Disorders Of Gastrointestinal Tract Research Articles

The Use of Ethanolic Extract of Sonchus Oleraceus in the Treatment of Hepatotoxicity Induced by Carbon Tetrachloride Injection in Rats

Purpose: To study the hepatoprotective activity of the ethanolic extract of Sonchus Oleraceus. The plant is of the family Asteraceas and was used in the traditional medicine for the treatment of gastrointestinal tract disorders, tumors and inflammatory diseases.
 Methodology: Sixty rats of both sexes were used, divided into 5 groups. The hepatotoxicity was induced by administration of carbon tetrachloride (CCL4) at dose rate of 0.2 mg /kg BW. The plant extract was administered orally at dose rates of 200 and 400 mg /kg BW.
 Findings: were compared to the standard drug known Silymarin at a dose rate of 100 mg/kg BW. The protective effect of ethanolic extract of Sonchus. Oleraceus was found to be better with the high dose (400 mg), hence the level of serum alanine amino transferase (ALT), serum Aspartate amino transferase (AST), were significantly decreased. Total protein, Albumin, Bilirubin and Alkaline Phosphatase (ALP) were also decreased, The Histological appearance of the given Sonchus Oleraceus. ethanolic extract (400mg/kg BW) showed few hepatocytes necrosis that has amorphous eosinophilic cytoplasm and areas of necrosis characterized by disintegration and disappearance of cells in many areas.
 Unique Contribution to Theory, Practice and Policy: According to the obtained results, it would be important to isolate the active ingredient of the plant used that responsible for the treatment of hepatotoxicity.

СОВРЕМЕННЫЙ СОЦИО-СОМАТИЧЕСКИЙ ПОРТРЕТ ЖЕНЩИНЫ С ПАТОЛОГИЧЕСКИМ КЛИМАКСОМ

Introduction. Nowadays, the number of menopausal women in the world population has strong tendency to increase. According to statistics the majority have a moderate and severe course of it. This is the reason preventive gerontology develops today, especially climatology. That is why using new machine learning technologies is relevant today. Such method as gradient boosting helped us to identify the characteristic features and factors that cause the pathological course of menopause in women which made it possible to draw up a medical «portrait» of such patients. Using the knowledge of these factors influence it is easily to recognize women needs to be observed even before the manifestations of menopause. Aim. The aim of the study is to conduct a socio-somatic «portrait» of a modern patient with a pathological menopause. Material and methods. A detailed survey of 1275 women aged 45–60 years was carried out with an assessment of the socio-cultural status, general somatic and gynecological health. The received data were sorted and categorized using modern statistical processing methods and machine learning method - gradient boosting. Results and discussion. Firstly, there are factors with high influence on menopausal syndrome developing: level of education, oncological anamnesis, diseases of the gastrointestinal tract, vegetative and insomnia disorders, the use of intrauterine contraceptives, the number of children 2 or more, the presence of abortions in anamnesis. The rest of the questionnaires were characterized as having only a small impact. This is a pathology of the thyroid gland, the cardiovascular system; hyperplastic processes in history; occupation, namely social and medical workers, as well as a negative attitude towards menopause. The greater number of these features one woman has, the higher the likelihood of developing a pathological menopause she gets. Conclusion. The collective image we have received of a modern patient with pathological menopausal syndrome is based on aspects of the life and health of women which it is worth paying attention on. This can serve as a kind of guideline for clinicians in order to achieve correction of hypoestrogenism with the development of a pathological menopause.

Mirabegron and Anticholinergics in the Treatment of Overactive Bladder Syndrome: A Meta-analysis.

