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The pathogenesis of irritable bowel syndrome (IBS) has not been clearly understood. Numerous factors, including neurotransmitters, can interfere with the functions of the digestive tract.The aim of present study was to determine the secretion and metabolism of serotonin in patients with unclassified irritable bowel syndrome (IBS-U).The study included 50 healthy subjects (Controls) and 50 patients with IBS-U, diagnosed according to Rome IV Criteria of functional gastrointestinal disorders. The severity of gastrointestinal symptoms was assessed using the Gastrointestinal Symptom Rating Scale (GSRS- IBS). The quality of sleep was estimated by Insomnia Severity Index (ISI). The serum serotonin and melatonin levels and 5-hydroxyindoleacetic acid (5-HIAA) and 6-sulfatoxymelatonin (aMT6s) concentration in urine were determined with ELISA method.Compared to control group, patients with IBS-U had a higher serum levels (201.3 ± 37.8 vs 145.4 ± 36.9 ng/ml, p0.001) and lower levels of melatonin (5.86 ± 1,16 vs9.11 ±2.43 pg/ml, p0.001). Likewise, in IBS-U patients urinary excretion of 5-HIAA was greater, while aMT6s excretion was lower. Due to the above changes cyproheptadine (6 mg daily) or melatonin (7 mg daily) was recommended to be taken. After 12 weeks of taking cyproheptadine, the IBS symptoms disappeared in 86.6% patients, and in 20.0% of those taking melatonin. Both drugs improved sleep in equal measure.Increased serotonin secretion may be the cause of abdominal complaints in unclassified irritable bowel syndrome, what should be considered in its treatment.

The causes of functional abdominal pain are still unclear. The role of food factors in their pathogenesis has been assessed by many researches, but the obtained results are varied.The aim of present study was to evaluate metabolism of tryptophan, which is substrate for serotonin synthesis and other bioactive compounds, in patients with recurrent functional abdominal pain.Thirty patients with recurrent abdominal pain and 30 healthy subjects were enrolled in this study. Urinary levels of tryptophan (TRP), 5-hydroxyindoleacetic acid(5-HIAA), L-kynurenine (KYN), xanthurenic acid(XA), and quinolinic acid(QA) were determined by liquid chromatography with tandem mass spectrometry (LC-MS/MS), and related to creatinine level (mg/gCr), during active phase(day with acute pain), and silence period, which recommended optimalisation of tryptophan intake.5-HIAA/TRP ratio and KYN/TRP ratio as well as QA level s were significantly higher in patients compared to control group (p0.001). After reducing TRP consumption, the above results improved, in particular, the level of QA decreased from 6.88±1.04 mg/Cr to 4,32±0.97 mg/gCr (p0.001).Altered tryptophan metabolism may affect locally-andcentrally mediated recurrent functional abdominal pain.

Small intestinal bacterial overgrowth (SIBO) is a frequent cause of chronic abdominal complaints. So far, a lot information has been gathered on its pathogenesis but are still doubts that raise question why its causes chronic diarrhea in some and constipation in other patients.The aim of the study was to assess the number of endothelial lymphocytes (IELs) in the duodenal and ileum mucosa in patients with SIBO with dominant diarrhea (SIBO-D) and dominant constipation (SIBO-C).The study was performed in 30 healthy patients (group I) and 40 patients with SIBO and diarrhoea (group II), and in 4o patients with constipation (group III). To diagnose SIBO the lactulose hydrogen breath test (LHBT) was performed. To determine the number of intraepithelial lymphocytes in duodenal and jejunal mucosa the histological assessment was performed using haematoxylin-eosin staining. Moreover, immunochistochemical method was used to assess the number of enterochromatoffin cells (EC, chromogranin A - LK-2H10) in these some parts of the gut.The results of LHBT were similar in group II and III - 75,6±18,1 ppm and 66,9±16,2 ppm(p0,05). The number of IELs in duodenal mucosa in controls was 14,6±4,1/100 EN, in group II - 28,3±6,8/100 EN (p0.01), and in group III - 23,0±9,9/100 EN (p0,05), and similar differences were in jejunal mucosa. The number of EC in both parts of the gut was higher in SIBO compared to controls. Furthermore, in patients with SIBO-D the number of IELs in duodenum, as well as in jejunum, was positively correlated with the number of EC cells ( p0,05, p=0,056, respectively).In patients with SIBO, particularly with SIBO-D, increased number of IELs I EC cells may be a cause of diverse abdominal symptoms.

