Diseases Of Gastrointestinal Tract Research Articles

The Impact of Storage Conditions on Stool Smellprints as Assessed by an Electronic Nose.

Necrotizing enterocolitis (NEC) is a devastating disease of the neonatal gastrointestinal tract. Volatile organic compounds (VOCs), odoriferous compounds released as a byproduct of bacterial metabolism, can be used as a proxy for gut health. We hypothesized that patients with NEC would have different microbial profiles and elicit different VOC signatures as assessed by gas chromatography/mass spectrometry (GC/MS) or an electronic nose compared to controls. Furthermore, we hypothesized that the temperature of sample storage and the length of time in storage would impact the VOC signatures. Forty-five human stool samples were obtained from Neonatal Intensive Care Units. They were stored at -80 °C as part of the Necrotizing Enterocolitis Biorepository. The microbiome composition was determined by 16S-rRNA gene sequencing and VOC profiles were obtained with GC-MS and by analysis with the Cyranose 320 electronic nose. In separate experiments, fresh stool samples were collected from three different strains of mice. Samples were stored for different times and different temperatures, and VOC signals were compared. A p-value less than 0.05 was considered significant. 16S-rRNA sequencing found a difference in the microbiome composition (p = 0.025) between human NEC and control samples. There was also a difference observed between NEC and control samples identified by GC-MS (p = 0.001). However, there were no differences in VOC smellprints between NEC and controls when analyzed with an electronic nose. When mouse specimens were analyzed, principal component values changed significantly over time and with different storage temperatures. NEC is associated with a different gut microbiome and the VOC profile compared to age-matched controls. However, this difference was not appreciated when biobanked stool samples were compared via an electronic nose. Older samples may experience VOC decay, or the electronic nose may not be sensitive enough to detect NEC in stool samples. Further studies on fresh human stool samples are needed, but the findings herein may limit the use of electronic noses as diagnostic tools for NEC.

Neurotensin receptor agonist PD149163 modulates LPS-induced enterocyte apoptosis by downregulating TNFR pathway and executioner caspase 3 in endotoxemic mice: insights from in vivo and in silico study.

This study was designed to evaluate the dose-dependent efficacy of neurotensin receptor-1 (NTSR1) agonist PD149163 in the amelioration of the lipopolysaccharide (LPS)-induced apoptosis in the gastrointestinal tract (GIT) of mice. PD149163 is an analogue of NTS, a GIT tri-decapeptide with anti-inflammatory and anti-oxidative effects. Swiss-albino mice (female/8 weeks/25±2.5g) were divided into six groups: control; LPS, LPS+PD149163L, and LPS+PD149163H groups were treated with LPS (0.2μmol/L/kgBW; 5 days), followed by exposure of PD149163 to LPS+PD149163L (10.6μmol/L/kgBW), and LPS+PD149163H (21.2μmol/L/kgBW) for 28 days. OnlyPD149163L (10.6μmol/L/kgBW) and onlyPD149163H (21.2μmol/L/kgBW) groups were maintained for 28 days. Both the LPS and PD149163 were given intraperitoneally. PD149163 treatment for 4 weeks alleviated the LPS-induced enterocyte apoptosis in a dose-dependent manner. LPS-induced excessive levels of caspase-3, tumour necrosis factor-α, and leptin (biomarkers of LPS-induced apoptosis) in plasma were decreased by PD149163H treatment. Moreover, LPS-induced gut oxidative stress was ameliorated by PD149163H supplementation, as evidenced by the decreased content of malondialdehyde, lipid-hydroperoxide and increased level of superoxide-dismutase, catalase. Furthermore, PD149163H mediated elevation of the plasma anti-apoptotic protein (B-cell leukaemia/lymphoma-2) along with the NTS level contributed to the modulation of LPS-induced enterocyte apoptosis, reflected in histopathology. In vivo results were substantiated with in silico molecular docking analysis that predicted the binding of PD149163-TLR4 complex, suggesting that PD149163 can act as a TLR4 modulator and inhibit the activation of TLR4. The role of PD149163 in ameliorating GIT apoptosis by its anti-apoptotic and antioxidative effects is suggested. Further research may provide significant insights into the therapeutic intervention of PD149163 in apoptosis-related diseases of GIT.

Typing of feces-derived Candida albicans strains using a novel seven-locus microsatellite panel reveals associations with yeast phenotype in individuals with inflammatory bowel disease.

