Treatment Of Gastroenterological Diseases Research Articles

Phytotherapeutic recommendations in medical guidelines for the treatment of gastroenterological diseases - a systematic review

Phytotherapeutics are gaining influence in the treatment of gastroenterological diseases. Their popularity and growing evidence of efficacy contribute to their integration into medical guidelines. A systematic screening identified recommended phytotherapeutic approaches. Based on current scientific data, some recommendations for the use of phytotherapeutic agents are given. For irritable bowel syndrome the use of peppermint oil is "strongly recommended", especially for pain and flatulence. Other phytotherapeutics such as STW-5, Tibetan Padma Lax or warm caraway oil pads have proven effective in alleviating symptoms. It is "recommended" to integrate them into the treatment concept. For chronic constipation, 30g of fiber per day is recommended. Best data exists for plantago psyllium with moderate evidence and chicory inulin. In case of ulcerative colitis, plantago psyllium as well as the combination of myrrh, chamomile flower extract, and coffee charcoal can be used as a complementary treatment in maintaining remission. There is also an "open recommendation" for curcumin for both, remission induction and maintenance. Some phytotherapeutic treatments (e.g., Artemisia absintium, Boswellia serata) show evidence of effectiveness for the treatment of Crohn's disease, but data are not yet sufficient for recommendations. Cannabis-based medicines can be considered for abdominal pain and clinically relevant appetite loss if standard therapy is ineffective or contraindicated, but they should not be used for acute inflammation in active Crohn's disease. Further recommendations for other gastroenterological diseases are discussed. The safety and tolerability of the phytotherapeutics were rated as predominantly "very good" to "acceptable". Some clear recommendations for the use of phytotherapeutics to treat gastroenterological diseases show their great potential. Due to their wide range of effects, phytotherapeutics can be used very well as a complement to conventional medicines in case of complex regulatory disorders. However, further methodologically well-conducted impact studies would be helpful in order to be able to make further recommendations.

Proč bychom měli a neměli využívat ChatGPT v gastroenterologii?

Summary: Artificial intelligence (AI) is increasingly being incorporated into medicine, including gastroenterology, opening new possibilities for the diagnosis and treatment of digestive tract diseases. ChatGPT, an AI model based on the GPT-4 architecture, has the potential to accelerate diagnosis and treatment, personalize care, educate, and train healthcare professionals, support decision-making, and improve communication with patients. However, with the use of AI come challenges such as the limited ability of AI to replace human judgment, data errors, issues related to security and personal data protection, and implementation costs. The future of ChatGPT in gastroenterology depends on its ability to process and analyze large amounts of data to identify patterns and create individual treatment plans. Thanks to advancements in AI and machine learning, ChatGPT is becoming more accurate and efficient, enabling faster diagnosis and treatment of gastroenterological diseases. In the field of education, ChatGPT will serve as an invaluable source of information on the latest research articles and procedures. Despite the benefits of AI in gastroenterology, it is essential to address issues of ethics, data protection, and collaboration between AI and healthcare professionals. Ensuring proper protocols and procedures will enable the safe and ethical use of AI in medicine. Although AI offers significant potential for improving the quality of care, it is necessary to address challenges associated with data protection, security, and ethics. Key words: artificial intelligence – AI – ChatGPT – gastroenterology

New perspectives on treatment of gastrointestinal diseases: therapeutic potential of mesenchymal stromal cells

Mesenchymal stromal cells (MSCs) are a promising resource for cell therapy of different organs and systems, including the gastrointestinal tract (GIT). Therapeutic effect of MSC transplantation in GIT diseases may be partly due to their differentiation into various cellular components of the digestive tube. However, more significant is regulatory influence of MSCs on survival, proliferation, and differentiation of the gastric and intestinal epithelial cells, as well as their immunomodulatory, pro-angiogenic and antifibrotic effects. Data from experiments on animals and clinical trials indicate prospect of using MSCs in various diseases affecting any parts of GIT. However, effective and safe clinical use of MSCs requires an in-depth study of the mechanisms of their therapeutic effect, the development of optimal methods of administration, and risk assessment of adverse effects. This review analyzes MSC participation in regeneration of GIT and systematizes data on the potential of using MSCs in the treatment of gastroenterological diseases.

