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Consumption of dietary supplements in childhood has increased significantly over the past decades. The most common dietary supplements are multivitamin-mineral complexes. Commonly parents make the decision to give dietary supplements without any pediatrician consultation, despite the presence of certain indications. The major reasons to use dietary supplements in children are protection against infections, accelerated growth, and unbalanced nutrition. Uncontrolled implementation of such supplements can lead to various adverse reactions. Promotion of healthy diet among children is crucial aspect of maintaining the children health. It should be noted that dietary supplements are not necessary for healthy children with diverse diet, and their excessive uncontrolled consumption can even do harm. At the same time, there are target groups of children whose diets can be enriched with dietary supplements. Among them are adolescent athletes who, with increased physical exertion, are recommended to consume protein dietary supplements, vitamin supplements are indicated in situations of poor nutritional quality, restrictive diets, pregnancy, the risk of vitamin deficiency, vegetarians and vegans need to make up for micronutrient deficiencies.

Pancreatitis refers to digestive system diseases that are challenging to diagnose and manage. They are also associated with irreversible changes in the organ’s parenchyma, that can lead to lethal outcome. The etiology of pancreatitis is diverse due to various exogenous and endogenous factors that determine the nature and severity of the pathological process itself. The major causes in children are the following: obstruction of ductus choledochus or duodenal papilla, abdominal trauma, viral infections, and some medications. Experts have revealed, after several studies, the association between pancreatitis and genetic factors causing up ton 75% of cases of chronic pancreatitis. Nowadays, genes associated with hereditary pancreatitis include PRSS1 (cationic trypsinogen gene), SPINK1 (serine peptidase inhibitor Kazal, type 1), CFTR (cystic fibrosis transmembrane conduction regulator), CTRC (encoding the functions of chymotrypsin C). The diagnostic criteria for hereditary pancreatitis have been established as for any other pancreatitis. The leading method for visualization of changes in pancreas remains ultrasound (US) examination of abdominal organs, endoscopic US, or magnetic resonance imaging. Molecular genetic testing is advisable for children with manifestations of pancreatitis in addition to recommended basic examinations.

Management of ulcerative colitis remains challenging. The search of new treatment approaches for this disease is constantly continuing. In recent years, the focus was changed to curcumin, active polyphenol found in turmeric roots, that has numerous positive effects on the human body such as anti-inflammatory, anti-carcinogenic, and antioxidant features. Curcumin affects several signaling cellular pathways and gut microbiota content. This review summarizes modern data on the curcumin potential use in ulcerative colitis management.

This review examines modern approaches to the diagnosis and treatment of irritable bowel syndrome (IBS) in children, one of the most common functional disorders of the gastrointestinal tract. IBS is characterized by chronic abdominal pain, intestinal motility disorders and stool changes, which significantly reduces the quality of life of patients. The article analyzes in detail the pathogenetic mechanisms of IBS, including the role of the gut–brain axis, gut microbiota and neuroendocrine factors. Special attention is paid to the pharmacotherapy of IBS in children, including the use of antidepressants, probiotics and herbal components, as well as the role of correctors of the motor activity of the digestive tract in relieving symptoms. Modern recommendations on the use of various classes of antidepressants are considered, taking into account their pharmacokinetic and pharmacodynamic characteristics. The prospects of using probiotics and herbal preparations in the complex therapy of IBS are also analyzed. The data obtained confirm the need for a personalized approach to the treatment of IBS, taking into account the genetic and physiological characteristics of patients.

Necrotizing enterocolitis (NEC) is a disease primarily affecting premature infants. NEC pathogenesis is based on the development of inflammation damaging mucous membranes associated with bacterial colonization, intestinal epithelium immaturity, intestinal blood flow regulation, and excessive inflammatory response activation. Inflammatory bowel disease (IBD) with very early onset (VEO-IBD) can also manifest in the neonatal period. They are characterized by severe course, often resistant to traditional immunosuppressive therapy. This article discusses the features of NEC pathogenesis and differential diagnosis with VEO-IBD. Despite certain similarities in pathogenesis, NEC and IBD are different diseases. Infantile onset IBD is more often associated with monogenic diseases and primary immunodeficiency. VEO-IBD is a chronic disease characterized by damage to all intestinal layers and has a lower incidence compared to NEC. Its clinical manifestations may include chronic diarrhea, blood in stool, delayed physical development, perianal diseases, and ulcerations in the oral cavity. Infantile onset VEO-IBD usually affects the colon, while NEC affects the ileum in premature infants. The intestinal microbiome in VEO-IBD also has specific features. It has been reported that clinical cases of Crohn’s disease in patients who had NEC in the neonatal period are associated with NEC surgery. It is crucial to consider perinatal period features when assessing the IBD risk (prenatal effects of antibacterial therapy and smoking, several courses of antibacterial therapy during the first year of life, and formula feeding).