Inflammatory diseases of the human gastrointestinal tract are affected by the microbes that reside in the mucosal surfaces. Patients with inflammatory bowel diseases (IBD) have altered bacterial and fungal intestinal compositions, including higher levels of fecal Candida yeasts. Ongoing research indicates that genetic and phenotypic diversity of Candida albicans may be linked with disease severity. Here, we set out to investigate feces-derived C. albicans strains from individuals with IBD and healthy volunteers through microsatellite-based genotyping and phenotypic assays. A seven-locus microsatellite panel was applied, of which six loci were newly developed. It appears that there is no specific lineage of C. albicans that is associated with IBD, but rather that the three study populations (Crohn's disease, ulcerative colitis, healthy volunteers) do have distinguishable distributions of genotypes. In addition, phenotypic characterization by means of enzyme release assays revealed trends between genotypes, virulence-related enzyme activity and clinical biomarkers. We thus show that microsatellite typing can describe genetic diversity of feces-derived C. albicans strains, and that phenotypic diversity of these strains may indeed correlate with fungal genotype or disease. This study opens further possibilities to investigate fecal fungi in relation to severity of inflammation in IBD or in other (intestinal) diseases.

The Effect of the Size of Gold Nanoparticle Contrast Agents on CT Imaging of the Gastrointestinal Tract and Inflammatory Bowel Disease.

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD). CT imaging with contrast agents is commonly used for visualizing the gastrointestinal (GI) tract in UC patients. Contrast agents that provide enhanced imaging performance are highly valuable in this field. Recent studies have made significant progress in developing better contrast agents for imaging the gastrointestinal tract using nanoparticles. However, the impact of nanoparticle size on this application remains unexplored. Gold nanoparticles (AuNPs) serve as an ideal model to investigate the effect of nanoparticle size on imaging of the gastrointestinal tract due to their controllable synthesis across a broad size range. In this study, we synthesized AuNPs with core sizes ranging from 5 to 75 nm to examine the effect of the size in this setting. AuNPs were coated with poly(ethylene glycol) (PEG) to enhance stability and biocompatibility. In vitro tests show that gold nanoparticles are cytocompatible with macrophage cells (∼100% cell viability) and remain stable under acidic conditions, with no significant size changes over time. Phantom imaging studies using a clinical CT scanner indicated that there was no effect of nanoparticle size on CT contrast production, as previously demonstrated. In vivo imaging using a mouse model of acute colitis revealed a strong contrast generation throughout the GI tract for all agents tested. For the most part, in vivo contrast was independent of AuNP size, although AuNP outperformed iopamidol (a clinically approved control agent). In addition, differences in attenuation trends were observed between healthy and colitis mice. We also observed almost complete clearance at 24 h of all formulations tested (less than 0.7% ID/g was retained), supporting their value as a model platform for studying nanoparticle behavior in imaging. In conclusion, this study highlights the potential of nanoparticles as effective contrast agents for CT imaging of the gastrointestinal tract (GIT) in the UC. Further systemic research is needed to explore contrast agents that can specifically image disease processes in this disease setting.

HIF-2α level in adolescents with chronic inflammatory pathology of the upper gastrointestinal tract

Сhronic inflammatory diseases of the gastrointestinal tract are among the most common pathological conditions in adolescents. A significant role in the pathogenesis of gastrointestinal tract diseases is given to the functioning of the oxygen sensor system, the main mediator of which is hypoxia-inducible factor 2 (HIF-2α). Therefore, the purpose of the study was to determine the level of HIF-2α in the plasma of patients with chronic inflammatory pathology of the gastrointestinal tract, taking into account the endoscopic picture of the lesion, localization of the pathological process, age and gender of the patient. The study involved 70 adolescents aged 8-18 years with chronic gastroduodenitis (CGD), gastroesophageal reflux disease (GERD), gastric or duodenal ulcer and 25 peers who had been classified as healthy. The plasma concentration of HIF-2α was measured by a sandwich-linked ELISA. Helicobacter pylori infection was determined by urease test or by ELISA. According to the data obtained, the HIF-2α plasma level was higher in patients with chronic inflammatory gastrointestinal disease compared to the control group. In boys with chronic gastroduodenal disease, the level of HIF-2α was higher than in girls. CGD and GERD were characterized by a higher HIF-2α level in plasma than gastric and duodenal ulcers. The HIF-2α level did not depend on the age of the patients or the presence of Helicobacter pylori infection. Keywords: adolescents, chronic gastroduodenitis, gastroesophageal reflux disease, gastrointestinal tract, HIF-2α

The impact of robotic surgery on the treatment of benign esophageal and gastric disease: early experience of a specialized unit.