The pathogenesis of functional dyspepsia is remains unknown. The diagnosis is based on subjective symptoms. However, many effort are being made in searching for the causes and objective indices which could facilitate the diagnosis and the treatment of this disease.The aim of study was to evaluate the indices of serotonin synthesis and metabolism in patients with functional dyspepsia in relation to psychosomatic symptoms.The study comprised 30 healthy subjects (group I - control) and 30 patients with functional dyspepsia(group II) as postprandial distress syndrome (PDS), according to Rome Criteria IV. Assessment of the severity of dyspeptic symptoms was performed using a 10-point visual-analogue scale(VAS). All patients completed the Hamilton Depression Scale. Serum serotonin and 5-hydroxyindoleacetic acid (5-HIAA) concentration in urine were measured by ELISA method using IBL antibodies (catalog numbers- RE-59121, RE-59131).Serum serotonin concentration in the control group was 205.1±34.1 ng/ml, and in dyspeptic patients - 154.2±52.9 ng/ml (p0.001). Significant differences were also found in daily urinary 5-HIAA excretion: 6.88±0.79 mg/24h vs 5.06±1.25 mg/24h, respectively ( p0.001). Moreover, a negative correlation was found between serotonin concentration as well as urinary 5-HIAA excretion and severity of depressive symptoms. The correlation between severity of dyspeptic and psychic symptoms was poorly positive.These results indicate that in patients with functional dyspepsia homeostasis of serotonin is disturbed, and it is in relation to psychosomatic symptoms.

Small intestinal bacterial overgrowth (SIBO) is a frequent cause of chronic abdominal complaining.The aim of this study was to assess the prevalence of the functional disorders in this group patients.The study was conducted in a group of 426 subjects, aged 22-65, including 294 women and 132 men with intestinal functional diseases, as defined in Rome IV Criteria. Small intestinal bacterial overgrowth was evaluated using the Gastrolyzer (Bedfont), assuming an increase of hydrogen concentration in the breath samples over 20 ppm in relation to the baseline value within 90 minutes after consumption of 10 g lactulose (LHBT test). In 185 subjects (group I) results of this test was negative, and in 241 patients (group II) was positive.On the whole the prevalence of functional disorders are similar in both groups (p0,05). However, in the group with a positive LHBT score, the diarrheal form of the irritable bowel syndrome was more often diagnosed (21,1% vs 28,2%; OR -1,47, 95% Cl - 0,94-2,31) as well as functional diarrhea (22,1% vs 17,8%; OR - 1,22; Cl 95% - 0,78-1,92). Less differences were determined in evaluation of the constipation and bloatedness.The LHBT is useful in the diagnosis of functional disorders of the gastrointestinal tract.

Abnormal reaction of food antigens cause a variety disorders of gastrointestinal tract. It is not clear why exactly the same products provoke diarrhea or constipation.The aim of this study was to assess the number of intraepithelial lymphocytes (IEL) in different parts of gastrointestinal tract in patients with specific IgG antibodies against wheat and secale products.The study was performed in 36 healthy subjects(group I) and in 70 patients with diarrhea predominant (group II, n=38) or with constipation (group III, n=32). The level of specific IgG antibodies in blood were determined using Food Detective tests (Cambridge Diagnostics). The biopsy material obtained from duodenum, jejunum as well as from right and left colon was used for routine hematoxylin-eosin staining.In group II compared to control group the number of IEL was statistical higher in all part of gastrointestinal tract. Furthermore, in 9 patients (23.6%) in duodenum exceed 30/100 enterocytes, and in colon mucosa exceed 25/100 (21.0%) enterocytes. In patients with constipation (group III) the number of IEL was similar to healthy subjects.Food intolerance of cereal products may cause immuneinflammatory changes in digestive tract comparable to celiakia and lymphocytic colitis.