Background. The low prevalence of Wilson’s disease, diversity of clinical signs, long latent course, inheritance features make it difficult to diagnose and require multidisciplinary approach from doctors. Clinical case description. This article describes a clinical case of Wilson’s disease, rare hereditary multisystem disease, diagnosed in patient F., 13 years old. The disease onset was at the age of 6 masked by gastroesophageal reflux disease. Hepatomegaly, cytolysis, and cholestasis were diagnosed 4 years later, thus diagnosis of hepatitis of unknown origin was established requiring further specification. The decrease of free copper level in serum was revealed at the age of 12, penicillamine test was positive. Molecular genetic testing was performed and the pathogenic variant c.3207C>A (heterozygous state) in the ATP7B gene was revealed. We have measured 4 points via the Leipzig score for Wilson’s disease (Leipzig, 2001): serum ceruloplasmin A (heterozygous state) in the gene ATP7B — 1 point. This score corresponds to the diagnosis of Wilson’s disease. The use of chelation and hepatoprotective therapy has led to positive dynamics. Thus, the disease can debut with nonspecific, asymptomatic increases in transaminases and ultrasound changes in liver at any age. Wilson’s disease is progressive disease and in the absence of timely initiated therapy, patients die due to complications of cirrhosis and/or (less often) progressive neurological symptoms. The prognosis can be favorable with effective chelation therapy or liver transplantation. Conclusion. The described clinical case demonstrates the variability of clinical signs in children with Wilson’s disease that complicates the diagnostic search and early diagnosis

At the moment, in most countries of Europe and North America, there has been a steady increase in the prevalence of inflammatory bowel diseases (IBD). There is little data on the correlation between dairy consumption and the development of IBD, despite the likely biological mechanisms linking these products with the etiopathogenesis of the disease. The exclusion of dairy products from the diet is usually associated with the occurrence of dyspeptic symptoms when they are consumed, which may indicate an exacerbation of the inflammatory process in the intestine or the presence of lactase deficiency. Patients with IBD are characterized by a high prevalence of osteoporosis, and limiting the consumption of dairy products has an even greater negative effect on the state of bone mineral density. In turn, correction of diet therapy in patients with IBD in the presence of intolerance to dairy products should be an important part of the treatment and prevention of complications of the disease.

Dried fruits contain a large number of biologically active compounds, including phenolic compounds, flavonoids, carotenoids, phytoestrogens, etc. These compounds have an antioxidant effect, which has great health benefits. Dried fruits also have a high fiber content. Evaluation of the bioavailability and biological properties of biologically active compounds can contribute to understanding the health effects of dried fruits. A number of studies indicate the beneficial effect of eating dried fruits on the state of the intestinal microbiota. Further research is needed to better understand the health effects of dried fruits and their underlying biological mechanisms.

Walnuts are major component of Mediterranean and Asian diets and are increasingly used in different diets around the world due to their confirmed nutritional and health benefits. Walnuts’ components are abundant with omega-3 polyunsaturated fatty acids, essential amino acids, vitamins, polyphenols, phytosterols, and other nutrients and biologically active compounds with antioxidant, anti-inflammatory and immunomodulating properties. Walnuts currently have demonstrated promising effect in inflammatory bowel diseases management. This study presents key mechanisms underlying walnuts’ therapeutic potential in inflammatory bowel diseases management, such as modulation of intestinal mucosa permeability, inflammatory processes regulation, oxidative stress reduction, and gut microbiota composition correction.

The review describes the state of the vitamin D system and bone metabolism in celiac disease, the mechanisms of the influence of vitamin D on the state of the intestinal mucosa, and risk factors that contribute to pathological changes in bones in celiac disease. Studies are presented that evaluate bone mineral density, bone metabolism, and vitamin D status in patients with celiac disease. The results of a discussion on the effect of calcium and vitamin D supplements on the course of celiac disease and the condition of bone tissue in this disease are presented.