To compare the use of mirabegron with anticholinergics drugs for the treatment of overactive bladder (OB). Systematic searches were conducted in EMBASE, PUBMED, Cochrane, and LILACS databases from inception to September 2021. We included RCTs, women with clinically proven OB symptoms, studies that compared mirabegron to antimuscarinic drugs, and that evaluated the efficacy, safety or adherence. RevMan 5.4 was used to combine results across studies. We derived risk ratios (RRs) and mean differences with 95% CIs using a random-effects meta-analytic model. Cochrane Collaboration Tool and GRADE was applied for risk of bias and quality of the evidence. We included 14 studies with a total of 10,774 patients. Fewer total adverse events was reported in mirabegron group than in antimuscarinics group [RR 0.93 (0.89-0.98)]. The risk of gastrointestinal tract disorders and dry mouth were lower with mirabegron [RR 0,58 (0.48-0.68); 9375 patients; RR 0.44 (0.35-0.56), 9375 patients, respectively]. No difference was reported between mirabegron and antimuscarinics drugs for efficacy. The adherence to treatment was 87.7% in both groups [RR 0.99 (0.98-1.00)]. Mirabegron and antimuscarinics have comparable efficacy and adherence rates; however, mirabegron showed fewer total and isolated adverse events.

Gut inflammation and tumorigenesis: every site has a different tale to tell.

Gut inflammation has been correlated with cancerogenesis by disrupting gastrointestinal homeostasis. Numerous chronic inflammatory disorders of the tubular gastrointestinal tract (e.g., gastroesophageal reflux disease, Helicobacter pylori-induced and autoimmune chronic gastritis, celiac disease, and inflammatory bowel diseases) have been variably associated with an increased neoplastic risk. Gastrointestinal inflammation-induced neoplasms include epithelial tumors (esophageal squamous cell carcinoma and adenocarcinoma, gastric adenocarcinoma and neuroendocrine tumors, small bowel adenocarcinoma and neuroendocrine tumors, and colorectal cancer) and lymphomas (such as gastric marginal zone lymphomas and enteropathy-associated T cell lymphoma). In the last decades, numerous studies have investigated the pathogenetic mechanisms and the microenvironmental/microbiome changes that trigger genetic and/or epigenetic alterations eventually leading to tumorigenesis, often through a histologically recognizable inflammation-dysplasia-carcinoma cancerogenic sequence. In the present review, an overview of the current knowledge on the links between inflammatory diseases and neoplasms of the tubular GI tract, applying a site-by-site approach, is provided.

Investigating the shared genetic architecture of post-traumatic stress disorder and gastrointestinal tract disorders: a genome-wide cross-trait analysis.

Observational studies suggest a correlation between post-traumatic stress disorder (PTSD) and gastrointestinal tract (GIT) disorders. However, the genetic overlap, causal relationships, and underlining mechanisms between PTSD and GIT disorders were absent. We obtained genome-wide association study statistics for PTSD (23 212 cases, 151 447 controls), peptic ulcer disease (PUD; 16 666 cases, 439 661 controls), gastroesophageal reflux disease (GORD; 54 854 cases, 401 473 controls), PUD and/or GORD and/or medications (PGM; 90 175 cases, 366 152 controls), irritable bowel syndrome (IBS; 28 518 cases, 426 803 controls), and inflammatory bowel disease (IBD; 7045 cases, 449 282 controls). We quantified genetic correlations, identified pleiotropic loci, and performed multi-marker analysis of genomic annotation, fast gene-based association analysis, transcriptome-wide association study analysis, and bidirectional Mendelian randomization analysis. PTSD globally correlates with PUD (rg = 0.526, p = 9.355 × 10-7), GORD (rg = 0.398, p = 5.223 × 10-9), PGM (rg = 0.524, p = 1.251 × 10-15), and IBS (rg = 0.419, p = 8.825 × 10-6). Cross-trait meta-analyses identify seven genome-wide significant loci between PTSD and PGM (rs13107325, rs1632855, rs1800628, rs2188100, rs3129953, rs6973700, and rs73154693); three between PTSD and GORD (rs13107325, rs1632855, and rs3132450); one between PTSD and IBS/IBD (rs4937872 and rs114969413, respectively). Proximal pleiotropic genes are mainly enriched in immune response regulatory pathways, and in brain, digestive, and immune systems. Gene-level analyses identify five candidates: ABT1, BTN3A2, HIST1H3J, ZKSCAN4, and ZKSCAN8. We found significant causal effects of GORD, PGM, IBS, and IBD on PTSD. We observed no reverse causality of PTSD with GIT disorders, except for GORD. PTSD and GIT disorders share common genetic architectures. Our work offers insights into the biological mechanisms, and provides genetic basis for translational research studies.

