Aim of review: To analyze current publications devoted to controversial issues of pathogenesis, diagnosis and differential diagnosis of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) in remission with IBS-like symptoms. Key points: There are three main hypotheses discussed in the literature: 1) IBS as a prodrome, pre-stage of the IBD; 2) IBS and IBD are different variants of inflammatory disorder which is common to both diseases; 3) The onset of IBS-like symptoms in IBD patients in remission. Conclusion: It is shown that modern literature data on this issue is contradictory and ambiguous.

Aim.To study the whole range of esophageal disorders in patients with irritable bowel syndrome (IBS) using high-tech methods. Materials and methods.102 IBS patients (47 males, mean age 40.8, diagnosis of IBS was established according to Rome III criteria) with esophageal symptoms (heartburn, belching, globus sensation and noncardiac chest pain) were examined in gastroenterology department. All patients underwent endoscopy, with biopsies if required, X-ray examination of upper gastrointestinal tract; 24-hour pH-impedance monitoring;13C-urea breath test. Evaluation of esophageal symptoms was carried out on the basis of Rome IV criteria. Results.21 (20.6%) individuals had esophagitis (ERD). According to 24-hour pH-monitoring data, 7 of them had overlap between GERD and functional esophageal disorders (FED). 27 (26.5%) individuals had nonerosive reflux disease (NERD). In 54 (52.9%) individuals endoscopy and pH-impedance monitoring data did not differ from normal, suggesting this group as group of patients with FED. There was no significant difference for age, sex and IBS subtypes in GERD, NERD and FED groups. Conclusion.Comorbid esophageal disorders in patients with IBS are different and represented by organic diseases, FED and overlap between them. Methods such as 24-h pH-impedance measurement and esophageal manometry should be used to assess comorbid esophageal disorders in IBS patients.

Objective. To conduct a comparative analysis of the emotional and personality characteristics ofpatients with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) in remission with IBS-like symptoms. Patients and methods. This study carried out based at a specialized gastroenterology clinic in the period from 2010 to 2015 included 125 patients with IBS (IBS-D - 46, IBS-C - 20, IBS-M - 59) and 37 patients with IBD in remission: Crohn's disease (CD) - 11 and ulcerative colitis (UC) -26 patients. The levels of depression (Beck questionnaire), urgent and personal anxiety (Spielberger questionnaire), the degree of alexithymia (Toronto scale) as well as the severity of psychopathology and behavioral symptoms (PBS) were estimated. Results. Patients with IBS were not significantly different from those with IBD in remission with IBS-like symptoms in terms of depression, actual anxiety, alexithymia and PBS. Only the index of personal anxiety was significantly higher in the group of patients with IBS compared with IBD in remission with IBS-like symptoms (p = 0.0376). Men with IBS exhibited significantly higher actual anxiety than men with IBD (p = 0.04). Maximum severity of depression, anxiety and alexithymia was documented in the locking version of IBS (IBS-C) in comparison with other variants of IBS (p <0.05). Patients with CD in remission are characterized by higher rates of depression and alexithymia compared to UC (p <0.05). Behavioural disorders are most pronounced in the diarrheal variant of IBS and CD. Conclusion. A higher personal anxiety was observed in patients with IBS compared to those in remission of IBD with IBS-like symptoms although other parameters were not significantly different. Patients with IBS-C were characterized by more pronounced manifestations of emotional and personality disorders. More severe emotional and behavioral disorders distinguish CD from UC.

На приеме невролога более 30% больных предъявля-ют жалобы соматического характера, которые невозмож-но объяснить каким-либо органическим заболеванием [1,2]. Так, диагноз «головная боль напряжения» (ГБН) по частоте занимает второе место среди 20 наиболее частых диагнозов, устанавливаемых неврологом [3]. На специа-лизированном отоневрологическом приеме диагноз «не-вестибулярное головокружение» занимает второе место после «доброкачественного пароксизмального позицион-ного головокружения» (ДППГ) [4]. Достаточно сказать, что распространенность синдрома раздраженного кишеч-ника (СРК), по разным данным, достигает в популяции 10-20% [5], число пациентов с функциональными рас-стройствами желудочно-кишечного тракта (ЖКТ) в спе-циализированном гастроэнтерологическом стационаре составляет около 45% [6], а СРК -23% [7]. Подобные данные можно привести и в отношении других клиниче-ских функциональных синдромов, в частности синдрома хронической усталости (СХУ), гипервентиляционного синдрома, некардиальных болей в грудной клетке, интер-ситициального цистита, небактериального простатита и др. © Коллектив авторов, 2016*e-mail: gdiukova@gmail.com Functional disorders hold a prominent place in the clinical practice of physicians of different specialties. the difficulties in the diagnosis of functional disorders need expensive examinations, and standard treatment is, as a rule, is not effective. Currently, the pathogenesis of these disorders is considered in the frames of the biopsychosocial model. in this literature review, the authors present modern concepts of terminology, classification, main features and general trends of the course of functional disorders. Special attention is drawn to comorbidity, a role of psychogenic factors and cerebral mechanisms of the pathogenesis including cognitive aspects. Keywords: functional disorders, psychogenic factors, pathogenesisНиже представлены функциональные симптомы, встречающиеся на приеме у врачей разных специально-стей: гастроэнтерология -СРК, неязвенная диспепсия; ревматология -фибромиалгия; кардиология -некарди-альные боли в грудной клетке; пульмонология -гипер-вентиляционный синдром; инфекционные заболевания -СХУ; неврология -ГБН, боли в спине, функциональное головокружение, психогенные припадки, парезы, дизба-зия и др.; стоматология -атипичные лицевые боли; ЛОР-заболевания -ощущение «кома в горле»; аллергология -множественная химическая сенситивность (псевдоалер-гия); уро-гинекология -интерситициальный цистит, не-бактериальный простатит, хронические тазовые боли, предменструальный синдром.В клинической картине вышеперечисленных заболе-ваний доминируют хронические болевые синдромы и раз-нообразные субъективные ощущения (головокружение, нехватка воздуха, утомляемость, «ком в горле»). Наряду с субъективными симптомами обнаруживаются и объек-тивно регистрируемые нарушения (изменения частоты и характера стула, тахикардия, подъемы АД, изменения паттерна дыхания, отечность, признаки неспецифическо-

The article reports a case of atypical picture of a combination ofperiodic disease and irritable bowel syndrome in a 52 year old patient.