Laparoscopic surgery is a well-established approach in the surgical treatment of reflux, hiatal hernia and esophageal motility disorders such as achalasia. Robotic platforms have only recently been incorporated in surgery for esophageal motility disorders and their exact value remains to be determined. In the present study, we present the preliminary results of our early experience with a case series of benign upper gastrointestinal diseases treated using the robotic system in our department. Data on all consecutive patients undergoing surgery for benign upper gastrointestinal tract (UGI) disease during the last 5years (01/2029-12/2023) was prospectively collected and retrospectively reviewed. All patients attended regular follow-up appointments. Patients with relapse or deterioration of their symptoms were referred for objective testing using high-resolution manometry and/or 24-h impedance pHmetry. A total of 34 patients were included in our series. Fourteen patients with achalasia underwent robotic Heller myotomy and modified Dor fundoplication, sixteen patients underwent hiatal hernia repair with fundoplication and four patients had a Nissen fundoplication for reflux esophagitis. The median postoperative Eckardt score of the patients treated for achalasia was 2 and a median GERD score of 1 was recorded for patients treated for reflux. Two patients with achalasia were evaluated with manometry due to temporary symptom relapse. The manometric findings were unremarkable. The incorporation of the robotic approach in the surgical treatment of benign UGI diseases is safe and feasible with excellent perioperative and postoperative functional results. Further experience and investigation will allow for reliable comparison to the laparoscopic approach.

Results of the experimental study of the antimicrobial activity of therapeutic waters from various wells managed by the federation of trade unions of Uzbekistan

Introduction. Currently, in addition to the traditional use of mineral waters (MW) for the treatment of gastrointestinal tract and renal diseases, they are also used to correct metabolic disorders, normalize lipid and carbohydrate metabolism. However, many of its properties remain poorly studied, and there is a very limited number of works in the scientific literature concerning the analysis of their antibacterial action. Aim. Study of sensitivity of common microorganisms to the action of some MW. Materials and methods. The following test samples from different wells (DW) served as materials for determining the antimicrobial activity of mineral waters: Sample 1. Sodium bicarbonate weakly alkaline mineral water from SW No. 7 (Chinobod Sanatorium, Tashkent); Sample 2. Radon mineral water mineral water from SW No. 2 (Abu Ali ibn Sino Sanatorium, Samarkand Region); Sample 3. Iodine-bromine mineral water from SW No. 4 (Chartak Sanatorium, Namangan Region); Sample 4. Sulfate-sulfur mineral water from SW No. 14 (Chimen Sanatorium, Fergana Region); Sample 5. Concentrated iodine-bromine brine from SCW No. 2 (Chartak Sanatorium, Namangan Region). Results and discussion. Sample No. 5 (concentrated brine) showed antimicrobial activity against Staphylococcus aureus and Pseudomonas aeruginosa, the diameter of the growth inhibition zone was 22 ± 0.26 and 18 ± 0.35 mm, respectively. Also, sample No. 4 (Sanatorium Chimen DW No = 14, sulfate-sulfur mineral water) showed antimicrobial activity against Staphylococcus aureus, the diameter of the growth inhibition zone was 16 ± 0.11 mm. The samples did not show antimicrobial activity against the other test cultures. The antimicrobial action of water samples was determined by the agar diffusion method against some types of opportunistic bacteria: Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Bacillus subtilis and the yeast fungus Candida albicans. All microorganism cultures were obtained from the collection of the Institute of Microbiology of the Academy of Sciences of the Republic of Uzbekistan. The determination was achieved through the use of the agar diffusion method on a dense nutrient medium. Conclusion. It was found that sample No. 5 concentrated brine «Iodine-shifo» from the Chartak Sanatorium showed antimicrobial activity against Staphylococcus aureus and Pseudomonas aeruginosa, i. e. Staphylococcus aureus and Pseudomonas aeruginosa, the diameter of the growth inhibition zone was 22 ± 0.26 and 18 ± 0.35 mm, respectively. Also, sample No. 4 sulfate-sulfur mineral water from the Chimen Sanatorium showed antimicrobial activity against Staphylococcus aureus, the diameter of the growth inhibition zone was 16 ± 0.11 mm. The samples did not show antimicrobial activity against the other test cultures.