THE SPREAD OF INTESTINAL SYMPTOMS IN PATIENTS WITH FUNCTIONAL DISORDERS OF THE UPPER GASTROINTESTINAL TRACT

The research aims to assess and characterize the prevalence of intestinal symptoms/strictures in patients with functional disorders of the upper gastrointestinal tract. The evaluation of the clinical data suggested that among the concomitant (intestinal) disorders detected in patients with functional disorders of the upper gastrointestinal tract, functional constipation predominated, strengthening the opinion that one of the major pathogenic mechanisms of functional disorders of the upper and lower intestines is a violation of gastric motor-evacuator function. The majority (over 80%) of patients with functional disorders of the upper gastrointestinal tract have a concomitant functional bowel disorder, indicating the possible common pathogenesis of functional disorders of the upper and lower gastrointestinal tract. Since the diagnosis and management of functional disorders of the digestive system still remains one of the main challenges in modern gastroenterology, regulation of the motor-evacuator process and management of functional disorders of the upper gastrointestinal tract may have a positive effect in terms of reduced intestinal strictures and improved general clinical condition.

Myristicin: From its biological effects in traditional medicine in plants to preclinical studies and use as ecological remedy in plant protection

AbstractMyristicin is an allylbenzene and a major key constituent of many plant species, such as Myristica fragrans Houtt. (nutmeg), Foeniculum vulgare Mill. (fennel), and Petroselinum crispum (Mill.) Fuss (parsley). Their plant parts have been used in traditional medicine and as a flavoring seasoning for cooking but, and as biopesticides with natural compounds. Myristicin has been related with several biological effects, such as anticarcinogenic, anti‐inflammatory, antimicrobial, antioxidant, antidiabetic, analgesic, and hepatoprotective. The traditional uses include the treatment of complications related to gastrointestinal tract, respiratory system, and gynecological disorders. However, several studies have been reported contraindications associated to high dose consumption of myristicin. This review summarizes the biological activities of myristicin and myristicin‐rich plants, toxicological effects along with its bioavailability, and metabolism. In addition, their traditional uses and their role as ecological remedy in plants protection has been reviewed. Nutmeg is the myristicin‐rich plant with more pharmacological effects reported but also with most contraindication and toxically reports.

Intestinal Microbiota and miRNA in IBD: A Narrative Review about Discoveries and Perspectives for the Future.

Inflammatory bowel disease (IBD) includes Crohn's disease (CD) and ulcerative colitis (UC) and comprises a chronic gastrointestinal tract disorder characterized by hyperactive and dysregulated immune responses to environmental factors, including gut microbiota and dietary components. An imbalance of the intestinal microbiota may contribute to the development and/or worsening of the inflammatory process. MicroRNAs (miRNAs) have been associated with various physiological processes, such as cell development and proliferation, apoptosis, and cancer. In addition, they play an important role in inflammatory processes, acting in the regulation of pro- and anti-inflammatory pathways. Differences in the profiles of miRNAs may represent a useful tool in the diagnosis of UC and CD and as a prognostic marker in both diseases. The relationship between miRNAs and the intestinal microbiota is not completely elucidated, but recently this topic has gained prominence and has become the target of several studies that demonstrate the role of miRNAs in the modulation of the intestinal microbiota and induction of dysbiosis; the microbiota, in turn, can regulate the expression of miRNAs and, consequently, alter the intestinal homeostasis. Therefore, this review aims to describe the interaction between the intestinal microbiota and miRNAs in IBD, recent discoveries, and perspectives for the future.

