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Background. The purpose of the study was to identify correlational parallels between morphological manifestations, clinical and hematological indicators and lymphocyte indices in patients with ulcerative colitis (UC). Materials and methods. Ninety patients with UC were examined. Morphologically, the degree of damage to the intestinal mucosa, the presence of crypt abscesses, atrophic changes, and changes in crypt architectonics were determined. The number of cells of the inflammatory infiltrate, linear measurements of the mucosa were assessed by morphometric method. Clinical blood parameters were evaluated in the inpatients of the department of intestinal diseases at the Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine. The severity of the disease was assessed according to the Mayo score. Statistical processing of the results was carried out using the Statistica 6.1 program. Results. In patients with UC, histological changes in the intestinal mucosa were found. The activity of the disease was evaluated by the presence of an increased number of inflammatory cells in the infiltrate of the mucosa: neutrophils (212.20 ± 20.93), lymphocytes (2922.80 ± 76.63), eosinophils (332.50 ± 17.24), macrophages (369.70 ± 16.21). Multiple crypt abscesses, deformation of the musocal epithelium in the form of erosions and ulcers were also noted. Clinical indicators of peripheral blood also confirmed the exacerbation of the disease (anemic state, increased inflammatory markers). An increased depth of the crypts correlated with such a morphometric indicator as mucosal thickness (r = 0.46; p

Background. Inflammatory bowel diseases, including ulcerative colitis and Crohn’s disease, are an urgent problem of modern gastroenterology. Therefore, the discovery of new laboratory approaches makes it possible to assess the degree of the disease. Purpose: to reveal the relationship between morphological manifestations and immunological indicators in patients with ulcerative colitis. Materials and methods. The studies were conducted on biological material (blood and colonic biopsy samples) of 90 patients with ulcerative colitis. The thickness of the mucosa, density of the inflammatory infiltrate and its composition, crypt sizes, their architectonics, the presence of crypt abscesses, atrophic and fibrotic changes were calculated in biopsies by morphological and morphometric methods. Immunological studies included the evaluation of mononuclear cells, the levels of B-lymphocytes, interleukin-10, tumor necrosis factor α, immunoglobulins (Ig) A, M, G. Results. The histological activity of the disease was determined by an increased level of inflammatory infiltrate (14,431.4 ± 483.3 per 1 mm2 of stroma) and the presence of many neutrophilic granulocytes (212.2 ± 20.9 per 1 mm2 of stroma) and lymphocytes (2,922.8 ± 76.6 per 1 mm2 of stroma) in it. Also, some patients had crypt abscesses (36.7 % of the total number of patients) and breaches in the epithelial integrity (54.4 % of the total number of patients). A correlation was found between the level of CD22+ lymphocytes and some morphometric parameters: the width of the crypts (r = 0.27; P

Background. The pathogenesis of chronic inflammatory bowel disease (IBD) is still not fully clarified. Modern research is aimed at studying the state of humoral immunity, production and intestinal absorption of short-chain fatty acids (SCFA). The purpose was to assess the state of the humoral part of immunity, cytokine regulation and the content of short-chain fatty acids in the feces of patients with IBD. Materials and methods. The study, which was carried out at the Department of Intestinal Diseases of the Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine, involved 34 patients with IBD: group I — those with ulcerative colitis (UC) (n = 25), group II — individuals with Crohn’s disease (n = 9). Determination of fecal SCFA, level of CD22+ lymphocytes, immunoglobulins A, M, G, interleukin-10 and TNF-α was determined. Results. There was a decrease in the humoral level of immunity, increase in the content of propionic (C3) acid (p

Background. Inflammatory bowel disease (IBD) is a global problem today, with a growing prevalence in the world. It significantly increases the economic burden on the health care system. Recently, many studies indicate the important role of immunoglobulin G4 (IgG4) in the formation of chronic inflammation in IBD and the possibility of using it as a biomarker of the inflammatory process. The purpose was to improve the diagnosis of chronic inflammatory bowel diseases by studying the status of IgG4-positive plasma cells in the mucous membrane of the colon in patients with ulcerative colitis (UC) and Crohn’s disease (CD). Materials and methods. We have examined 34 patients with IBD, 25 with UC and 9 with CD, of them 20 women and 14 men, with an average age of (38.8 ± 3.0) and (38.2 ± 3.7) years, respectively. Patients were divided into groups depending on the noso­logy and severity of the disease. All patients underwent endoscopic examination of the colon to establish or clarify the diagnosis, and biopsy specimens were taken for histological and immunohistochemical examination. Results. In 13 (38.3 %) of 34 examined patients, a positive result for the presence of tissue IgG4 (≥ 10 cells in the field of view) was found. Among patients with UC, 48 % have a positive result of immunohistochemical examination of tissue IgG4, in people with CD, this figure is 11.1 %. This gives us reason to say that in UC, elevation of tissue IgG4 levels occurs 4.4 times more often. Positive tissue IgG4 in patients with moderate UC was found 1.1 times more often than in severe UC. Among patients with mildly active disease, tissue IgG4 was not detected. Conclusions. In UC, IgG4-positive cells in the mucous layer of the colon are more common than in CD, which makes it possible to use this indicator for the differential diagnosis of ulcerative colitis and Crohn’s disease. Positive tissue IgG4 is more common in moderate form than in severe one.