The main symptoms of irritable bowel syndrome (IBS) include abnormal frequency of bowel movements. On this basis, three main clinical types of the disease have been distinguished, i.e.: constipation (IBSC), diarrhea (IBS-D) and mixed-type (IBS-M) in accordance with the Rome III criteria. These disorders mainly affect the colon, but symptoms related to upper gastrointestinal tract are also often observed.The aim of the study was to assess the oro-caecal transit time in patients with irritable bowel syndrome with IgG-dependent hypersensitivity to cereal products.The study was performed in three 30-person groups, aged 27-48 years (38.3 ± 10.4), in whom three types of IBS were diagnosed basing on the Rome III criteria . The control group consisted of 30 subjects without gastrointestinal symptoms. Orocaecal transit time was measured by hydrogen breath test using lactulose and Gastro + Gastrolyzer (Bedfont).The mean oro-caecal transit time was respectively in the groups: controls - 86,3 ± 5,95 min., IBS-C - 95,8 ±10,9 min. (p0,05), IBS-D - 77,8 ± 8,21 min (p0,01) and IBS-M - 80,6 ± 14,2 (p0,05). There was a positive correlation between the transit time and disorder severity in IBS-C (p=0,05) group and negative in IBS-D (p0,001) group. No significant correlation was found in IBS-M group (p=0,864).Disturbed digestic passage in the upper gastrointestinal tract may affect the clinical manifestation of irritable bowel syndrome.

Dopamine is one of major neurotransmitter in the central and peripheral nervous system. A significant amount of dopamine is also produced in the visceral nervous system and in gastrointestinal tract, where exhibits inhibitory activity on motility.The aim of the study was to assess the parameters of dopamine secretion and metabolism in patients with functional dyspepsia.The study was conducted in a group of 30 healthy subjects and 60 patients with functional dyspepsia (FD), that met the Rome Criteria III, for epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS). The severity of dyspeptic symptoms was determined using a 10-point Visual-Analogue Scale (VAS). Fasting plasma concentration of dopamine (DA) and the contents of homovanillic acid (HVA) in the urine collection were determined by ELISA.DA concentration in plasma was similar in both clinical forms FD (EPS - 55.6 pg/ml, in patients with PDS - 63.5 pg/ml, p0.05). Urine excretion of HVA in patients with PDS - 6.63 mg/24 h (p0.05) was higher than in heathy subjects - 5.65 mg/24 h (p0.05) and those with EPS - 5.07 mg/24 h (p0.001). In the group with PDS severity of dyspeptic symptoms showed a positive correlation with the DA concentration in plasma and HVA excretion in the urine.Increased secretion of DA may play a significant role in the pathogenesis of PDS.