Assessment of comorbid profile, quality of life and social functioning in patients with schizophrenia and schizotypal disorders

One of the most common mental illnesses is schizophrenia and schizotypal disorders. According to the literature data, mortality among patients with schizophrenia is 1.5-2 times higher than among the general population. Patients with schizophrenia have a higher prevalence of cardiovascular disease, obesity, diabetes, osteoporosis in comparison with the general population. Such comorbid somatic diseases in the case of schizophrenia have a more acute course, a significant impact on the course of the underlying disease, the development of complications, decrease in quality of life and social functioning. The aim of the study was to study the presence and features of comorbidity, its impact on the quality of life and social functioning of patients with schizophrenia and schizotypal disorders. 100 patients were included in the study. They were divided into two groups: experimental (Group I) with schizophrenia and comparison (Group II), with other schizophrenic diseases, such as schizoaffective and schizotypal disorder. All patients were scaled according to the following methods: The Cumulative Illness Rating Scale (CIRS), Clinical Global Impression – Severity Scale (CGI-S), The Personal Social Performance Scale (PSP), CGI-S, and a short form of the questionnaire Medical Outcomes Study 36-Item Short-Form Health Status (SF-36). Charlson Index was also calculated for all patients included in the study. Due to CIRS, we detected undiagnosed comorbidity that aggravated the course of the underlying disease: 38% in Group I and 26% in Group II. The most common components in the structure of comorbidity in the patients with schizophrenia were diabetes mellitus, musculoskeletal diseases, cardiovascular diseases, non-alcoholic fatty liver disease (NAFLD). Patients with schizotypal disorders were more often diagnosed with peripheral vascular diseases, chronic lung diseases, chronic kidney diseases, and upper gastrointestinal tract disorders. A com­pre­hensive approach to be important in the treatment of such patients. The nature and extent of comorbidity should be definitely taken into account. This will promote the compliance and improve the indicators in the examined category of patients.

English

Wireless capsule endoscopy (WCE) is a non-invasive wireless imaging technology that gained wider popularity. The main drawback of WCE is that it produces a massive amount of images that healthcare professionals should analyze, which is time-consuming. Many researchers have suggested machine learning and image-processing methods for classifying gastrointestinal tract disorders. Data augmentation and classical image processing techniques are integrated with the adjustable pre-trained deep convolutional neural network (DCNN) to categorize diseases in the digestive tract from WCE images. This study develops an Intelligent Wireless Endoscopic Image Classification using Gannet Optimization Algorithm with Deep Learning (IWEIC-GOADL) model. The IWEIC-GOADL technique mainly examines the WCE images for classification purposes. As a preprocessing step, the presented IWEIC-GOADL technique executes the Gabor filtering (GF) method for the noise removal process. In addition, the presented IWEIC-GOADL technique employs a deconvolution VGG19 (DeVGG19) model for feature vector generation, and its hyperparameter tuning process takes place by the GOA. Finally, the IWEIC-GODL technique applies the deep belief network (DBN) model for WCE image classification purposes. A wide range of simulations was performed on a benchmark dataset to demonstrate the better performance of the IWEIC-GODL technique. The stimulation outcome stated the improvements of the IWEIC-GODL algorithm over other recent techniques.

The Protective Eff ects Trimetazidine on Indomethacin Induced Gastric Ulcer in Rat Model

Introduction: Gastric ulcer (GU) is the most common gastrointestinal tract disorder, representing about 20% of peptic ulcer due to an imbalance between gastric defense mechanisms and aggressive factors, mainly Helicobacter pylori and non-steroidal anti-infl ammatory drugs (NSAIDs). The study aims to evaluate trimetazidine’s protective eff ect on histopathology, GU severity, infl ammatory and oxidative stress markers (TNF- alpha, MPO and MDA) in rate model of indomethacin induced GU. Method: Total 30 healthy male albino rats were divided into fi ve groups each of ten (N=10). Group A: Given indomethacin vehicles (normal saline 0.9% and tween 80) orally via gavage tube and serve as control positive group. Group B: Induced ulcer by Indomethacin 60 mg/kg orally via oral gavage serve as control negative. Group C: Pretreated with trimetazidine 50 mg/ kg orally by gavage tube 1-hour before administering indomethacin 60 mg/kg. At the end of study histological examination, anti-infl ammatory and antioxidant markers were evaluated. Results: TMZ 50 mg/kg pretreated groups show a signifi cant (p 0.01) reduction in GU severity score and histopathology damage score in comparison with the indomethacin ulcerated group. Moreover, pretreated groups TMZ 50 mg/kg showed a signifi cant reduction in infl ammatory markers (TNF-alpha and MPO) and oxidative stress marker (MDA) in comparison with the induction group, similar to the results of the reference drug. Conclusion: TMZ dihydrochloride has similar effi cacy as standard omeprazole drug by a decrease in oxidative stress status manifested by a reduction in lipid peroxidation indicator marker and a reduction in pro-infl ammatory cytokine level and leukocyte recruitment indicator marker and fi nally, macroscopic and microscopic evaluation show a reduction GU severity.