Holter monitoring results in adolescents with chronic inflammatory pathology of the upper gastrointestinal tract

Background. Upper gastrointestinal tract (GIT) chronic disorders in adolescence may be accompanied by the cardiac complaints and electrophysiological changes in the myocardium. Considering of cardiovascular activity assessment modern methods and new way of gastrointestinal tract disease therapy management, heart functional state needs further clarification. Purpose. Clarifying the nature and frequency of changes in the heart Holter ECG monitoring (HM ECG) in adolescents with chronic inflammatory pathology of the upper gastrointestinal tract and determining the significance of concomitant conditions (benign CSF hypertension syndrome, autonomic dysfunction syndrome, and undifferentiated connective tissue dysplasia) in relation to their occurrence. Materials and methods. 69 adolescents with chronic inflammatory process of the GIT were examined. Control group included 36 children without GIT disorders. Presence of the most common concomitant diseases: benign intracranial hypertension syndrome (BIHS), autonomic dysfunction syndrome (ADS), undifferentiated connective tissue dysplasia (UCTD), were considered. Сardiovascular system examination, standard 12-channel resting ECG (electrocardiography), HM ECG considering the data of the well-being diary, heart echocardiographic examination (EchoCS) was provided for all patients. Results. Тhe frequency of HM ECG changes was more common among adolescents with inflammatory diseases of the GIT patients compared to the peers of the control group (72.46% vs. 52.78, respectively, р < 0,05). Impaired impulse formation was observed in 71.01% of cases, the ST-T interval and T wave abnormalities were present in 60.87% of adolescents, combined rhythm disorders – in 13.04% of cases, cardiac conduction disorders – in 18.84%. Sinus tachycardia and combined rhythm disturbances were significantly more frequently detected among female patients (pj < 0.05). Impaired impulse formation was recorded significantly more often in children with gastroesophageal reflux disease (GERD) than in children with chronic gastritis (85.71% vs 65.91; p < 0.05). Arrhythmias were benign in 85.51% of cases. The frequency of their detection did not depend on the clinical variant of the gastrointestinal tract disease. The analysis results of the influence probability of concomitant diseases or their combination on the development of arrhythmias in patients did not reach the level of statistical significance (p > 0.05). Conclusions. In adolescents with chronic diseases of the gastrointestinal tract, various bioelectrical ECG phenomena are more often registered. Among them, there is a violation of automatism, conduction and repolarization of the myocardium of the ventricles. Sinus tachycardia and combined rhythm disturbances were significantly more common in girls. Violation of the automated heart was more typical for patients with GERD. Unfavorable variants of arrhythmias were registered in 14.49% of teenagers. It was established that such concomitant conditions as benign CSF hypertension, autonomic dysfunction syndrome and undifferentiated connective tissue dysplasia do not have a significantly greater influence on the development of functional heart disorders in children with gastrointestinal tract pathology.

Enhancing image-based diagnosis of gastrointestinal tract diseases through deep learning with EfficientNet and advanced data augmentation techniques

The early detection and diagnosis of gastrointestinal tract diseases, such as ulcerative colitis, polyps, and esophagitis, are crucial for timely treatment. Traditional imaging techniques often rely on manual interpretation, which is subject to variability and may lack precision. Current methodologies leverage conventional deep learning models that, while effective to an extent, often suffer from overfitting and generalization issues on medical image datasets due to the intricate and subtle variations in disease manifestations. These models typically do not fully utilize the potential of transfer learning or advanced data augmentation, leading to less-than-optimal performance, especially in diverse real-world scenarios where data variability is high. This study introduces a robust model using the EfficientNetB5 architecture combined with a sophisticated data augmentation strategy. The model is tailored for the high variability and intricate details present in gastrointestinal tract disease images. By integrating transfer learning with maximal pooling and extensive regularization, the model aims to enhance diagnostic accuracy and reduce overfitting. The proposed model achieved a test accuracy of 98.89%, surpassing traditional methods by incorporating advanced regularization and augmentation techniques. The application of horizontal flipping and dynamic scaling during training significantly improved the model’s ability to generalize, evidenced by a low-test loss of 0.230 and high precision metrics across all classes. The proposed deep learning framework demonstrates superior performance in the automated classification of gastrointestinal diseases from image data. By addressing key limitations of existing models through innovative techniques, this study contributes to the enhancement of diagnostic processes in medical imaging, potentially leading to more accurate and timely disease interventions.

Gastrointestinal tract disease detection via deep learning based structural and statistical features optimized hexa-classification model.

