Introduction: Motility disorders can be an important factor in the occurrence of symptoms of dyspepsia that consequently require evaluation of clinical significance of noninvasive diagnostic approaches when observing patients with functional dyspepsia (FD), gastroesophageal reflux disease (GERD), and Helicobacter pylori-associated diseases of the stomach and duodenum. Aim: To determine the relationship between various motility disorders and to improve the diagnostics and treatment with the use of 13 C-urea (UBT) and 13 C-octanoic breath tests (OBT). Material and methods: A total of 591 patients, aged 18-83 years, who underwent upper gastrointestinal endoscopy at our department were evaluated. Age, sex, and duration of symptoms of dyspepsia were recorded. UBT and OBT were examined in patients with dyspepsia, GERD, and H. pylori-associated diseases. Results: Patients with dyspepsia syndrome had H. pylori infection in 70 ±1.3% of cases. The strategy of "test-and-treat" using UBT can be applied in 76.5% of cases of unexplained dyspepsia in the Ukrainian population. In patients with GERD, slowing down of the gastric emptying (GE) prevails (overall 79.7 ±4.4%), which is a reliable predictor of early relapse of GERD symptoms (OR = 4.9, 2.4-7.0). In the case of H. pylori-associated diseases, the slowing down of GE according to OBT data is a prognostic sign of the return of the symptoms of dyspepsia after successful eradication of H. pylori (OR = 2.1, 1.9-2.3). In H. pylori-associated diseases with a slow GE, recurrence of dyspeptic syndrome after H. pylori-eradication therapy is observed in 33.1% of cases; the appointment of prokinetics reduces this probability to 9.2% (p = 0.0074). Conclusions: Investigations into the clinical use of new facilities of 13 C-breath tests in gastroenterology are shown. The clinical efficacy of urea and octanoic breath tests in FD, GERD, and H. pylori-associated diseases was proven experimentally among patients of the Ukrainian population. New simplified diagnostic and treatment approaches were proposed for certain groups of patients with gastric dyspepsia syndrome, based on the results of the UBT and the OBT.

Introduction: secretion of bacterial bile salt hydrolase (BSH) is one of the main mechanisms by which gut microbiota play role in cholesterol metabolism. There are limiting and controversial data regarding the clear effect of gut BSH activity correction on modification of serum cholesterol and cardiovascular risk (CVR). Aim of investigation was to evaluate the relationship between modification of the gut bacterial BSH relative activity (RA) by probiotic L. plantarum and serum cholesterol with CVR levels. Methods: the study was conducted as open, comparative, randomized, parallel and included 26 almost healthy participants (healthy control group) and 77 patients with dyslipidemia and without anamnesis of major cardiovascular events, that were divided in two groups: main treatment group (n=41) received combination therapy (capsules with Lactobacillus plantarum in the amount of 2*109 CFU one time a day and tablets simvastatin 20 mg one time a day) and control treatment group (n=36) received monotherapy (simvastatin 20 mg one time a day) during 12 weeks. Before and after 12 weeks of treatment the assessment of total RA of gut BSH, lipid profile and CVR level according to 5 risk scores were performed. Results: at baseline the RA of BSH was higher in healthy adults comparing to participants with dyslipidemia (p<0,001); after 12 weeks of treatment there wasn`t difference between healthy control and only main treatment groups (р=0,45). It was found that with increasing of RA of gut bacterial BSH, the risk of failure of treatment efficacy endpoints achievement (³20% reduction of values) decreased regarding: total cholesterol (TC) (p=0,0306), OR=0,00133 (95% CI; 3,28*10-6-0,538); low-density lipoproteins (LDL) (p<0,001), OR=5,65*10-14(95% CI; 6,38*10-20-5*10-8); CVR level according to Framingham score (р=0,0035), OR=4,09*10-5(95% CI; 4,66*10-8-0,0359); CVR level according to 2013 ACC/AHA algorithm (р=0,0135), OR=3,8*10-4(95% CI; 7,34*10-7-0,197); CVR level according to PROCAM score (p=0,00125), OR=8,38*10-6 (95%; CI; 6,93*10-9-0,0101). Conclusions: additional supplementation with BSH-producing bacteria L. plantarum was more effective in increasing of BSH activity compared to simvastatin monotherapy. Increasing of BSH RA by L. plantarum was associated with higher chances to achieve treatment efficacy goals regarding reduction of TC, LDL and CVR levels according to Framingham, 2013 ACC/AHA algorithm and PROCAM scores.