Detection of gastrointestinal tract disorders using deep learning methods from colonoscopy images and videos

Colorectal cancer (CRC) is the world's third most common cancer, with the second highest fatality rate. It is primarily the result of lower gastrointestinal tract (GI) disorders. The prevention of CRC mainly depends on the early detection and treatment of anomalies in the lower GI tract. Colonoscopy is the gold standard device used for diagnosing abnormalities in the lower GI tract as well as identifying anatomical landmarks and bowel preparation scales. However, it is time-consuming, tedious, and prone to error process, especially for those hospitals in low resource settings. Therefore, in this research, a real-time automated detection, classification, and localization of lower GI tract pre-colorectal cancerous abnormalities were done. The proposed system enables real-time detection, classification, and localization of common pathology, anatomical landmarks, and bowel preparation scale from colonoscopy images. To do the research, data was gathered both online (at hyper k-vasir dataset) and locally from the Yanet Internal Specialized Center and the Ethio-Tebib Hospital. Data augmentation techniques were applied to increase the training dataset. The pre-trained transfer learning SSD, YOLOv4, and YOLOv5 object detection model was used to develop the system with minimal fine-tuning of the hyper parameters and their performance was compared. The Yolo v5 model achieves good precision, recall, and mean average precision (mAP), 99.071%, 98.064% and 98.8%, respectively, on the testing data set. The developed artificial intelligence-based module would have the potential to assist gastroenterologists and general practitioners in decision-making. Even though the proposed work achieved the best performance, further improvement is required by increasing the size of the dataset to include other GI tract disease diagnoses.

Evaluating the Anti‐Gastric Ulcer Activity of Aegle marmelos: A Brief Review

AbstractGastric ulcer is a deep hole in the stomach wall that penetrates the entire mucosa. About 10 % of the world population suffers from gastrointestinal tract disorders frequently known as gastric ulcers. Synthetic drugs are used to prevent gastric ulcers by suppressing the formation of gastric acid or stopping bacterial infections, however, these synthetic drugs have a number of harmful effects. Therefore, drug candidates with improved potency and minimal toxicity are crucial for the treatment and management of gastric ulcers. Recently, there has been a lot of interest in the medicinal potential of plants and their ability to treat gastric ulcers. There is an urgent need for herbal remedies to treat ulcers, and Aegle marmelos presents a better option due to scientifically proven antibacterial and antiulcer properties. In this context, A. marmelos highlights various benefits including anti‐inflammatory and antioxidant properties. It is well known that every component of A. marmelos has therapeutic and medical use. The two main causes of stomach ulcers are Helicobacter pylori and NSAIDs. A. marmelos shows strong antioxidant and antiulcer effects and guard against H. pylori‐caused ulcers on the stomach mucosa by inhibiting secretory factors and activating antioxidant processes.

Enhancing Wireless Capsule Endoscopy images from intense illumination specular reflections using the homomorphic filter