Gastrointestinal tract (GIT) diseases impact the entire digestive system, spanning from the mouth to the anus. Wireless Capsule Endoscopy (WCE) stands out as an effective analytic instrument for Gastrointestinal tract diseases. Nevertheless, accurately identifying various lesion features, such as irregular sizes, shapes, colors, and textures, remains challenging in this field. Several computer vision algorithms have been introduced to tackle these challenges, but many relied on handcrafted features, resulting in inaccuracies in various instances. In this work, a novel Deep SS-Hexa model is proposed which is a combination two different deep learning structures for extracting two different features from the WCE images to detect various GIT ailment. The gathered images are denoised by weighted median filter to remove the noisy distortions and augment the images for enhancing the training data. The structural and statistical (SS) feature extraction process is sectioned into two phases for the analysis of distinct regions of gastrointestinal. In the first stage, statistical features of the image are retrieved using MobileNet with the support of SiLU activation function to retrieve the relevant features. In the second phase, the segmented intestine images are transformed into structural features to learn the local information. These SS features are parallelly fused for selecting the best relevant features with walrus optimization algorithm. Finally, Deep belief network (DBN) is used classified the GIT diseases into hexa classes namely normal, ulcer, pylorus, cecum, esophagitis and polyps on the basis of the selected features. The proposed Deep SS-Hexa model attains an overall average accuracy of 99.16% in GIT disease detection based on KVASIR and KID datasets. The proposed Deep SS-Hexa model achieves high level of accuracy with minimal computational cost in the recognition of GIT illness. The proposed Deep SS-Hexa Model progresses the overall accuracy range of 0.04%, 0.80% better than GastroVision, Genetic algorithm based on KVASIR dataset and 0.60%, 1.21% better than Modified U-Net, WCENet based on KID dataset respectively.

Image-enhanced endoscopy in upper gastrointestinal disease: focusing on texture and color enhancement imaging and red dichromatic imaging.

Endoscopic examination plays a crucial role in the diagnosis of upper gastrointestinal (UGI) tract diseases. Despite advancements in endoscopic imaging, the detection of subtle early cancers and premalignant lesions using white-light imaging alone remains challenging. This review discusses two novel image-enhanced endoscopy (IEE) techniques-texture and color enhancement imaging (TXI) and red dichromatic imaging (RDI)-and their potential applications in UGI diseases. TXI enhances texture, brightness, and color tone, which improves the visibility of mucosal irregularities and facilitates earlier detection of neoplastic lesions. Studies have suggested that TXI enhances the color differences between lesions and the surrounding mucosa and improves the visibility of the lesion. TXI aids in the diagnosis of various UGI diseases, including early gastric cancer, esophageal cancer, premalignant conditions such as atrophic gastritis and Barrett's esophagus, and duodenal tumors. RDI utilizes specific wavelengths to enhance the visualization of deep blood vessels or bleeding points, aiding in the rapid and accurate identification of bleeding sources during endoscopic procedures. Although promising, TXI and RDI require further large-scale studies across diverse populations to establish their clinical utility, diagnostic performance, and cost-effectiveness before integration into the guidelines. Standardized training is also required for effective utilization. Overall, these IEE techniques has the potential to improve the diagnosis and management of UGI.

Oral Administration of Bioactive Nanoparticulates for Inflammatory Bowel Disease Therapy by Mitigating Oxidative Stress and Restoring Intestinal Microbiota Homeostasis.

The management of inflammatory bowel disease (IBD) continues to pose significant challenges due to the absence of curative therapies and a high rate of recurrence. Therefore, it is imperative to explore novel approaches to enhance the efficacy of IBD therapy. Herein, a bioactive nanoparticulate s is tailored designed to achieve a "Pull-Push" approach for efficient and safe IBD treatment by integrating reactive oxygen species (ROS) scavenging (Pull) with anti-inflammatory agent delivery (Push) in the inflammatory microenvironment. The multifunctional nanomedicine, designated MON-PAMAM@SASP, is developed through the encapsulation of sulfasalazine (SASP), a widely utilized clinical drug for the treatment of IBD, within cationic diselenide-bridged mesoporous organosilica nanoparticles (MONs) that possess significant antioxidant properties. Herein, poly(amidoamine) (PAMAM) endows the original MONs with positive charge characteristics. The MON-PAMAM@SASP not only displays the remarkable capability of neutralizing ROS to ameliorates intestinal damage, but also achieves controllable release of SASP to mitigate intestinal inflammation. Consequently, this nanomedicine effectively mitigates IBD by colitis in mouse models, and our current research has not identified any significant drug toxicity. Beyond regulating inflammatory microenvironment in intestine, treatment with MON-PAMAM@SASP results in increased richness and restores intestinal microbiota homeostasis, thereby mitigating IBD to a certain extent. Together, our work provides a highly versatile "Pull-Push" approach for IBD management and encourages the development of similar nanomedicine to treating multiple inflammatory diseases of gastrointestinal tract.