Functional dyspepsia is often accompanied by emotional disturbances, especially in postmenopausal women. Impaired homeostasis of the dopaminergic system maybe one of the common pathogenetic factors. The aim of the study was to assess the effect of drugs which block dopamine D2 receptors on psychosomatic condition in postmenopausal women.The study was conducted in a group of 60 women, aged 53-61 years, with postprandial distress syndrome (PDS) that met the Rome Criteria III. The severity of dyspeptic symptoms was determined statistically using a 10-point Visual Analogue Scale (VAS). The emotional state was estimated with the Hamilton Anxiety Rating Scale (HARS) and the Beck Depression Inventory (BDI), whereas the body mass index (BMI) was the indicator of the nutritional status. Sulpiride (2 x 50 mg) was administered to 30 women for 16 weeks and itopride (2 x 50 mg) to 30 others.After sulpiride and itopride treatment equal decrease of dyspeptic symptoms was observed, respectively from 9.08 to 4.76 pts and from 9.02 to 4.64 pts. Significant reduction in the level of anxiety (p0.001) and depression (p0.01) was obtained in both groups, slightly higher after sulpiride. However, no significant change in BMI was found.Sulpiride and itopride are effective in the treatment of dyspepsia in the form of postprandial distress syndrome. These drugs in the several-month treatment have no significant effect on body weight.

In order to maintain ulcerative colitis (UC) in remission, chronic use of aminosalicylates is recommended. All patients have a fear of the recurrence of symptoms, which makes their mental state and quality of life worse. Because of this a number of patients are recommended to use different sorts of anxiolytic drugs and antidepressants.Evaluation of the influence of tianeptine (selective serotonin reuptake enhancer) on the mental and somatic status in the group of patients.The research was conducted in two groups of thirty patients, with benign form of ulcerative colitis in remission, aged 24-46 years. Patients, during a period of 12 months, were given aminosalicylates in a daily doses 2 x 1.0 g and tianeptine in a doses 3 x 12.5 mg (group I) or placebo (group II). During the treatment every three months anxiety (Hamilton Anxiety Rating Scale-HARS), depression (Back Depression Inventory-BDI), The Mayo Clinic Disease Activity Index (MCDAI), hemoglobin and C-reactive protein (CRP) level were evaluated.After 12 months in a group of patients who took tianeptine decrease in anxiety (from 20.35 +/- 4.03 to 12.65 +/- 3.78 points) and depression (from 19.95 +/- 4.49 points to 9.60 +/- 2.76 points) was obtained; difference compared with placebo was statistically significant (p0.01). At the same time significant decrease compared with placebo (p0.05) of disease activity index (respectively 3.05 +/- 1.36 and 4.65 +/- 1.69), insignificantly lower level of CRP (7.00 5.65 and 9.41 +/- 10.12) and higher level of hemoglobin (11.93 +/- 0.83 and 11.0 +/- 0.70) was observed.Tianeptine has a positive influence on mental and somatic status of patients with UC. Results give the support for tianeptine apllication in UC as adjuvant drug.

Drugs inhibiting gastric acid secretion are most commonly used in a long-term treatment of GERD. In a number of patients their therapeutic effects are not satisfactory enough. For that reason other medicines are added as a concomitant therapy, e.g., prokinetics. Adverse drug reactions of widely available prokinetics limit their application and inspire us to search for different pharmacological compoundsTo evaluate if sulpiride can prevent episodes of gastroesophageal refluxes.The study comprised 25 men, aged 26-58 years, suffering from GERD, with erosive oesophagitis of A and B grades according to Los Angeles classification. In each subject 24-hour oesophageal pH-metry (Digitrapper Marc III, Synectics) was performed three times: prior to sulpiride administration, after the first two doses of 50 mg and after 6 weeks of treatment in the daily dose of 2 x 50 mg. On the day of the measurements patients remained on a standard liquid diet (Nutridrink 3 x 400 ml).The initial reflux index prior to the drug administration was 18.8 +/- 10.7; after the first two doses it was 13.6 +/- 9.9 (p = 0.020), whereas after 6 weeks of therapy it was 16.3 +/- 10.1 (p = 0.034). The De Meester scores were: 74.0 +/- 52.3; 53, 4 +/- 41.9 (p = 0.002) and 56, 6 +/- 38.7 (p = 0.014) respectively.Sulpiride reduces intensity of gastroesophageal refux. Sulpiride can be considered in the combined treatment of GERD.

