The paper presents algorithms for adult outpatient care of coronavirus disease 2019 (COVID-19) and its assumption.

Study goal: Identify clinically significant stigmas of reduced esophageal mucosal resistance.Materials and methods: The study included 181 patients aged 18–70 years with gastroesophageal refl ux disease (GERD).Complaints, age, sex, history of the disease, life history, physical examination data, results of laboratory and instrumental examinations, data on medication intake at the time of enrollment of the patient for the main disease and concomitant pathology were noted in the individual registration card (IRC).Results: The study demonstrated the presence of features suggesting with a higher degree of probability a reduced esophageal mucosal resistance in a certain group of patients with GERD. Individuals with early- onset GERD, males, young adults, smokers, and individuals with a high body mass index (BMI) have a higher risk of esophageal mucosal erosions. The presence of esophageal hernia of the diaphragm (EVD), intake of acetylsalicylic acid (ASA), calcium channel blockers (CCBs), or nonsteroidal anti-inflammatory drugs (NSAIDs) are factors that reduce esophageal mucosal resistance. The formation of erosive esophagitis is not associated with the subjective perception of GERD symptoms and does not affect the patient’s complaints.Conclusion: Clinical manifestations of GERD are not associated with the degree of esophageal mucosal damage and cannot be a phenotypic sign of erosive esophagitis requiring mandatory prescription of an esophagoprotector. Clinically significant stigmas of decreased esophageal mucosal resistance were revealed. The need in research of expediency and efficacy of prescription of esophagoprotector in patients with GERD, having GVHD or regularly taking BCA, ASA and other NSAIDs, including obligatory estimation of therapy effi cacy taking into account patient gender and age, has been established.

A characteristic feature of inflammatory bowel diseases (IBD) is an increased risk of neoplasia and colorectal cancer (CRC). The introduction of screening programs, as well as modern advances in therapy and endoscopic technologies, awareness of the risk factors of IBD-associated CRC will contribute to reducing the frequency of this dangerous complication of IBD. The presented review describes epidemiological data on the incidence of IBD-associated CRC, established risk factors for CRC, as well as modern methods of prevention, screening and early diagnosis. Literature search was conducted in PubMed and Google Scholar systems by keywords: inflammatory bowel diseases, ulcerative colitis, Crohn’s disease, colorectal cancer, risk factors, screening, endoscopy, dysplasia.

To optimize non-drug methods of treatment of patients with irritable bowel syndrome (IBS) against the background of obesity to identify the peculiarities of food preferences and permeability of the intestinal wall.Materials and methods: An anonymous questionnaire survey of 52 IBS patients was carried out using the author’s set of dietary assessment questions “Nutrition Information and Food Behavior” developed at the Department of Hygiene, Human Nutrition of Omsk State Medical University. The study of the level of zonulin in the feces was carried out at the Central Research Laboratory of the Federal State Budgetary Educational Institution of Higher Professional Education Omsk State Medical University of the Ministry of Health of Russia by enzyme immunoassay using the IDK Zonulin ELISA test system (Immundiagnostik, Germany).Results: The eating habits of IBS patients with BMI ≥25 kg/m2 diff er from those of normal weight patients and can be considered a component of the phenotype of this patient cohort. IBS patients with BMI ≥25 kg/m2 have a higher level of intestinal permeability as assessed by zonulin content in feces.

Gastroesophageal reflux disease (GERD) is the most common of all acid-related diseases, it is recognized as the leading cause of esophageal adenocarcinoma. The natural factor of protection against aggressive refluxate components is the integrity of the esophageal mucosa, which performs a barrier function with the participation of a number of mechanical, chemical and immunological mechanisms. Their damage under the regular influence of acidic or mixed reflux causes the development of the pathological process. The review was prepared to systematize knowledge of the main components of mucosal barrier of the esophagus providing resistance of mucosa under conditions of GERD. The literature was searched in Embase, PubMed, and Google Scholar using the keywords: gastroesophageal reflux disease, mucosal protection, esophageal mucosa epithelium, dense contact proteins, epithelial protection, esophagoprotection. The main structural and functional components of esophageal mucosal protection were emphasized