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Introduction. Diverticular disease of the colon is one of the most common gastrointestinal diseases. During the last 30–40 years, there has been a “rejuvenation” of the disease. Today, the prevalence of the disease in people under 40 years of age is 5–10%, and therefore the costs of diagnostic testing and treatment are gradually increasing, which makes the disease socially significant.Aim. To study the clinical features of diverticular disease, the features of diagnosis and treatment, and prophylactic approaches. The specific objectives of the analysis were to study epidemiology; study the role and a necessary minimum set of laboratory diagnostic test methods for the diagnosis of diverticular disease; study the incidence rate of SIBO and its impact on the clinic presentation and treatment; develop an algorithm for the diagnosis, treatment, prevention, and management of patients with diverticular disease.Materials and methods. A total of 195 patients with different forms of diverticular disease were examined. As diagnostic tests, we used blood tests, stool tests, biochemical tests; inflammatory tests: calprotectin, CRP, fibrinogen, ferritin; ultrasound imaging, irrigoscopy, CT, NMR, colonoscopy (if medically required); clinical manifestations at different stages of the course of diverticular disease. 5-aminosalicylates were used to treat exacerbation with inflammation; alpha-normix and motility regulators were used to treat exacerbation without signs of inflammation.Results. On the basis of the study results, we suggested an algorithm for the diagnosis, management and treatment of patients with diverticular disease. According to the particulars of the management, it is reasonable to divide all patients with diverticular disease into three groups: 1) patients who underwent acute diverticulitis; 2) patients with uncomplicated diverticular disease; 3) patients with complicated diverticular disease.Conclusions. The first two groups should be followed up by a gastroenterologist/general practitioner, the third group should be followed up by a surgeon. The patient tested positive for SIBO should receive drugs to eradicate SIBO. The treatment regimens for exacerbation of diverticular disease are proposed.

Objective of the study: comparative evaluation of the bacteriotropic activity of Actoflor-S metabiotic and the exometabolic bifidobacteria complex.Materials and methods: in our work we used Actoflor-S dietary supplement as oral solution in 2 ml drop tubes (Solopharm). As a comparator drug, we used an exometabolite complex from the culture fluid of strain Bifidobacterium bifidum 1 obtained by method of ultrafiltration using separation apparatus with HOMM 15 kDa. We studied the stimulating effect of metabolite compositions on the acid forming activity and dynamics of the accumulation of lactobacilli Lactobacillus plantarum 8P-A3. Antagonistic activity against enterobacteria was determined in the test of inhibition of bioluminescence of the indicator strain Escherichia coli lum+ and quantified as an index of antibacterial activityResults and discussions. A comparative study of the effects of metabiotics on the acid forming activity of lactobacilli showed that both drugs have a pronounced stimulating effect on the probiotic strain L. plantarum. A comparative study of the effects of metabiotics on the model test strain of enterobacteria showed that whole preparations quickly and significantly (by more than 90%) inhibit the bioluminescence of E.coli lum+. Preparation dilutions 1:10 and 1:100 discovered significant differences in their activity. Given equal pH values (5.8 ± 0.1), Actoflor-S (dilution 1:10) inhibited the luminescence of E. coli lum + to a greater degree, exceeding almost 2 times the indicators of the metabolite bifidobacteria complex. It is revealing that Actoflor-S diluted 1:10 is not inferior to the whole preparation in terms of the level of effect on the test strain culture. What calls attention to itself is that large dilutions of UFLC of bifidobacteria after a short period of inhibition of luminescence of E. coli lum + have a stimulating effect. There is evidence that effect of inhibition of the luminescence of the control culture is dose-dependent.Conclusion. The results of a comparative examination of the bacterial action profile of the native exometabolites complex and Actoflor-S preparation confirm the presence of combination of the necessary inhibitory and stimulating activity against various agents of the microbiota. Creation of the metabiotics line based on Actoflor-S preparation with variability of biological properties and specialized for the management of various dysbiotic conditions show promise. An additional inclusion of native exometabolites of bifidobacteria and/or lactobacilli into the formula of artificial compositions will make it possible to expand the spectrum of the positive effect of probiotic preparations on the microorganism.

Based on the evaluation of the composition and functions of the intestinal microflora and mechanism for the realization of "microflora - macroorganism" relationship, as well as causes of intestinal micro-ecological disorders, the need and options for their timely correction are demonstrated. The main principles of treatment and preventive actions are presented. Taking into account recent classifications and requirements for drugs, as well as evaluation of the mechanism of action and therapeutic options, the main groups of drugs (pro-, prebiotics and metabiotics) used in the management of gut microbiota in disease are described.