The purpose of this review is to present modern data on the correlations between viruses and celiac disease. Some viruses probably have crucial role in celiac disease pathogenesis according to the results of recent studies. However, the virus exposure itself does not lead to the development of autoimmune disease. Number of studies have demonstrated that there are several viruses that can cause celiac disease, and several activation pathways leading to food tolerance loss. Thus far, the role of some reoviruses strains has been proven in the development of celiac disease. Further research is needed for better understanding of the viruses role in the celiac disease development and to improve management and prevention of this disease.

Background. Congenital duplication of small intestine is a complex disease in terms of early diagnosis due to the absence of specific clinical manifestations. Screening methods do not always help to reveal the lesion localization. Only special methods, such as contrastenhanced fluoroscopy, computed and magnetic resonance imaging, allow us to diagnosis gastrointestinal tract (GIT) malformation more precisely. Moreover, the lack of sufficient awareness about this pathology among primary care physicians also postpones diagnosis and, therefore, the timely correction of this congenital GIT malformation. Thus, our clinical case should help primary care physicians to increase alertness on congenital bowel anomaly. Clinical case description. This clinical case demonstrates that intestinal abnormality was suspected in utero at the first trimester of pregnancy according to ultrasound examination. Intestinal colics can be considered as the first clinical non-specific manifestation of congenital anomaly of small intestine in a child under the age of 1 year. Constipation, abdominal pain, and occasional pyretic fever were observed from the age of 2. Intestinal ultrasound has revealed changes, and radiological and magnetic resonance methods confirmed the presence of small intestine malformation. Conclusion. Screening ultrasound of an intrauterine child in the first trimester of pregnancy could force pediatricians to search congenital GIT anomalies despite its non-specific clinical signs. Imaging methods revealed the defect localization, while surgical intervention recovered it. It has prevented any possible complications and improved the patient’s quality of life.

In recent years, there has been a significant increase in the prevalence of inflammatory bowel diseases. Despite the significant progress made in the instrumental diagnosis of this group of diseases, their treatment in most cases remains formalized, based on fairly strict schemes. In this context, an urgent area of modern research is to study the effectiveness of the use of diet therapy and certain foods in order to modulate the activity of the inflammatory process, which allows avoiding adverse reactions of immunosuppressive, including immunobiological, therapy. Adherence to the Mediterranean diet has proven its effectiveness in the treatment of chronic non-infectious diseases. Recent studies have also established its benefits in the treatment of inflammatory bowel diseases. Recent studies have also established its benefits in the treatment of inflammatory bowel diseases. This article will present the results of modern research on the effect of the use of olive oil and its components on the course of inflammatory processes in the intestine. A number of studies conducted in vitro and in animal models have revealed the mechanisms by which olive oil and its components have a positive effect on the course of inflammation in the intestinal wall through anti-inflammatory, antioxidant, immunomodulatory and antitumor effects. Few clinical studies conducted on patients with inflammatory bowel diseases have shown the possibility of using diet therapy with the addition of olive oil in this group of patients as an additional treatment.

Nowadays, an urgent problem of pediatric gastroenterology is the study of inflammatory bowel diseases with very early onset (VEO-IBD), which have unique genetic, clinical, immunological, morphological, and laboratory sings. Early VEO-IBD is usually considered as monogenic disease, especially in combination with congenital immune defects, which leads to difficulties in diagnosis and management this pathology. Despite this, systematization of information about this group of nosological forms of IBD is practically not carried out. This article presents a review of the available information on etiological factors, course variants, and therapeutic options for VEO-IBD.

The pathogenesis of inflammatory bowel diseases still remains unclear nowadays. Genetic disposition, impaired immune regulation, disturbance in intestinal microbiota composition, exposure to environmental factors are associated with the development of inflammation in intestinal mucosa and increased epithelial penetrance that define disease's development and progression. There is a theory in scientific literature that vitamin D deficiency (among other environmental factors) increases the risk of inflammatory bowel disease. However, the role of vitamin D in the development of gastrointestinal tract diseases remains poorly studied. This article presents current data on the vitamin D effect on the intestinal mucosa barrier function, on the immune system and on the intestinal microbiota in the context of inflammatory bowel diseases pathogenesis.