The pathogenesis of functional dyspepsia is still not clear. One of the supposed mechanisms are disturbences of motility of upper part of gastrointestinal tract. There only the few informations, concerning the role of retrograde refluxes.Comparative analysis of grade of duodenogastric reflux intensity in healthy subjects and in patients with functional dyspepsia.The study included 40 subjects with functional dyspepsia (the mean age 33.4 +/- 11.8) and 20 clinically healthy subjects (the mean age 36.9 +/- 10.5). Functional dyspepsia was diagnosed according to the Rome III Criteria. In study group other diseases and H. pylori infection were excluded. 24-hour bilirubin concentration monitoring in gastric juice was performed using spectrophotometer (Bilitec 2000, Medtronic). Seven days before the investigation. the patients were told to obtain from drugs intake. On the day of investigation an equal diet was applied.In the group of healthy subjects the following results were obtained: the total percentage of absorbance time0.14 - 12.4 +/- 7.3%, the reflux index--2.6 +/- 1.6 (R/h). In group of subjects with functional dyspepsia the results were higher, respectively: 59.9 +/- 19.6% (p0.001) and 9.8 +/- 5.1 (p0.001). The total number of reflux and the number of reflux episode, lasting over 5 minutes were also higher.(1) In patients with functional dyspepsia the significant longer periods of bilirubin presence in stomach are observed (comparably with healthy subjects). (2) The intensive duodenogastric reflux could be be a reason of dyspeptic symptoms.

The pathogenesis of functional dyspepsia is very complicated and its etiology is still not clear. One of the supposed pathophysiological mechanisms are disturbences of gastric acid secretion and gastric motility. Recently, it has been recognized, that in the pathogenesis of above disturbances may play a role enterohormones, like gastrin.To establish if in patients with functional dyspepsia the level of gastrin concentration changes and wheather it correlates with type and grade of symptom's intensity.The study included 50 subjects between of 20 to 54 years with diagnosed functional dyspepsia (according to the Rome III Criteria). The study group was divided into two subgroups: group I--25 subjects with Epigastric Pain Syndrome--EPS and group II--25 subjects with Postprandial Distress Syndrome--PDS. Control group comprised 20 healthy subjects (without any clinical or morphological symptoms of digestive tract disease). In each patient due to gastrointestinal tract organic disease exclusion the gastroscopy, histological examination of gastric mucosa, ultrasonography of abdomen and laboratory tests were performed. H. pylori infection was detected using fast urea test (CLO-test), confirmed by histopathological examination (stained Giemsa method) and non-invasive urea breath test (UBT-13C) using mass spectrophotometer FANci 2 (Fisher Analyser Instrumente GmbH). In each patient the level of gastrin concentration in blood serum, in fasting state, was determined, based on ELISA method considering the length of the weave lamda=430 nm. The study group was also divided into 3 subgroups, using 10-points scale of symptom's intensity: --grade 1--mild (1-3 points); --grade 2--moderate (4-6 points); --grade 3--severe (7-10 points).The concentration of gastrin in blood serum in healthy subjects was 2.4 +/- 1.23 pmol/L. In patients with functional dyspepsia was significantly higher; in patients with Epigastric Pain Syndrome--7.51 +/- 2.46 pmol/L (p0.05), in patients with Postprandial Distress Syndrome - 6,92 +/- 2.18 pmol/L (p0.05). There were no significant differences in dependence on pain's intensity in EPS--the concentrations in subgroups 1, 2 and 3 were: 7.36 +/- 1.4 pmol/L, 7.53 +/- 2.43 pmol/L and 7.64 +/- 2.55 pmol/L. The gastrin concentration in PDS in dependence on symptom's intensity in subgroup 1 was 6.34 +/- 1.2 pmol/L, in subgroups 2 and 3 were higher: 6.99 +/- 2.31 pmol/L and 7.42 +/- 2.2 pmol/L, but the differences were not statistically significant. In patients with functional dyspepsia, infected with H. pylori the gastrin concentration was significantly higher and was 15.28 +/- 5.3 pmol/L (p0.05). There were no significant differences in dependence on type of dyspepsia.The gastrin concentration in blood serum in fasting state in patients with functional dyspepsia is higher than in control subjects, both in patients with Epigastric Pain Syndrome--EPS as well as with Postprandial Distress Syndrome--PDS. The grade of symptom's intensity does not correlate with increase of gastrin concentration.