Physiological Review of Ajeerna in the Development of Various Diseases

According to World Health Organization, health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. In Ayurveda also, health is nothing but harmonious balance in Doshas, Dhatus, Malas as well as Agni alongside a pleasant state of Atma, Manas and Indriya. Food and lifestyle plays important role in maintenance of health. Out of which food is most important factor for sustenance of healthy life and ensuring physiological function in human body. Food is not only essential for our physical wellbeing but it also nourishes mind. Digestion and assimilation of food is immensely important otherwise it can lead to diseases of gastrointestinal tract. Ajeerna means indigestion which is the first biomarker of malfunctioning of Jathaaragni. According to Charak Samhita, weak state of Jathaaragni (Agnimandya) is the root cause of all disease. Similarly, Madhav nidan also has mentioned that if Ajeerna is left untreated can lead to many diseases. So process of Ajeerna must be blocked by following the correct diet according to an individual's Prakriti and with proper medication treatment and lifestyle modifications. For the prevention of Ajeerna, Acharya Charak has mentioned dietary rules in the form of Ashtau ahar Vidhi Vishesh Ayatana and Acharya Shushrut has mentioned Dashvidha Ahara Vidhi vidhan. By following these guidelines and making thoughtful adjustments to diet and lifestyle, individuals can prevent the onset of Ajeerna and related diseases, ensuring the maintenance of balanced Agni and overall health.

Pain in the epigastral area: current aspects of differential diagnosis

Epigastric pain can have a variety of etiologies, including not only diseases of the upper gastrointestinal tract (GIT): gastroesophageal reflux disease, hiatal hernia, gastritis and duodenitis, gastric and/or duodenal ulcers, polyps and stomach cancer, functional dyspepsia, but also other gastrointestinal diseases, somatic diseases of other organs and systems, vascular pathology, infections and invasions, medications and a number of other reasons. More than 10 years have passed since the publication of our previous article on the issues of differential diagnosis of pain in the stomach. In the Elibrary.ru information base, both in the period of time preceding the publication and to this day, we have not found similar publications. This explains its placement in full or in fragments on specialized gastroenterological sites and guidelines for differential diagnosis in gastroenterology. Over the past 10 years, new consensuses and clinical recommendations have been published on diseases and conditions associated with epigastric pain, and the number of publications on other diseases and conditions that were previously considered very rare, but which today must be taken into account when carrying out differential diagnosis, has increased. Several foreign publications on the problem in recent years were found in the PubMed electronic database. In this regard, we consider it appropriate to consider the current aspects of the differential diagnosis of epigastric pain from the perspective of today. The list of diseases and conditions presented in the review, in which epigastric pain occurs in the clinical picture, indicates that the differential diagnosis of this syndrome is an interdisciplinary problem and is of interest not only to the gastroenterologist and therapist, but also to doctors of other specialties.

BLOOD VISCOSITY AND GIT DISORDERS OF HCV PATIENTS

Background: Hepatitis C virus (HCV) infection is a blood-borne viral illness responsible for significant morbidity and mortality all over the world. The current study aims to determine the role of HCV in increasing blood viscosity that is accompanied by attacks and serious heart disorders, in addition to knowing the effect of this infection on irritations and disorders of the digestive system. Methods: The practical side included collecting blood samples from 50 HCV infected persons and 50 healthy persons as a control group. Laboratory and clinical tests were carried out at Al-Diwaniyah General Teaching Hospital, where HCV was determined by checking for antibodies using the ELISA test, while blood viscosity was determined by knowing the percentage of red blood cells (hemocrit) as part of the complete blood test. Gastrointestinal tract (GIT) diseases were diagnosed using gastroendoscopy and x-rays, in addition to investigations Helicobacter pylori (H. pylori). Result: ulcers and stomach acidity with colitis together (A,B,D) were in high rates in patients (58%) compared with healthy people (6%) and produced this is a clear statistical difference (p<0.05). Moreover, Blood viscosity increased (71.54%) with a rise titer of HCV in patients blood (18.38 logIU/mL) that associated with appearance of strong positive linear correlation (r= 0.965, p= 0.004). In conclusion: HCV leads to serious complications, especially the digestive system and circulation, and the risk of these disorders increases with the increased survival of the virus C in the patient's liver. Therefore, it is necessary to use appropriate treatments, especially effective modern treatments represented by Harvoni.