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Background. The purpose of the present work was to assess the level of circulating immune comple­xes (CIC) and lipid metabolism state in patients with inflammatory bowel disease (IBD). Materials and methods. We examined 80 patients with IBD: 53 with ulcerative colitis (UC) and 27 with Crohn’s disease (CD). Depending on the gender, they were divided into two groups: 40 womеn and 40 men. Also, depending on the age, all patients were divided into three groups: young (45 individuals — 28 with UC and 17 with CD); middle-aged (15 persons — 10 with UC and 5 with CD); elderly (20 patients — 15 with UC and 5 with CD). The control group included 20 appa­rently healthy individuals. In patients’ blood serum, the levels of CIC, total cholesterol, triglycerides, phospholipids, high-density, low-density and very low-density lipoprotein cholesterol were determined, as well as atherogenic index. Results. Serum level of CIC significantly exceeded the normal values in women with IBD — by 1.57 times (p < 0.05), which can be considered as an indicator of inflammation intensity, involvement of the immune system in the pathological process. In women with UC, the content of CIC was significantly increased — by 1.62 times (p

The abuse of laxatives is a disorder characterized by an incomprehensible and changing range of gastrointestinal, electrolytic and acid-base abnormalities that can lead to both the onset of chronic diseases and fatalities. Abuse is self-induced, veiled and associated with psychological abnormalities, making it difficult to diagnose. As a safe laxative drug for patients who need long-term treatment of constipation, the drug EasyDo may be recommended.

Актуальність. Стаття присвячена актуальній проблемі — вивченню вікових особливостей структурних змін печінки при хронічних запальних захворюваннях кишечника (ХЗЗК). Мета роботи: вивчити вікові особливості структурних змін печінки при неспецифічному виразковому коліті (НВК) та хворобі Крона (ХК). Матеріали та методи. Проведено обстеження 40 пацієнтів за допомогою неінвазивних методів дослідження — стеатометрії та зсувнохвильової еластометрії (ЗХЕ), у тому числі 27 хворих на НВК, 13 — на ХК. Усі хворі були розподілені на групи залежно від віку (відповідно до класифікації Всесвітньої організації охорони здоров’я: від 25 до 44 років — молодий вік, 45–59 років — середній вік). В обстеження включено 29 пацієнтів молодого та 11 пацієнтів середнього віку. Результати. Встановлено, що зміни печінки мали вікові відмінності. Так, за результатами стеатометрії печінки виявлені зміни, характерні для стеатозу печінки за шкалою NAS, у 32,5 % хворих на ХЗЗК, причому у пацієнтів середнього віку стеатоз печінки виявлявся в 1,8 раза частіше порівняно з хворими молодого віку. За даними ЗХЕ, виявлено зміни жорсткості паренхіми печінки у 14 (35 %) у хворих на ХЗЗК, у вигляді І і ІІІ стадії фіброзу — у 25 та 10 % відповідно. У пацієнтів середнього віку у 2,6 раза частіше зустрічалася І та ІІІ стадія фіброзу печінки. Висновки. Враховуючи отримані дані, хворим на ХЗЗК старшої вікової групи доцільно включати в стандарт діагностики проведення ультразвукового дослідження печінки з зсувнохвильовою еластометрією та стеатометрією, що дозволить своєчасно виявити ознаки жирового переродження печінки та визначити раціональну тактику ведення пацієнта, що буде сприяти зниженню ризику розвитку ускладнень захворювань.

The article deals with an actual problem — the state of the microflora of the colon and faecal calprotectin level in patients with chronic inflammatory bowel diseases with different nutritional status. The study involved 76 patients with chronic inflammatory bowel diseases, including 28 patients with Crohn’s disease and 48 — with ulcerative colitis. We analyzed the findings depending on the nosology and nutritional status. It was found that among the patients of studied groups, patients with subcompensated form of dysbiosis dominated. Reducing the concentration of bifidobacteria in the colon content of patients from group III was detected more often — in 78.9 % of cases. Deficiency of lactobacilli was most often observed in patients of group II (92.3 %). The content of calprotectin was significantly increased in 84.2 % of patients, it positively correlated with the degree of severity of the disease and did not depend on their nutritional status.

The article deals with the actual problem — the influence of nutritional status on the quality of life in patients with chronic inflammatory bowel diseases. A survey of 80 patients was conducted using general (SF‑36) and special (IBDQ) questionnaires. We have analyzed findings, depending on the nutritional status. It was found that the decline in nutritional status affects the quality of life in patients with inflammatory bowel diseases that is caused by both the intestinal disorders and violations of the psychoemotional state and social activity limitations. The worst quality of life was observed in patients with reduced nutritional status.

The article deals with the study of nutritional status in patients with chronic inflammatory bowel disease (CIBD) using bioimpedancemetry. 40 patients with CIBD were examined. The high prevalence of deviations in the percentage of fat mass in the body (87.5 %) has been detected, with a predominance of nutritional deficiency (65.0 %) associated with a decrease in the body’s adaptive capabilities and severe course of the disease. 70.0 % of patients were characterized by redistribution of water sectors of the body due to increased amount of extracellular fluid and reduced amount of intracellular fluid, which was more significant in patients with increased nutritional status compared to patients with nutritional deficiency. More expressed changes of the component composition of the body were in patients with Crohn’s disease.