Wireless Capsule Endoscopy (WCE) is a non-invasive medical imaging device that gastroenterologists use to investigate gastrointestinal tract disorders. WCE images often suffer from specular reflections (SRs). SR is an outcome of the rigorous light and luminous regions emerging in WCE images, impacting the performance of abnormality detection approaches and physician analysis. The current study aims to invent a method that can automatically segment and eliminate SRs in WCE images to increase the accuracy of abnormality detection approaches and help physicians to make a potent diagnosis. In this study, we introduce a novel method for SR elimination with a negligible damage to the image texture using a homomorphic filter. The proposed method encompasses three steps. Initially, we utilize a robust segmentation technique using the U-Net model to segment SRs based on semantic segmentation. Then, we use the homomorphic filter to separate the illumination and reflection components. Damage caused by SR has different effects on these two components. Our proposed method enhances each of these components separately instead of enhancing the whole image uniformly. Eventually, we reconstruct SR regions using the Navier-Stokes inpainting technique based on fluid dynamics. Our experiments were conducted on three different types of WCE datasets. The evaluations were performed with the following criteria accuracy, false negative rate, false positive rate, precision, recall, and F-Measure. The results show that our proposed method eliminates SRs admirably and quantitatively increases the accuracy of the state-of-the-art abnormality detection methods in WCE and improves their performance.

Medicinal plants and their uses by a folk medicinal practitioner of Matlab Upazila in Chandpur district, Bangladesh

Background: Bangladesh is a small developing country with the majority population still residing in villages; most villages lack many modern amenities like proper drinking water facilities, sanitation, and conventional (allopathic) doctors and hospitals. On the other hand, although it is getting lost with possibly every passing day, villagers have a long history of traditional medicinal practitioners, who are also known as folk medicinal practitioners or Kavirajes (in Bengali). Kavirajes for the most part use medicinal plants, which are locally available for treatment and thus saves the villagers from costly conventional treatment, the medicines of which are neither readily available nor affordable. Once common, Kavirajes are fast disappearing along with loss of their folk medicinal knowledge. This loss is irreparable because plants and their phytochemicals still form the basis for discovery of modern drugs. For more than a decade, we had been conducting ethnomedicinal surveys among folk and tribal medicinal practitioners of Bangladesh.Methods and Findings: Interviews were conducted of the only folk medicinal practitioner (FMP) in Matlab Upazila. Prior permission was obtained from the FMP. Interviews were conducted with the help of a semi-structured questionnaire, extensive discussions, and field trips to areas frequented by the FMP to collect medicinal plants. Information was noted carefully. Plants were pictured, and plant samples identified by a trained botanist following collection, drying and mounting onto herbarium sheets. We could obtain information on only ten formulations, which were used for treatment of respiratory disorders, gastrointestinal tract disorders, pain, dengue, diabetes, acne, fever, eye problems, jaundice, gonorrhea, sexual problems, and debility.Conclusions: The richness of folk medicinal practice can be glimpsed from the diversity of illnesses treated with just twelve medicinal plant species. Some of these plants urgently need scientific attention before plants and FMPs disappear altogether. The phytochemicals present in the plants can be sources of potential drugs, lead compounds, or scaffolds for better drugs.

Immunoepigenetic Regulation of Inflammatory Bowel Disease: Current Insights into Novel Epigenetic Modulations of the Systemic Immune Response.

The immune system and environmental factors are involved in various diseases, such as inflammatory bowel disease (IBD), through their effect on genetics, which modulates immune cells. IBD encompasses two main phenotypes, Crohn's disease, and ulcerative colitis, which are manifested as chronic and systemic relapse-remitting gastrointestinal tract disorders with rising global incidence and prevalence. The pathophysiology of IBD is complex and not fully understood. Epigenetic research has resulted in valuable information for unraveling the etiology of this immune-mediated disease. Thus, the main objective of the present review is to summarize the current findings on the role of epigenetic mechanisms in IBD to shed light on their potential clinical relevance. This review focuses on the latest evidence regarding peripheral blood mononuclear cells and epigenetic changes in histone modification, DNA methylation, and telomere shortening in IBD. The various identified epigenetic DNA profiles with clinical value in IBD could be used as biomarkers for more accurately predicting disease development, treatment response, and therapy-related adverse events. Ultimately, the information presented here could be of potential relevance for future clinical practice in developing more efficient and precise medicine to improve the quality of life for patients with IBD.

Peroxiredoxins and Hypoxia-Inducible Factor-1α in Duodenal Tissue: Emerging Factors in the Pathophysiology of Pediatric Celiac Disease Patients.