Advances in colon-targeted drug technologies.

Herein, we present an overview of innovative oral technologies utilized in colonic drug delivery systems that have made significant translational and clinical advancements to treat inflammatory bowel disease (IBD) in recent years. The colon is home to distinct physiological conditions, such as pH and microbiota, that have been exploited in the development of colonic drug delivery systems for the treatment of local and systemic diseases. However, given the intra and interindividual variability in the gastrointestinal tract of both healthy and diseased states, various systems have shown inconsistencies in targeted drug release to the colon. Recent breakthroughs have led to systems that incorporate multiple independent trigger mechanisms, ensuring drug release even if one mechanism fails due to physiological variability. Such advanced platforms have bolstered the development of oral biologics delivery, an especially promising direction given the lack of commercially available oral antibody medications for IBD. These concepts can be further enhanced by employing 3D printing which enables the personalisation of medicines. Leveraging these novel technologies can accurately deliver therapeutics to the colon, allowing for treatments beyond gastrointestinal tract diseases. To realize the full potential of colonic drug delivery, it is paramount that research focuses on the clinical translatability and scalability of novel concepts.

Role of Inflammation and Motility Disorders in the Development, Course and Consequences of Functional Gastrointestinal and Biliary Tract Diseases (Literature Review and Expert Panel Resolution)

Aim: to present the results of the Expert Panel with a discussion of modern concepts of the pathogenesis of functional gastrointestinal diseases and the possibilities of multitarget therapy with trimebutine. Key points. Low-grade inflammation can be considered as a morphological substrate of functional diseases with an increase in activated mastocytes and eosinophils, T-helpers 2 and T-helpers 17 in the gastrointestinal mucosa. In the development in the content of visceral hypersensitivity, the functional connection between mastocytes and TRPV1-positive sensory endings of the vagus nerve is of great importance. Proinflammatory cytokines and matrix metalloproteinases can enter the systemic circulation, provoking the development of systemic manifestations. Increased levels of proinflammatory cytokines are supported by altered intestinal permeability and microbiota. Functional diseases are believed to modify the symptoms and course of concomitant organic diseases of the gastrointestinal tract (for example, functional diseases of the biliary tract may contribute to the development of cholelithiasis, pancreatitis). The peripheral μ-, κ- and δ-receptor agonist trimebutine (Trimedat®) regulates the production of enterohormones, modulates motility throughout the gastrointestinal tract and normalizes visceral sensitivity. The effectiveness of trimebutine in the treatment of functional disorders has been shown in various studies. Trimebutine helps reduce the production of proinflammatory cytokines, including interleukin-6. Conclusion. In the treatment of functional diseases of the gastrointestinal tract, trimebutine can be considered as a multitarget agent, since the drug helps to normalize motility, reduces the degree of visceral hypersensitivity, exhibits anti-inflammatory and neuroregenerative effects, and can also increase the effectiveness of treatment of concomitant diseases.

The role of Helicobacter pylori in the development of inflammatory eyelid diseases

Background. Blepharitis is one of the most common eye diseases: it accounts for 23.3 % of the total number of patients with inflammatory eye diseases worldwide. 40.2 % of these patients seek outpatient care. The incidence of blepharitis is 1.5–2 times higher in women than in men. The leading factors in the development of blepharitis are both general (gastrointestinal tract diseases, diabetes mellitus, hypertension, systemic use of corticosteroids, etc.) and local (atopic and seborrheic dermatitis or rosacea). The main causative agents of this disease are Staphylococcus spp. (S. aureus, S. epidermidis). As a rule, the disease manifests itself in patients aged 30–50 years, while in women aged 40 to 45 years, 80 % of blepharitis are of staphylococcal origin. Currently, there are reports in the literature about apotential link between Helicobacter pylori infection and the development of chronic blepharitis, but the data are very contradictory.The aim of the study. To analyze the features of the relationship between Helicobacter pylori and inflammatory eyelid diseases.Materials and methods. We conducted a search and analysis of literary sources in the Web of Science, PubMed and Google Scholar databases, as well as in the Russian Science Citation Index database for the period from 2000 to 2022.Conclusion. The review analyzes and summarizes the pathogenic mechanisms of the relationship between chronic blepharitis and Helicobacter pylori. We carried out an analysis of numerous studies, which give grounds to assume a possible role of Helicobacter pylori infection in the development and course of inflammatory eyelid diseases (blepharitis). The main pathogenic aspects in these studies are: chronic inflammation of the eyelids and gastrointestinal tract (antigenic mimicry); excretion of toxic substances from the oral cavity (ammonia, hydrogen nitrite, hydrogen cyanide and other substances causing indirect inflammation of the conjunctiva and eyelid cartilage); the presence of Helicobacter pylori in tears.

