А. В. Васютин

Bio: А. В. Васютин is an academic researcher. The author has co-authored 1 publications.

Современные аспекты ведения пациентов с синдромом раздраженного кишечника

Abstract: A review of modern data from the study of functional disorders of the digestive tract is performed. In the United States, 4 million people with functional bowel disorders seek medical care annually, and the annual cost of managing these patients is $ 358 million. Due to the urgency of the problem, new developments appear, among which it is necessary to highlight the American College of Gastroenterology (ACG) guidelines for the management of patients with IBS. To examine patients with suspected IBS, the authors of the ACG guideline proposed a positive diagnostic strategy, which is based on a careful study of the anamnesis, focusing on the key symptoms of the relationship between abdominal pain and bowel function during a long course of the disease (more than 6 months) and the absence of alarming symptoms with minimal use of instrumental diagnostic tests. For the diagnosis of IBS, the authors recommended serological testing for celiac disease, determination of fecal calprotectin and C-reactive protein to exclude inflammatory bowel diseases, but they did not consider it necessary to routinely analyze stool for intestinal pathogens. From our point of view, the absence of routine stool analysis for intestinal pathogens is completely inapplicable for Russia, since in our country the frequency of detection of diphyllobothriasis, giardiasis and opisthorchiasis is very high. The ACG consensus drew attention to the need to expand the evidence base for the use of some standard drugs for the treatment of IBS, proposed a number of new drugs (lebiprostone, linaclotide), recommended the use of rifaximin (for the treatment of IBS with a predominance of diarrhea) and tricyclic antidepressants (for the treatment of IBS). Analysis of modern international recommendations suggests that the clinical guidelines of the Russian Gastroenterological Association and the Association of Coloproctologists of Russia for the diagnosis and treatment of IBS are currently the main document governing the management of these patients in our country.

Computer electroacupuncture for irritable bowel syndrome: efficacy and search for efficacy predictors

Abstract: Non-pharmacological treatment modalities, in particular, a new technique in reflexology – computerized electroacupuncture (CEAP), allow us to increase the efficacy while treating patients with irritable bowel syndrome (IBS). Search for predictors of CEAP efficacy in IBS will optimize the choice of patients for treatment, improving the CEAP efficacy profile. The aim of the study is to evaluate CEAP efficacy in the complex therapy of various clinical IBS forms. Materials and Methods. The study involved 80 IBS patients. Patients of the main group underwent three courses of CEAP in addition to standard pharmacological therapy, patients of the reference group received only pharmacotherapy. At the beginning and at the end of each CEAP course, the severity of pain syndrome (visual analogue scale), stool frequency, stool consistency (Bristol stool scale), and subjective state indicators (Zung Self-Rating Depression Scale, Spielberger-Khanin test) were assessed. A retrospective analysis of the research results was carried out to search for predictors of CEAP efficacy. The impact of such parameters as patient’s gender, age, disease form and severity on treatment outcome was assessed. Results. After the first CEAP, the severity of abdominal pain in patients of the main group decreased from 6.1 mm to 3.9 mm and after the third CEAP to 3.7 mm. After three courses of CEAP, defecation frequency in IBS patients with diarrhea decreased from 4.7 to 1.9 per day, and in IBS patients with constipation increased from 0.26 to 0.77 per day. The proportion of patients with normal stool consistency increased significantly both among patients with constipation and among those with diarrhea to 47.1 and 55.6 %, respectively. Retrospective analysis showed the best treatment results in patients with mild and moderate IBS.