The pathogenesis of functional dyspepsia is very complicated and its etiology is still not clear. One of the supposed pathophysiological mechanisms is the deficiency of melatonin. The deficiency of melatonin leads to increase the oxide reactive form's concentration as nitric oxide metabolites and to decrease of antyoxidative enzymes activity. This last factor seems to be very important in correct digestive tract function. The aim of our study was answer the question if is the difference between NO metabolites concentraction in gastric juice in patients with functional dyspepsia and in healthy subjects and wheather the treatment with melatonin plays the role in normal digestive tract function.The study included 60 subjects between of 18 to 48 years with diagnosed functional dyspepsia (according to the Rome III Criteria). The study group was divided into two subgroups: group I--30 subjects with Epigastric Pain Syndrome-EPS and group II--30 subjects with Postprandial Disorders Syndrome-PDS. Control group comprised 25 healthy subjects (without any clinical or morphological symptoms of digestive tract disease). In each patient the gastroscopy was performed. During gastroscopy 5 ml gastric juice was collected. The juice was centrifuged for 15 min (4500 rotations). The undiluted supernatant was frozen in the temperature -70 degrees C. The concentration of nitric oxide metabolites in gastric juice was determined with spectrophotometric based on ELISA test (540 nm wavelength) using a microplates reader (Multiscan, Labsystems). In patients with functional dyspepsja the investigations were performer twice before and after 6 weeks treatment with melatonin. Melatonin was applied in dose 5 mg daily, in the evening.The concentration of nitric oxide metabolites in gastric juice in healthy subjects was 6.81 +/- 2.23 microM. In patients with functional dyspepsia was significantly higher; in patients with Epigastric Pain Syndrome--10.99 +/- 2.46 microM (p0.05), in patients with Postprandial Disorders Syndrome--9.28 +/- 2.18 microM (p0.05). After treatment with melatonin the concentration of nitric oxide metabolites in gastric juice in both groups decreased and were 8.21 +/- 1.83 microM in patients with Epigastric Pain Syndrome and 6.93 +/- 1.61 microM in patients with Postprandial Disorders Syndrome.In patients with functional dyspepsia the concentration of nitric oxide metabolites in gastric juice was significantly higher than in control group. After treatment with melatonin the concentration of nitric oxide metabolites in gastric juice in both groups decreased--in patients with Epigastric Pain Syndrome as well as in patients with Postprandial Disorders Syndrome. The treatment with melatonin seems to be suitable in combined therapy of functional dyspepsia.