“Old” and “new” probiotics in the treatment of gastroenterological diseases in children and adults: how to increase effectiveness?

The purpose of the review is to analyze the real benefits of the use of traditional probiotics and to highlight the issues of the possibility of creating and using new generation probiotics in the treatment of gastroenterological pathology. Questions of effectiveness of therapy with traditional probiotics of functional and organic diseases of the gastrointestinal tract in children and adults from the points of view of evidence-based medicine are analyzed, insufficient number of studies in children and frequent absence of significant differences in the effect of probiotics compared to placebo are emphasized. New generation probiotic candidates are described, which could become potential sources of new drugs for various diseases, including gastroenterological pathology. The main problems in the way of creation and introduction of new probiotics are outlined. Data on an alternative approach of probiotic therapy based on use to restore microbiocenosis of own bacteria, which are grown as pure genetically characterized cultures and can be used as probiotic products, are presented.

Possibilities of pharmacotherapy in the treatment of gastroenterological diseases during pregnancy

The article discusses the possibilities of modern pharmacotherapy of various gastroenterological pathologies of pregnant women. Having revealed the reasons for careful monitoring of prescribing drugs to pregnant women (thalimidomide tragedy), the authors cited the FDA classification of drug safety depending on the possibility of their use during pregnancy (A, B, C, D, X categories). Physiological changes in the basic biochemical parameters in pregnant women associated with neuroendocrine and metabolic processes are listed. Features of treatment of gastroesophageal disease are emphasized: the most optimal is the appointment of alginates and antacids. During pregnancy, Helicobacter pylori eradication therapy is impossible, as well as the appointment of M-anticholinergics, bismuth preparations, therefore, antacids, alginates, sucralfate may be recommended for pregnant women suffering from chronic gastritis and gastric ulcer, duodenal ulcer. The only one proton pump inhibitor proven to be safe during pregnancy is the original omeprazole. Exacerbation of chronic pancreatitis is an indication for hospitalization of a pregnant woman in a hospital with a therapeutic profile, while acute pancreatitis must be treated in a surgical hospital after preliminary delivery. Features of damage to the hepatobiliary system during pregnancy are considered, possibility of bearing the fetus in autoimmune hepatitis, primary biliary cirrhosis, and primary sclerosing cholangitis is emphasized. Indications for the appointment of various hepatoprotectors, glucocorticosteroids are listed. Management schemes for pregnant women with inflammatory bowel diseases are indicated with the primary use of sulfasalazine, 5-aminosalicylic acid, steroids, infliximab.

Место полиметилсилоксана полигидрата в лечении гастроэнтерологических заболеваний

Место полиметилсилоксана полигидрата в лечении гастроэнтерологических заболеваний

Hexapeptide dalargin in clinical gastroenterology: 30 years' of clinical application of the drug

Aim of review. To discuss results of application of the Russian drug dalargin in the treatment of gastroenterological diseases. Summary. Dalargin is the first synthetic opioid peptide agent created on the basis of endogenous leucineenkephaline. Pharmacological effects of dalargin are caused by opioid receptors. The pilot studies showed protective properties for ulceration and antisecretory effect. In therapeutic practice it is applied for treatment of peptic ulcer of the stomach and duodenum, acute and chronic pancreatitis and pancreatic necrosis. Article presents results of use of hexapeptide, algorithm and guideline on its application are analyzed, possible mechanisms of action are discussed. The therapeutic effect of dalargin at various gastro-intestinal diseases is determined by its bioregulator properties maintaining body homeostasis up to standard. Conclusion. Dalargin has demonstrated high therapeutic efficacy and safety for almost 30 years of application in practical gastroenterology and significantly expanded facilities of gastroenterologists in treatment of digestive diseases.

CMV Colitis in Immunocompetent Patients: 2 Cases of a Diagnostic Challenge

CMV infections are generally thought to be opportunistic by immunosuppression. Many literature cases though indicate that CMV infections can be also observed in immunocompetent patients. We present an unusual case of an extensive concentric benign stenosis due to CMV colitis and a case of coexistence with Crohn's Disease, both observed in nonimmunosuppressed individuals. The right diagnosis was set after implementation of multiple unsuccessful treatment strategies. Our purpose is therefore to familiarize clinicians involved with the diagnosis and treatment of gastroenterological diseases with this entity.