Diagnostics and treatment of exocrine pancreatic insufficiency: clinical guidelines of the Russian gastroenterological Association

Ивашкин, В. Т.; Маев, И. В.; Okhlobystin, Alexey; Алексеенко, С. А.; Белобородова, Е. В.; Кучерявый, Ю. А.; Лапина, Т. Л.; Трухманов, А. С.; Хлынов, И. Б.; Чикунова, М. В.; Шептулин, А. А.; Шифрин, О. С.

doi:10.22416/1382-4376-2017-27-2-54-80

Cited by 7 publications

(4 citation statements)

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“…До и после основного этапа лечения оценивали качество жизни больных с использованием опросника SF-36 с учетом особенностей этой шкалы при ХП [21].…”

Section: материалы и методыunclassified

Dynamics of clinical manifestations, functional state and structural changes of the pancreas, quality of life of patients with chronic pancreatitis in combination with chronic obstructive pulmonary disease under the influence of eradication of the syndrome of excessive bacterial growth in the small intestine

Е.

Zakomoldina²,

Лукашевич

et al. 2023

jour

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The lack of efficiency in the diagnosis and treatment of chronic pancreatitis (CP) is associated with a number of objective and subjective reasons, one of which is insufficient knowledge about the pathogenesis of the disease, especially when it is combined with other internal diseases, in particular, with chronic obstructive pulmonary disease (COPD). The frequent combination of COPD and CP is associated not only with the frequency of these diseases, but also with the common links of pathogenesis, and a significant place in the pathogenesis of both diseases is occupied by the syndrome of excessive bacterial growth in the small intestine (SIBO). Aim: to increase the effectiveness of the treatment of CP in combination with COPD based on the inclusion of rifaximin and probiotic Subalin in the complex therapy of concomitant diseases. Materials and methods. We examined 128 patients with CP in the stage of exacerbation in combination with COPD in the stage of mild exacerbation, which were divided into two groups: the main group and the comparison group. The basic treatment of CP was carried out according to the clinical recommendations of the Russian Gastroenterological Association. Patients of the main group, in addition to basic therapy, received rifaximin (Alfa Normix) for 10 days, and then Subalin-forte for 2 weeks. Patients in the comparison group received only basic therapy. Results. Due to the treatment with the inclusion of rifaximin and Subalin, there is a significant suppression of the phenomenon of “evasion” of the pancreatic-specific enzyme into the blood, an improvement in the exocrine function of the pancreas according to the results of the fecal elastase test and the response of the pancreas to food intake according to the dynamics of uroamylase flow rates and endogenous pancreozymin induction coefficients. Under the influence of the main treatment option, there is an increase in the frequency of normalization of the echogenicity of the pancreas and less often than with traditional therapy, an increase in the pancreas or part of it, blurring and unevenness of the contours persist. In addition, the indicators of ultrasonic histography of the pancreas are significantly improved, and a more pronounced positive dynamics of the clinical manifestations of COPD is observed. Thus, the eradication of SIBO provides a significant increase in the effectiveness of the treatment of patients with a combination of CP and COPD.

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Section: материалы и методыunclassified

Dynamics of clinical manifestations, functional state and structural changes of the pancreas, quality of life of patients with chronic pancreatitis in combination with chronic obstructive pulmonary disease under the influence of eradication of the syndrome of excessive bacterial growth in the small intestine

Е.

Zakomoldina²,

Лукашевич

et al. 2023

jour

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“…Современные представления по диагностике и лечению хронического панкреатита отражены в международных и национальных, в том числе и российских (РГА, НОГР, «Профессиональное медицинское сообщество «Панкреатологический клуб»), рекомендациях [279,286,287,288,289,290], основанных на принципах доказательной медицины.…”

Section: диагностикаunclassified

“…Возможно проведение лечения полиферментными препаратами в виде микротаблеток/ минимикросфер по 25000-50000 ЕД во время приема пищи с антисекреторными препаратами (фамотидин 40 мг 2 раза/сут., ИПП -омепразол 20-40 мг/сут., рабепразол -20 мг/сут.) [279,289]. В положениях Российского консенсуса панкреатические ферменты не рекомендуют к использованию с целью облегчения боли, связанной с ХП [287].…”

Section: диагностикаunclassified

“…Для купирования проявлений внешнесекреторной недостаточности [289] рекомендуется дробный прием пищи с соблюдением диетических ограничений, достаточным содержанием белков и углеводов (степень ограничения жиров зависит от тяжести мальабсорбции и эффективности заместительной ферментной терапии). Необходимо назначать заместительную ферментную терапию: микротаблетки и минимикросферы, покрытые кишечнорастворимой оболочкой более эффективны: рекомендуемая минимальная доза составляет 25000-50000 единиц липазы на основной прием пищи и 10000-25000 единиц липазы -на промежуточный прием пищи, следует тщательно подбирать адекватную дозу.…”

Section: диагностикаunclassified

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Management of patients with digestive diseases during the COVID-19 pandemic. Clinical Practice Guidelines by the Russian scientiﬁc medical society of internal medicine (RSMSIM) and the Gastroenterological Scientiﬁc Society of Russia (2nd edition)

Гриневич

Kravchuk

Педь

et al. 2021

jour

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The presented clinical practice guidelines of the Gastroenterological Scientiﬁc Society of Russia (GSSR), diagnostic, and therapeutic approaches for patients with digestive diseases during the COVID-19 pandemic. The guidelines were approved by the XXIII Congress of the GSSR and the 22nd International Slavonic-Baltic Scientiﬁ c Forum “St. Petersburg - Gastro-2020 ON-LINE” (St. Petersburg, June 11, 2020). The presented clinical practice guidelines of the Russian Scientiﬁc Medical Society of Internal Medicine (RSMSIM) and the Gastroenterological Scientiﬁc Society of Russia (GSSR), diagnostic, and therapeutic approaches for patients with digestive diseases during the COVID-19 pandemic. The recommendations were approved at the XV National Congress of Internal Medicine, XXIII Congress of NOGR on the basis of the 1st edition, adopted at the 22nd International Slavic- Baltic Scientiﬁc Forum “St. Petersburg - Gastro-2020 ON-LINE”.

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Duodenum-preserving total pancreatoduodenectomy with segmental duodenectomy vs pylorus-preserving pancreaticoduodenectomy for chronic pancreatitis with duodenal dystrophy: Retrospective study

Baydarova,

Kiseleva,

Tupikin

et al. 2024

Current Problems in Surgery

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Diagnostics and treatment of exocrine pancreatic insufficiency: clinical guidelines of the Russian gastroenterological Association

Cited by 7 publications

References 0 publications

Management of patients with digestive diseases during the COVID-19 pandemic. Clinical Practice Guidelines by the Russian scientiﬁc medical society of internal medicine (RSMSIM) and the Gastroenterological Scientiﬁc Society of Russia (2nd edition)

Duodenum-preserving total pancreatoduodenectomy with segmental duodenectomy vs pylorus-preserving pancreaticoduodenectomy for chronic pancreatitis with duodenal dystrophy: Retrospective study

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