Serotonin (5-HT) is among other factors involved in gastrointestinal motility, secretion and visceral sensation. Available data suggest that secretion and metabolism of 5-HT may be disturbed in irritable bowel syndrome (IBS). Interpretation of these observations have been hampered by the variable methodology used and small numbers of patients involved in the previous studies. Aim of this study was to measure serum 5-TH concentration under fasting condition in patients with irritable bowel syndrome (IBS), compared with controls (K). The metabolite of serotonine--5-hydroxyindole acetic acid (5-HIAA) in urine was also assessed.71 subjects, aged 19-50 years were included in this study. Three groups were distinguished: group I (n=25)--healthy volunteers, group II (n=23)--patients with constipation predominant (IBS-C), group Ill (n=23)--subjects with diarrhea predominant irritable bowel syndrome (IBS-D). IBS was diagnosed according to Rome Ill Criteria. On the day of the experiment, patients received a standard meal (Nutridrink 6 x 300 kcal) and blood samples were collected during fasting. 5-HIAA concentration was determined in 24-hour urine collection. Concentration of 5-HT and 5-HIAA was measured by immunoenzyme ELISA method employing standard kits IBL nr RE59121 i RE59131 and Labsystems Multiscan detector.The average serotonin concentration during fasting was found in group I--156.67 +/- 49.12 ng/ml, in group II--221.73 +/- 91.56 ng/ml (p0.05), in group III--3.50 +/- 1.71 mg/24h. 5- HIAA concentration in urine was decreased in group Ill--3.50 +/- 1.71 mg/24 hrs (p0.05) and group II--4.37 +/- 2.95 mg/24 hrs compared with healthy volunteers--5.65 +/- 2.31 mg/24 hrs.(1) Serotonin concentration is increased in C-IBS and D-IBS patients. (2) Urine 5-hydroxyindole acetic acid excretion is decreased in IBS-subjects. (3) Disturbed metabolism of serotonin probably may play role in pathogenesis of functional bowel diseases.

It was confirmed that enterochromaffin cells (EC) in the digestive system are a source of serotonin and melatonin. Both hormones possess an important, but opposed, influence on secretory and motoric function of gut. The aim of our study was to evaluate fasting secretion of serotonin and melatonin in patients with functional dyspepsia. Material and methods. 25 healthy subjects (K, group I), 25 patients with epigastric pain syndrome (EPS, group II) and 25 patients with postprandial distress syndrome (PDS, group III), aged 18-50 years, were included in this study. Diagnosis of functional dyspepsia was established according to the Rome Criteria III. Organic diseases of gut, H. pylori infection and another disorders were excluded. Seven days before the examinations the patients were told to abstain from drugs intake and equal diet was applied. On the day of investigation the subjects remained in a red-light room at night and received standard liquid diet (Nutridrink, 4 x 200 ml, 1800 kcal). Blood samples were taken for examination at 8 am on the subsequent day and serum was frozen in -80 degrees C. The concentration of serotonin and melatonin was measured by ELSA, using antibodies from IBL (catalogue no. RE 59121, RE 54021).The mean concentration of serotonin in group I (K) was 162.9 +/- 49.1 ng/ml, in group II (EPS)--225.8 +/- 111.3 ng/ml (p0.05) and in group III (PDS)--152.7 +/- 83.2 ng/ml (p0.05). The concentration of melatonin was in group I--7.3 +/- 4.0 pg/ml, in group II 8.7 +/- 8.0 (p0.05) and in group III 14.3 +/- 10.1 (p0.01).During fasting time secretion of serotonin is higher in patients with EPS, and similarly higher secretion of melatonin in patients with PDS, compared to healthy subjects.

Melatonin is synthesized not only in the pineal gland, but also in gastrointestinal tract by enterochromaffin cells (EC) and it has a gastroprotective properties. Helicobacter pylori infection causes functional and organic changes of gastric mucosa, particularly in endocrine cells (D, G, ECL, EC).The aim of own studies was to evaluate nocturnal secretion of Melatonin in subjects with asymptomatic and symptomatic (dyspepsia, duodenal ulcer disease) H. pylori infection (Hp).116 subjects, aged 19-61 years were included in this study. Four groups were distinguished: group I (n=30) healthy subjects, Hp (-), group II (n=26)--subjects with asymptomatic infection Hp, group III (n=32) patients with ulcer-like dyspepsia, Hp (+), and group IV (n=28) patients with duodenal ulcer Hp(+). H. pylori infection was diagnosed by using urea breath test (UBT-(13)C) and rapid urease test. The concentration of melatonin in serum was measured with ELISA method, before and after eradication of H. pylori. Blood samples were taken for examination at 10:00 p.m., 2:00 a.m. and 6:00 a.m.The average melatonin concentration at night hours was found in group I--34.74 +/- 4.77 pg/ml, in group II--48.29 +/- 12.22 pg/ml (pO.005), in group III--41.56 +/- 12.31 pg/ml (p0.05) and in group IV--26.16 +/- 6.89 pg/ml p0.01). Such statistical differences were not observed in all group after eradication H. pylori.(1) Nocturnal secretion of melatonin in subjects with asymptomatic infection of H. pylori is higher than in patients with ulcer-like dyspepsia and with duodenal ulcer disease. (2) Lower nocturnal secretion of melatonin probably may play role in pathogenesis of upper digestive tract diseases.