Background. The usage of new psychoactive substances (NPAS) is increasing every year among various social groups around the world. According to various authors, the use of abused drugs during pregnancy remains at a high level — from 2.8 to 7% of pregnant women. The usage of NPAS, as well as other groups of abused drugs, during pregnancy is fraught with intrauterine multi-organ damage, however, any organ and tissue specificity for NPAS has not been described. In intervention trials conducted on laboratory animals, negative pathophysiological mechanisms triggered by synthetic cathinones have been demonstrated in the form of increased proapoptotic activity, the formation of autophagolysosomes and reactive oxygen intermediates in cells of nervous tissue, and the pro-inflammatory orientation of cells of the immune system.Case report describes a predominant lesion of the nervous system (developmental brain malformations, damage to the inspiratory center) and the musculoskeletal system (pronounced miotonical syndrome, congenital pathological fractures of the femurs), leading to multiorgan dysfunction, uncontrolled inflammatory response and, as a result, to the development of severe disablement of such children and an increase in the cohort of palliative pediatric patients. In the article, the authors focus on the pathophysiological mechanisms of NPAS for a deeper and more holistic understanding of the pathological process occurring in the body, in order to form and improve the medical judgment of specialist doctors and cite their own clinical observation as an illustration of the consequences of using NPAS during pregnancy. The authors believe that this review describing the case report is valuable from the point of view of practical applicability both for clinicians of various fields and for researchers.Conclusion. In addition, it is necessary to pay attention to the fact that the use of NPAS is of great social and economic significance, the description of such clinical observations, as well as in vitro studies, is relevant, and the expansion of ideas about the short-term and long-term negative consequences of the use of NPAS should serve as an initiating stage for the development of rehabilitation strategies for these patients

Various human lifestyle and environmental factors are known to influence sleep. The number of adults and children suffering from chronic sleep disorders has grown over the past decade. Lack of sleep and impaired circadian rhythms have been proven to be associated with adverse metabolic health effects. Often, such disorders are associated with gastrointestinal tract diseases, and accompanied by dysbiosis. Significant number of studies have been conducted on animal models in recent years. They have shown the correlation between the gut microbiota and brain functions. According to these results scientists have clearly demonstrated the role of gut microbiota in regulating brain function, sleep, and behavior. The number of studies with volunteers is currently limited. The bacteria forming gut microbiota have significant impact on human health by synthesizing and secreting biologically active substances such as vitamins, essential amino acids, lipids, and others. Moreover, they have an indirect effect by modulating metabolic processes and the immune system. Changes in gut microbiota diversity occur due to the lack of sleep and shifting circadian rhythms, and it can lead to changes in the structure and function of microorganisms living in the gut. This can lead to changes in the composition and number of metabolites synthesized by these microorganisms (such as short-chain fatty acids and secondary bile acids) which contributes to the development of chronic inflammation, increased body weight and endocrine changes. This article provides the literature review on issues of interaction between gut microbiota and processes occurring during sleep.

Recent studies have shown the correlation between stress, immunity and intestinal microbiota. Chronic stress is associated with high production of inflammation mediators and risk of infection development, chronic systemic inflammation and inflammatory diseases development, as well as depressive disorders. Intestinal microbiota produces a wide range of compounds important for the organism: all major neurotransmitters, including serotonin, cytokines, tryptophan and short-chain fatty acids. Serotonin deficiency is considered as significant cause factor for development of anxiety, aggression, affective disorders and stress. Tryptophan is the serotonin precursor. Tryptophan is produced by intestinal microbiota or derived from food can be metabolized into kinurenine. Proinflammatory cytokines activate hypothalamus-pituitary-adrenal axis that increases of the level of circulating kinurenine and reduces the serotonin synthesis. Besides that, more kinurenine enters the brain during the inflammation process, and the neurotoxic pathway of kinurenine metabolism overwhelm the neuroprotective one. The less various microbiota microbiota is associated with increased response of the hypothalamus-pituitary-adrenal system, increase of pro-inflammatory cytokines, reduction of stress resistance, and depression. Enrichment of the diet with prebiotic components increases the diversity of the intestinal microbiota. Dietary interventions for intestinal microbiome also include probiotics promoting increased body resistance and cause less exposure to depression.