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The caudal ventrolateral medullary reticular formation is the first supraspinal level processing visce- ral nociceptive signals. In experiments on rats reactions of neurons of this zone to nociceptive stimulation of large intestine were examined and effects of selective blockade of 5-HT3-receptors on these reactions were assessed. According to the character or responses to nociceptive colorectal stimulation (CRS) the re- corded medullary cells were divided into three groups - excitated, inhibited and indifferent. Intravenous injection of 5-HT3-antagonist granisetron (1 and 2 mg/kg) as well as local application of the substance on medulla surface (1.25 and 2.5 nmole) suppressed dose-dependently background and evoked discharges of the reticular neurons excited by CRS but did not exert so much expressed influence on the cells inhibited by visceral nociceptive stimulation. Spike activity of the group of neurons indifferent to CRS under simi- lar conditions was of 5-HT3-independent character. The results obtained provide evidence that 5-HT3-re- ceptors mediate the facilitating effect of serotonin on the supraspinal transmission of abdominal nocicep- tive stimulus which, partly at least, is realized through selective activation of visceral nociceptive neurons of the medulla. The blocking of this mechanism may underlie the analgesic effect of 5-HT3-antagonists in a abdominal pain syndromes.

The majority of the diseases of biliary tract circuit is accompanied by different degree of manifestation by pains. The paper gives different treatments of the determination of the pain, including of abdominal, the classification of abdominal pain, are determined the special features of biliary pain depending on kinds, levels of the defeat of the biliary circuit presence of primary and second functional disorders of the biliary tract. Accordingly, the presence of biliary pain is signal for taking of diagnostic measures for the purpose of the refinement of the nature of the defeat of biliary circuit and finalizing of the tactics of treatment. The analysis of effectiveness in the application of different spasmolitics preparations is carried out. Are shown the advantages of the use of preparation of hymecromone during the treatment of patients by the biliary pathology, that does not require surgical treatment, or as the means of the rehabilitation of patients after surgery treatment.

Porphyrias are a group of rare disorders caused by enzyme defects in haem biosynthesis pathway. Acute intermittent porphyria is the most common hepatic porphyria. The disorder presents with severe neuropathic abdominal pain that can be accompanied by a wide range of gastrointestinal, psychiatric and neurological symptoms, making the diagnosis clarification very challenging. We report a case of a 27-year-old female patient who presented with acute abdominal pain, vomiting and marked hyponatremia, developed seizures and disorientation, and eventually required intensive care unit treatment to maintain breathing. Her symptoms were initially misinterpreted as a functional gastrointestinal disorder, thus delaying the needed specific treatment. She was diagnosed a week after the initial hospital admission, and her condition improved after receiving treatment with intravenous glucose and haemin. For patients with acute neurovisceral attacks, early clinical recognition is essential. Severe hyponatremia, urine that develops orange colour on exposure to light and gastrointestinal symptom combination with neurologic symptoms are three valuable clues that may lead to the right diagnosis faster. Pathophysiology of hyponatremia in case of acute intermittent porphyria in only partly understood and can be associated with syndrome of inappropriate antidiuretic hormone secretion, gastrointestinal or renal sodium loss.

One of the important problems in the treatment of patients with inflammatory bowel disease are the persistent complaints of pain, abdominal distention, frequent stools, excretion of mucus with faeces with the presence of endoscopic or roentgenologic remission in the damaged parts of gastrointestinal tract. In this review we describe possible causes of such complaints and some methods of their therapeutic correction.

In different countries a set of recommendations for the diagnostics and treatment of chronic pancreatitis (CP) have been published, but to date a unified systematic management has not been developed yet. Because CP is within the interests of physicians of various specialties: surgeons, gastroenterologists, endoscopists and others, approaches to the most effective treatment--conservative therapy, endoscopic or surgical treatment--should be determined on an equal footing on the basis of well-known and well-conducted trials at the minimization of possible interpretations of the terms and tactics. In most cases there is a need for a comprehensive approach, which allows to achieve the main tasks: to cut pain short, maintain the function of the gland and/or compensate for pancreatic insufficiency, eliminate or prevent the development of complications, using a combination of the most effective methods of treatment. The opinion of all involved in the fate of particular patient specialists in the absence of common international standards, must be based on the results of the research evidence. The purpose of this review is to analyze the scientific studies in this field with a focus on existing practical guide of pancreatilogical associations of different countries of the world. Formulated during the analysis, the conclusions and provisions on the basis of strict methodological approach can be useful for Russian gastroenterologists, surgeons and general practitioners.

Our own results of two-stage research are presented in the article. The first stage contains the retrospective analysis of 3682 X-ray examining of large bowel which were conducted in 2002-2004 to define the structure of colon disease and to determine gender differences. The second stage is prospective research which took place from 2003 to 2012 and 486 patients with diverticular disease were regularly observed. Following parameters were estimated: dynamics of complaints, life quality, clinical symptoms. Multiple X-ray and endoscopic examining were done with estimation of quantity and size of diverticula, changes of colon mucosa, comparison of X-ray and endoscopic methods in prognosis of complications. Two basic clinical morphological variants of diverticular disease (DD) of colon are made out as a result of our research. There are IBD-like and DD with ischemic component. The variants differ by pain characteristics, presence of accompanying diseases, life quality parameters and description of colon mucosa morphological research. We suppose that different ethiopathogenetic factors of development of both variants mentioned above influence the disease prognosis and selection of treatment.

The prevalence and its specific features of Lamblia invasion in children in some districts of the Perm Region, which differ in the nonstandard quality of drinking water samples are described. For the specific diagnosis of giardiasis, a serological study of the population was made by enzyme immunoassay determining specific Lamblia antibodies in the serum. The authors proposed a questionnaire that may suspect giardiasis in a child. The data obtained from the questionnaire study correlate with the positive results of enzyme immunoassay in 47.5% of cases. The clinical picture of Lamblia invasion in the examinees corresponds to the data available in the literature on the course of giardiasis.

Clinical symptoms of the initial stage of the disease (before the onset of pathognomonic signs of amoebiasis--the formation of ulcers in the colon) have been analysed in 287 patients with intestinal amoebiasis (IA). The following variants of the clinical pattern have been identified: slow-progressing IA (59.2% of the patients examined) and fast-progressing IA (40.8% of the patients examined). In 5 patients with body eight deficit and clinical manifestations of vitamin C and B deficiency the disease assumed a fulminant course. The patients' condition was considered severe or very severe already on the first days of the infection. The results of endoscopic studies (rectoromanoscopy, fiber colonoscopy) demonstrate that the formation of amoeba-induced damages in the colon mucosa takes place by the 6th-14th day of the disease onset.