The basic diagnostic procedure in ulcerative colitis is an endoscopy of gastrointestinal tract. It allows the macroscopic evaluation as well as the specimen taking for histological assessment what is the basis for ultimate diagnosis. In case of Crohn's disease the radiological diagnostics is of equal importance as endoscope evaluation. The imaging of inflammatory changes in Crohn's disease still poses some difficulties, especially, that located in the small intestine. Lately, the range of accessible examinations has been wider. We have in disposal the ultrasonography, the computed tomography, the magnetic resonance imaging and the capsular endoscopy. All of them are of great use in the diagnosis of Crohn's disease. In case of microscopic colitis all the imaging diagnostics has no use. The only one mean to establish the diagnosis is a histological assessment. What is more, in the period of remission the colon tissue could be normal. In this paper we discussed the traditional and contemporary intestine imaging methods in inflammatory bowel diseases. The conclusion is that the further progress in science offers a better imaging and, what is even more important, the more efficient diagnostics and treatment of these diseases.

Helicobacter pylori is a known carcinogen but the natural history of gastric carcinoma development has not been recognized thoroughly and early diagnostics is difficult particularly in asymptomatic infection. The aim of own study was gastric mucosa morphological estimation in subjects with asymptomatic H. pylori infection. Investigations were performed in 60 subjects, aged 24-55 years with family history of gastric cancer and with asymptomatic (group I; n=30) and symptomatic infection (group II; n=30). The infection and its severity were confirmed with breath test with the use of 75 mg of 13C labelled urea and Olympus FANci-2 analyzer. Gastric mucosa macro- and microscopic state was evaluated according to 4-degree Sydney scale. In group II macroscopic changes were more pronounced than in group I (p=0.032); no such differences were seen in microscopic picture (p=0.625). The extent of macro- and microscopic changes demonstrated positive correlation with the results of breath test (group I: r=0.8169; group II: r=0.8393). In subjects with family history of gastric cancer H. pylori infection both, symptomatic and asymptomatic causes similar gastric mucosa histopathological changes including intestinal metaplasia. The degree of morphological changes demonstrates positive dependence with the severity of infection.

In practice, breath and serologic tests are applied to confirm the diagnosis of H. pylori and for epidemiologic studies. The aim of the study is quantitative evaluation of the results of both tests in relation to the examined subjects' age, clinical symptoms and family history of gastric cancer. Investigations were carried out in 300 subjects, aged 16-70 years, 186 of them with asymptomatic H. pylori infection and 114 with family history of gastric cancer. The breath test was performed with 13C-labelled urea and Olympus FANci-2 analyzer and antibody titer was determined with ELISA in serologic test. The infection severity was the highest in the age group 31-40 years (result of the breath test 32.4+/-20.3/1000) and the lowest in the group aged 61-70 years (8.4+/-8.11/1000; p0.01). The antibody titer was the highest at the age 21-30 years (89.6+/-39.5 U/ml) and significantly lower in the group over 60 years of age (31.0+/-27.2 U/ml; p0.01). In subjects with asymptomatic infection the results of both tests were lower than in symptomatic infection in all age groups. No statistically significant differences were found between the subjects with and without family history of gastric cancer. H. pylori infection severity and immune response depend on the age of the examined subjects. H. pylori infection severity and immune response are lower in asymptomatic than in symptomatic subjects.