Inflammatory bowel diseases (IBD) are immune-mediated diseases and usually manifest at a young age. They are requires in a long-term treatment or surgery with a high probability of surgical intervention. IBDs are accompanied by a decrease in working capacity, impaired quality of life and social disadaptation. However, timely diagnosis with using modern diagnostic methods, the use of evidence-based immunosuppressive and biological therapy significantly changed the pathomorphosis of this disease. But despite the achievements of the pharmacotherapy, the incidence and prevalence of IBD are still increasing, a demand for surgery remains both for Crohn`s disease and ulcerative colitis throughout all the period of illness. At the same time there is a trend towards the variability of symptoms, mismatch of the clinical symptoms with the real severity of inflammation, increase of a number of patients with extraintestinal manifestations and resistance to induction and maintenance therapies. In addition to this, the observation of this group of patients is complicated due to the difficulty of the early diagnosis and differential analysis of IBD, the need of early induction treatment according to the guidelines and the lack of adherence to the therapy.

Treatment of inflammatory bowel diseases IBD (Crohns disease, ulcerative colitis) is aimed at achieving clinical, endoscopic and histological remission, minimizing surgical complications, and ensuring a normal quality of life. However, the use of medical treatment is potentially associated with various adverse events, among which infectious complications, malignant neoplasms, as well as myelotoxicity, hepatotoxicity, skin lesions and others. The risk of side effects depends on the type of drug therapy (5-aminosalicylates, thiopurines, biologicals, etc.), the duration of treatment, the presence of extra-intestinal manifestations, etc. The article provides an overview of data on both the effectiveness and frequency of various side effects of the main classes of drugs in IBD, presents methods of investigation which can predict the effectiveness and development of side effects, the implementation of which can be considered as a variant of personalized therapy in IBD.

Non-alcoholic fatty liver disease (NAFLD) being increasingly diagnosed worldwide is considered as the most common liver disease in Western countries. The incidence is growing rapidly due to the continuing epidemic of the obesity and diabetes mellitus type 2. There is the extremely topical question of the affordable, effective and early diagnosis of NAFLD. Over the past few years, significant progress has been made in the understanding of its risk factors, pathogenesis, clinical course, methods of diagnosis and treatment of NAFLD. The article gives an overview of modern and promising methods for diagnosing NAFLD, useful for physicians of various specialties who have to deal with NAFLD patients. Key problems of diagnostics are formulated and directions for further research are determined. There is discussed the role of biomarkers as promising noninvasive diagnostic methods, that provides to assess the severity of necrotic inflammatory processes and liver fibrosis in NAFLD patients.

Liver cirrhosis (LC) takes the main place in the structure of the pathology of the digestive system in terms of the frequency of mortality, as well as in the development of fatal and poorly controlled complications, which requires the search for effective methods for preventing the progression of the disease and the development of complications. The article provides updated information on the role of the intestinal microbiota, as well as endotoxemia and increased intestinal permeability syndromes in the pathophysiology of LC and its complications. The results of recent meta-analyses of the impact of dysbiotic disorders on the prognosis of the LC and the options for their correction are presented. Understanding of the significance of involvement of gut microbiota in the pathogenesis of LC has become one of the levers of management of the risks of complications of LC. In this case, the livergut axis can be considered to be the leading link to the formation of most of the main complications of LC.

Diagnosis of liver disease in particular non-alcoholic fatty liver disease (NAFLD) is largely determined by methods that are informative, safe, non-invasive, highly sensitive and can be used in all patients without exception. One of these methods is gas chromatography-mass spectrometry (GC-MS). Our study presents the results of serum metabolome assessment by the GC-MS method in male patients for the diagnosis of NAFLD at the stage of non-alcoholic steatohepatitis. In serum samples obtained from 25 patients, 319 compounds were identified, among them 109 were annotated. In patients with NAFLD, there was a significant increase in indole carboxylic and fatty acids, hypoxanthine, hydroxycarboxylic and phenylcarboxylic acids. The results of the study showed that low-molecular metabolites in particular reduced levels of 4-hydroxybutyric acid and 360 compounds suggests possible influence of metabolites on the pathogenesis of NAFLD, and an elevated level of sugar alcohol suggests a possible damaging effect on liver cells. For the detected compounds 4-hydroxybutyric acid, compound-360 and sugar alcohol, high specificity and sensitivity values, high confidence intervals and AUC values were shown, which indicates the possibility of using mass spectrometry analysis of plasma metabolome at high levels of steatohepatitis with high degree of reliability and probability.