Impact of physical activity on gastrointestinal health and prevention and treatment of common gastrointestinal diseases: Irritable Bowel Syndrome and Inflammatory Bowel Diseases

Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Diseases (IBD), among them Crohn's disease and ulcerative colitis, are common chronic diseases affecting a growing group of patients. Physical activity (PA) is an important part of a healthy lifestyle. The aim of the study was to critically evaluate current knowledge of impact of PA on gastrointestinal (GI) health and prevention and treatment of some most common GI tract diseases, such as IBS and IBD. The comprehensive research of literature available on PubMed, Google Scholar, ResearchGate and Springer Link was performed. PA improves function of GI by increasing colon transit and bowel movements. These mechanisms contribute to reducing the risk of colorectal cancer and, to varying degrees depending on location, other digestive-system cancers. There is a potential association between PA and the more health-beneficial gut microbiota, but more research in this area is needed. Sedentary lifestyle seems to be a risk factor for IBD, while physical activity seems to be a protective factor only for Crohn disease. Altough, PA contributes to improvement of quality of life and reduction of stress in patients with IBD, futher conclusions on the effect of PA on the course of ulcerative colitis and Crohn disease still require expanded research. Available literature suggests that physical activity prevents obesity, a proven risk factor for worsening the course of the disease, and osteoporosis, an important complication of glucocorticosteroid therapy. Despite evidence of a sedentary lifestyle as a risk factor for IBS, there is still a lack of studies examining the impact of physical activity as a protective factor. the number of RCTs examining the effect of PA on the course of IBS remains insufficient, and studies conducted should take into account the various symptoms of IBS.

Quality of life assessment with SIBDQ in children with upper gastrointestinal pathology

Functional and organic diseases of the digestive system today occupy one of the leading places in the structure of somatic pathology of childhood and adolescence and negatively impact young patients’ quality of life. Among the gastrointestinal tract diseases, the first place is occupied by the pathology of the gastroduodenal zone in children. Gastrointestinal diseases rarely occur in isolation in the form of damage to only the upper or lower parts of the digestive system, especially in childhood. Therefore, in the presence of dysfunction symptoms and pathological changes in the upper gastrointestinal tract, it is advisable to use non‑invasive means to diagnose pathological changes in the lower gastrointestinal tract. Objective — to analyze the quality of life using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ) in children and adolescents with upper gastrointestinal tract pathologies. Materials and methods. The study involved 174 children who visited the Kharkiv city children’s clinical hospital No 19 with complaints about upper gastrointestinal disorders (7—18 years old). Patients were interviewed using the self‑reported inflammatory bowel disease quality of life questionnaire SIBDQ, which assesses physical, social and emotional well‑being (the result is determined from 10 to 70 points, where 10 is the worst condition). Results. The median SIBDQ score for the entire sample was 51 points [Q1; Q3: 45; 58], with 47.1±3.7% of respondents having up to 50 points. In girls, the median was significantly lower than in boys — 49 [40; 55] versus 55 [49.0; 65.5] (pU=0.05). According to the nature of the endoscopic picture, 55% of children with gastroesophageal and duodenogastric reflux, 38.6% of children with erythematous duodenopathy, 45.9% of children with erosive and ulcerative changes and 61.5% of patients with esophagitis had a low SIBDQ score. Boys with low SIBDQ scores were more prone to gastroesophageal and duodenogastric reflux. All other endoscopic changes were significantly more common (p <0.05) in girls with less than 50 points according to the survey results. Conclusions. In 47% of children with complaints of upper gastrointestinal dysfunction, the quality of life score was low by the SIBDQ (< 50). The median SIBDQ score in girls was significantly lower than in boys: 49 [40; 55] versus 55 [49.0; 65.5] points (pU=0.05), respectively. Girls with instrumentally confirmed esophagitis had significantly lower SIBDQ scores compared to boys with esophagitis and girls with other gastrointestinal disorders — 41.5 [37; 46] (p <0.05). The use of the SIBDQ questionnaires in school‑age children and adolescents is advisable not only for lower gastrointestinal tract diseases but also for gastroduodenal zone diseases.