Celiac disease (CD) is an autoimmune enteropathy triggered by the ingestion of dietary gluten from some cereals mainly in individuals carrying the HLA-DQ2 and/or HLA-DQ8 haplotypes. As an autoimmune disease, CD is manifested in the small intestine in the form of a progressive and reversible inflammatory lesion due to immune response to self-antigens. Indeed, CD is one of the most challenging medicosocial problems in current gastroenterology. At present, the global CD prevalence is estimated at approximately 1% based on data sent from different locations and available CD screening strategies used. However, it is impossible to estimate global CD prevalence without all the data from the world, including Russia. In this review, we summarize the data on the incidence and prevalence of CD across geographically distinct regions of Russia, which are mostly present in local Russian scientific sources. Our conclusion is that the situation of CD prevalence in Russia is higher than is commonly believed and follows global tendencies that correspond to the epidemiologic situation in Europe, America, and Southwest Asia.
Coeliac disease (CD) is an autoimmune enteropathy triggered by the ingestion of gluten-containing grains in genetically predisposed individuals. Identification of CD in clinical practice is often difficult due to the manifestation of non-specific symptoms and signs, so a relatively significant proportion of CD cases remain undiagnosed. Timely detection of the disease is necessary to provide an appropriate approach to control of the disease treatment, in order to avoid potential complications. This is even more important in the case of children and adolescents, to ensure their proper growth and development. In this review, we discuss the data on the current strategies for CD detection among paediatric populations and the role of questionnaire-based discovery of CD cases in the area of interest. We assume that mass screening is a preferable strategy for finding CD cases within the paediatric population because this could uncover symptomatic, oligosymptomatic, and asymptomatic CD cases. However, under conditions of limited financial resources, screening for CD in risk groups, members of which can be identified using questionnaires, is essential. The pros and cons of CD screening in paediatric populations are presented. These depend on a number of situational criteria (cost-effectiveness, lack of awareness), but screening is designed to improve the detection of the disease and therefore improve the quality of life of patients.
Клинические рекомендации по диагностике и лечению функциональных нарушений органов пищеварения у детей подготовлены группой экспертов, ведущих отечественных специалистов в области детской гастроэнтерологии, которые обобщили зарубежные рекомендации и отечественный опыт, предложив тактику действий врача-педиатра в условиях повседневной практики. Во второй части рекомендаций обсуждаются функциональные нарушения, сопровождающиеся абдоминальной болью: функциональная тошнота и рвота, функциональная диспепсия, синдром раздраженного кишечника, функциональная абдоминальная боль. Уточнены определения, классификация и критерии диагностики функциональной диспепсии и синдрома раздраженного кишечника с позиции современных представлений. Кроме того, определены актуальные принципы терапии. Диагнозы функциональной тошноты и рвотаы, а также функциональной абдоминальной боли редко устанавливаются в отечественной педиатрической практике, в связи с чем представленная подробная информация об этих заболеваниях имеет особое значение для практического врача.
The clinical guidelines for the diagnosis and treatment of the3 functional disorders of the digestive system in children were prepared by a Group of Experts, domestic leading specialists in the field of the pediatric gastroenterology, who generalized the foreign guidelines and domestic experience, suggesting the tactics for the pediatrician actions in the everyday practice. Part 3 of the Guidelines discusses the billiard tract dysfunctions and functional constipations. There are no biliary tract dysfunctions in the Pediatric Sections of Rome Consensus IV; however, the Russian pediatric school of thought has always considered them as important in terms of one of the causes for abdominal pain in children. This attitude was supported by the experts, and it is maintained in these Guidelines. The functional constipations are common in the children of different ages, and they present not only a medical problem, but also a serious social one for both children and their parents. That is why the considerable attention has been paid to this pathology considering the psychosocial aspects of the correction.
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