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Introduction. Statistical data indicate a frequent combination of functional biliary disorders with non-alcoholic fatty liver disease.Aim. To study the efficacy and safety of Phosphogliv® URSO in patients with functional disorders of the gall-bladder, biliary sludge in combination with fatty hepatosis in comparison with the group receiving monotherapy ursodeoxycholic acid (UDCA).Materials and methods. The study included 30 patients with a diagnosis of functional gall-bladder disorder, biliary sludge in combination with non-alcoholic fatty liver disease. Patients of the main group received monotherapy with Phosphogliv® URSO. The comparison group received monotherapy UDCA. After three-month therapy, the dynamics of clinical symptoms, laboratory parameters, and ultrasound parameters were assessed.Results. Positive dynamics of clinical manifestations of functional disorders of the gallbladder, as well as parameters of cholestatic syndrome and bilirubin level was observed in both groups. In patients taking Phosphogliv® URSO, a significant decrease in cytolysis syndrome indicators was recorded, a significant difference was revealed in relation to an increase in HDL levels and a decrease in the atherogenic coefficient in the main group. When assessing the ultrasound parameters of the gall-bladder in patients of group 1, a significant decrease in the thickness of its wall, reverse development of biliary sludge, an improvement in the contractile function of the gall-bladder in comparison with the UDCA monotherapy group were revealed.Conclusion. The use of a combined medicine containing glycyrrhizic acid and UDCA (Phosphogliv® URSO) can be recommended for patients with functional disorders of the gallbladder, biliary sludge and non-alcoholic fatty liver disease, given its more pronounced anticytolytic effect, restoration of functional disorders of the gallbladder and resolution of biliary sludge in comparison with monotherapy UDCA.

Introduction. The prevalence of functional biliary disorders continues to increase with insufficient effectiveness of existing treatment approaches. Among them, functional biliary disorders of sphincter of Oddi account for at least 50%.Objective. To study efficacy, safety and tolerability of a fixed combination of glycyrrhizic acid and ursodeoxycholic acid (Fosfogliv Urso) in capsule form in patients with functional biliary disorders of sphincter of Oddi.Materials and Methods. The study included 32 patients diagnosed with functional biliary sphincter of Oddi disorders established according to the Rome Criteria IV revision (2016). Patients received Fosfogliv Urso (250 mg ursodeoxycholic acid and 35 mg glycyrrhizic acid) 1 capsule 3 times a day for 8 weeks. Prior to treatment, all study participants underwent a standard set of laboratory and instrumental examinations.Results. Against the background of Fosfogliv Urso treatment, statistically significant decrease of biliary pain prevalence up to 48.3% (p < 0.001); intense biliary pain up to 11.4% (p < 0.0001); intensity of pain syndrome on visual analogue scale down to 1.7 ± 0.9 cm was registered (p < 0.0001). Alanine aminotransferase activity significantly decreased to 34.0 ± 4.0 U/L (p < 0.001). There was a tendency of choledochal diameter decrease to 0.57 ± 0.01 cm. Treatment efficacy was rated by patients as very good and good in 83.4% of cases. The safety profile was assessed as favorable and tolerability as satisfactory.Discussion. The results obtained were superior to those previously obtained for ursodeoxycholic acid monotherapy and confirmed the data of the previously conducted phase III study. The rationality of the combination is due to the mutual complementation and possible synergism of the pharmacological effects of glycyrrhizinic and ursodeoxycholic acids.Conclusion. The results obtained allow to recommend the prescription of Fosfogliv Urso in the complex scheme of treatment and prophylaxis of functional biliary disorders of sphincter of Oddi.

Aim: to review the common risk factors and links in the pathogenesis of functional gastrointestinal disorders (FGID) to optimize therapy of patients with a combination of multiple FGID.Key points. FGID occurs in more than 40 % of people globally, mainly affecting the working-age population in young and middle-aged subjects. At the same time, more than 30 % of patients have a combination of 2 or more functional gastrointestinal (GI) disorders i.e. overlap syndrome. Common links in the pathogenesis of FGID include disorders of gut-brain interaction, visceral hypersensitivity, changes in intestinal microbiota, overproduction of proinflammatory cytokines, impaired epithelial permeability and motor activity of the gastrointestinal tract. The combination of FGID in various gastrointestinal segments is associated with more pronounced clinical symptoms (mutual burden syndrome). Common risk factors and pathogenetic links of the functional disorders enables reducing the number of prescribed medications when several FGIDs overlap in one patient, which also increases adherence to therapy. Treatment of FGID includes adjustment of risk factors and drug therapy. As a pathogenetically justified pharmacotherapy of overlap syndrome, Kolofort, highly diluted antibodies to TNF-α, histamine and brain-specific protein S-100, is of interest.Conclusion. Kolofort has demonstrated high efficacy and safety including among patients with overlap FGID enabling to consider it as the treatment of choice in these patients.