evaluating the Oddi sphincter. Decrease of GB bile density from 2.21 ± 0.51 to 1.88 ± 0.25 units of grey scale is the indirect indicator of improvement in the movement of bile.
An objective confirmation of BI replenishment was received. After treatment coprogram results showed that 32 individuals (88.9 %) achieved the absence of fatty acids and only 4 people (11.1 %) had mild symptoms of BІ (+). According to the USI of kidneys and urinary sediment analysis, uric diathesis saved for 5 (20.8 %) of 24 people, who had it before treatment. Side effects and allergic reactions during Hepanaze medication were not detected. The patients assessed Hepanaze tolerance as good.
Conclusions. The study showed high clinical efficiency of Hepanaze in removing of BІ with background of the primary GB dysfunction for hypokinetic type and hypertonicity of Oddi sphincter. Treatment effect appeared to be associated with normalization of GB contractility and the Oddi sphincter normalization. BІ compensation was reached mostly by choleresis stimulation and recovery of the digestion of fats. Complex positive effect on altered function of the hepatobiliary system, intestines and kidneys, application security and good toleration allow to assess Hepanaze as the most rational treatment for the contingent of ambulatory patients with biliary pathology.

Keywords: dysfunctional biliary disorders, Hepanaze, biliary insufficiency, urinary diathesis.

The article outlines the pathogenetic mechanisms of development of liver tissue damage at the blood diseases. The basis of the pathogenesis of liver damage at leukemia lies in the disorders of energy metabolism in hepatocytes, resulting in the changes of cellular membranes’ permeability and hence development of the mitochondrial cytopathy. The latter associated with the administration of the tetracycline antibiotics,, analogues of nucleosides, that are used for the treatment of viral infections. The clinical and morphological manifestations of toxic liver damage include the hepatocellular, cholestatic and mixed ones. The histological research of liver preparations in most cases show specific leukemia infiltration of liver was the undifferentiated cages of myeloid and lymphoid type. The use of hepatoprotectors with different mechanisms of action is advisable for stabilization of the homeostasis of the liver parenchyma and activation of the intracellular metabolisms in patients with the blood diseases. Their application promotes the oppression of the lipid peroxidation and binding of free radicals that accompanied with the stimulation of protein synthesis and regenerative-reparative processes.

Keywords: liver, leucosis, mitochondrial cytopathy, hepatoprotectors.

Non-steroidal anti-inflammatory drugs are widely used for treatment of chronic inflammatory diseases. Despite significant beneficial effects, including reduction of inflammation and pain, prolonged use of non-steroidal anti-inflammatory drugs is associated with severe injury of gastrointestinal tract. Administration of antisecretory therapy combined with anti-inflammatory medications leads to severe damage of small intestine and enteropathy development. Discovery of potent anti-inflammatory and cytoprotective effects of endogenous nitric oxide, hydrogen sulphide and carbon monoxide promoted developing of new medications combining anti-inflammatory drugs with gas-releasing molecules. Hydrogen sulphide-releasing anti-inflammatory drugs are considered as one of the most promising therapy, associated with powerful anti-inflammatory and antioxidant effect, improvement of local blood flow, cell proliferation and apoptosis, etc. Growing body of evidences demonstrates protective effect and safety of H2S-releasing anti-inflammatory drugs that opens new perspectives for gastrointestinal protection under treatment of chronic inflammatory diseases.

Keywords: gastrointestinal protection, gaseous mediators, anti-inflammatory therapy, hydrogen sulphide.

The overview is devoted to the improvement of and treatment of enteropathies. The author presented the modern concepts of microscopic enteritis, including its definition, reasons of formation, peculiarities of diagnosis and approaches to its treatment.

Keywords: enteropathy, celiac disease, microscopic enteritis, diagnosis, treatment.