Currently, the problem of early rehabilitation of stroke patients is important, since in terms of the prevalence of cerebrovascular diseases and disability after suffering a stroke, Russia is one of the first places in the world. The complex of medical rehabilitation of such patients should provide for the early and most complete restoration of all body functions, patient education for lost skills, re-socialization of the patient and improvement of the quality of life. One of the factors contributing to a significant reduction in the quality of life after a stroke is the development of chronic constipation. The article reflects the modern methods of correction of chronic constipation in patients with limited mobility.

Currently, patients quite often and often uncontrollably take antibacterial drugs, which leads to the development of various complications from many organs and systems. One of the most common adverse reactions to taking antibiotics is antibiotic-associated diarrhea. Moreover, such a pathological condition is due to both the direct effect of the drug, and a change in the composition of the intestinal microflora. Despite the frequent occurrence of antibiotic-associated diarrhea, this problem raises many questions among practitioners, since the risk factors for its development and methods of prevention have not been fully studied. This is especially important in patients who have undergone surgical interventions, since the combination in this contingent of the appointment of broad-spectrum antibacterial drugs and altered body reactivity in most cases leads to the development of adverse effects.

Currently, there is an increase in the number of patients with irritable bowel syndrome (IBS). However, to date, there is no single concept of the etiopathogenesis of functional disorders of the digestive tract. Initially, great attention was paid to disorders of motility and impaired regulatory interactions of the brain‑intestine as causes of irritable bowel syndrome, but in recent years the focus has shifted to subclinical inflammation in the colon mucosa and the development of visceral hypersensitivity. The reasons contributing to the formation of immune inflammation in the intestinal wall, include a violation of the composition of the intestinal microbiota, as well as food allergies and food intolerance. This article discusses the qualitative and quantitative changes in the intestinal microbiota in patients with irritable bowel syndrome if they have food allergies, as well as the effect of the composition of the intestinal microbiota on the clinical variant of irritable bowel syndrome. The study included 257 patients with IBS. At the first stage, an assessment was made of the history of food allergies, such as IBS, in accordance with the Bristol scale, as well as a microbiological study of feces. At the second stage, the evaluation of intestinal microbiota correction schemes was carried out in patients who had food allergies. The patients were divided into two equal groups, the first group received intestinal antiseptic in combination with multi‑component probiotic, the second — intestinal antiseptic in combination with Saccharomyces boulardii. When analyzing the obtained results, it was noted that approximately half of patients with IBS in the anamnesis had manifestations of food allergy. In most cases, food allergy was associated with the development of patients with IBS variant with diarrhea and excessive growth of conditionally pathogenic microflora with a decrease in the number of lactic and bifidobacteria. When comparing schemes for the correction of disorders of the intestinal microbiota, the greatest efficacy was observed with the combination of intestinal antiseptic and Saccharomyces boulardii.

АннотацияАртериальная гипертония часто сопровождается наличием депрессивных состояний, что способствует формированию функциональных расстройств желудочно-кишечного тракта (ЖКТ). Помимо этого, к развитию последних приводит нерациональное питание и нарушение пищевого поведения, хронические психоэмоциональные перегрузки, постоянное нарушение режима сна и бодрствования, сопутствующий прием медикаментозных препаратов, влияющих на моторику пищеварительного тракта. Терапия таких пациентов требует пристального внимания ввиду высокой распространенности патологии и снижения качества жизни пациентов. В данной работе проведен анализ различных схем терапии функциональных расстройств ЖКТ, а также лечение пациентов при перекресте функциональной патологии в условиях поликлиники. При лечении пациентов учитывалось наличие сопутствующей артериальной гипертонии. Лечение таких пациентов требует назначения нескольких лекарственных препаратов, длительного подбора и коррекции терапии, учета риска лекарственных взаимодействий. При проведении исследования учитывалась динамика клинической симптоматики функциональных расстройств ЖКТ, устойчивость ремиссии, наличие значимых лекарственных взаимодействий при лечении артериальной гипертонии и функциональной патологии, стоимость терапии, приверженность пациентов к терапии. Использование комплексного растительного препарата Иберогаст© для лечения функциональных расстройств ЖКТ в сравнении с монотерапией ингибиторами протонной помпы или прокинетиками является оптимальным вариантом, так как это помогает снизить расходы на лечение, минимизировать время подбора терапии, а также не вызывает развития лекарственного взаимодействия в случае наличия коморбидной патологии и способствует сохранению стойкой ремиссии после отмены препарата.

The pandemic of a new coronavirus infection in recent years has led to more frequent and aggressive prescription of antibiotic therapy, which could not but affect the intestinal microbiota. In addition, the direct effect of coronavirus on enterocytes leads to the development of subclinical inflammation in the intestinal wall, contributing to the disruption of the qualitative and quantitative composition of the normal intestinal microflora. Against this background, the number of patients with antibiotic-associated diarrhea, including diarrhea caused by C. difficile, including severe ones. Moreover, the number of clostridial diarrhea resistant to classical vancomycin therapy has increased, which dictates the need to find new ways to treat patients and methods for further prevention of such conditions.