Celiac disease (CD) is an autoimmune enteropathy. Peroxiredoxins (PRDXs) are powerful antioxidant enzymes having an important role in significant cellular pathways including cell survival, apoptosis, and inflammation. This study aimed at investigating the expression levels of all PRDX isoforms (1-6) and their possible relationships with a transcription factor, HIF-1α, in the small intestinal tissue samples of pediatric CD patients. The study groups consisted of first-diagnosed CD patients (n = 7) and non-CD patients with functional gastrointestinal tract disorders as the controls (n = 7). The PRDXs and HIF-1α expression levels were determined by using real-time PCR and Western blotting in duodenal biopsy samples. It was observed that the mRNA and protein expression levels of PRDX 5 were significantly higher in the CD patients, whereas the PRDX 1, -2, and -4 expressions were decreased in each case compared to the control group. No significant differences were detected in the PRDX 3 and PRDX 6 expressions. The expression of HIF-1α was also significantly elevated in CD patients. These findings indicate, for the first time, that PRDXs, particularly PRDX 5, may play a significant role in the pathogenesis of CD. Furthermore, our results suggest that HIF-1α may upregulate PRDX-5 transcription in the duodenal tissue of CD.

The gut microbiome as a factor in the development of Parkinson's disease

Parkinson's disease (PD) is a neurodegenerative disease characterized by the progressive death of dopaminergic neurons in the substantia nigra of the brain and the deposition of α-synuclein in the form of Lewy bodies in other parts of the brain. Characteristic manifestations of this disease, along with motor symptoms, are the gastrointestinal tract disorders, accompanied by a change in the cellular composition of the intestinal biocenosis. This made it possible to propose the so-called "intestinal" theory of the PD origin. According to this theory, degenerative changes begin in the nervous apparatus of the large intestine, and then spread to the brain. Changes in the intestinal microbiota composition can contribute to the development of the neurodegenerative process through neural, immune, endocrine mechanisms, as well as through biologically active substances.

Role of Endoscopy in Motility Disorders of Upper Gastrointestinal Tract

Gastrointestinal motility disorders have a wide range of symptoms and affect patients' quality of life. With the advancement of endoscopy, the diagnostic and therapeutic roles of endoscopy in motility disorders is becoming more significant. Endoscopy is necessary to rule out possible organic diseases in patients with suspected motility disorders and provide significant clues for their diagnosis. Moreover, interventional endoscopy may be a primary or alternative treatment option for selected patients with motility disorders, and it is becoming a promising field as new therapeutic applications are developed and utilized for various motility disorders. This review may provide suitable indications for the use of endoscopy in diagnosing and treating motility disorders of the upper gastrointestinal tract.

Characteristics of digestive system lesions in patients with diabetes mellitus

Lesions of the digestive system in diabetes mellitus (DM) are of secondary nature and arise due to autonomic neuropathy. As a result of hyperglycemia, lesions of the esophagus, stomach, small and large intestine develop. The most common disorder of the digestive system in diabetes is gastroparesis. The diagnosis of gastroparesis is currently insufficient. It is connected with low awareness and, as a consequence, rare visit of patients to specialists, and also with similarity of clinical symptoms with other functional disorders of gastrointestinal tract (GIT). The main risk factors for gastroparesis are hyperglycemia, smoking, alcohol, and certain medications. Most patients with gastroparesis suffer from depression and increased anxiety. Taking medications to treat depression negatively affects the function of the digestive system. This problem interferes with patients’ quality of life. During the pandemic of coronavirus infection, the number of patients seeking medical care due to exacerbation of gastrointestinal disorders increased. The question of etiology is subject to further study. This review also considers the effect of cholecystectomy on the development of gastroparesis in these patients. These patients need special monitoring of glucose levels to prescribe timely antidiabetic therapy and prevent future gastroparesis. For the treatment of lesions of the digestive system in diabetes mellitus, a special diet, in particular the exclusion of hard-to-digest fiber, fatty foods, inclusion of vitamin complexes and normalization of the microbiota plays a paramount role. The main therapeutic value is the timely diagnosis and normalization of glucose levels.