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Autoimmune hepatitis (AH) is a chronic inflammatory immunodependent disease of the liver. Women are affected more frequently than men. The patients show clinical and morphological signs of chronic hepatitis, extrahepatic manifestations of immune disorders (autoimmune thyroiditis, non-specific ulcerative colitis, vitiligo, diabetes mellitus, etc.), readily respond to glucocorticoid therapy have elevated levels of ALA, gamma-globulins (especially IgG), serum ANA, SMA, LKM or SLA antibodies. Untreated AH promotes rapid development of liver cirrhosis with 90% 10-year lethality. AH is diagnosed by exclusion and is of primary importance for clinical practice. The treatment is based on the use of immunosuppressors as a rule prescribed in addition to steroid therapy. It results in complete remission and normal life expectancy in 80% of the cases.

The dynamics of hormonal secretion was studied in relation with the development of an ulcer defect in rats with acetate-induced gastroduodenal ulcer after Okabe. The formation of the ulcer was accompanied by increased gastrin, glucagon, cortisol, growth hormone, and histamine secretion and reduced glucose tolerance. The level of intragastric pH reduced, the activity of proteolytic enzymes in the gastrointestinal tract increased. Correlation analysis bore evidence for the contribution of gastroenteropancreatic hormones to the compensatory-adaptational responses, whereas with a higher blood cortisol level the surface of the ulcer defect was larger. Oral mineral water (Essentuki No. 17) promoted the secretion of gastrin, glucagon, and insulin and the experimental ulcers grew smaller in this case. The involvement of the hormonal factors in the mechanisms of the development of experimental acetate-induced ulcer is discussed.

Ultrasonic scanning following a course of mud therapy found out a stimulatory effect of the treatment on gallbladder motility. The bile composition reflected an anti-inflammatory action of mud applications which also enhanced bile lithogenesis.

Basing on literature reports and original investigations, the author considers recovery of normal gastrointestinal function as one of the mechanisms of mineral water action. Curing effect is realized by normalizing the function of the affected organ rather than gastric secretion and is due to a beneficial effect of the water on the regulatory gastrointestinal systems.

Hypersecretion of hydrocortisone, that of insulin, triiodothyronine, thyroxin reflecting phases of stress response and persistence were recorded in early and late postcholecystectomy terms, respectively. As intake of mineral water stimulates secretion of anabolic hormones (insulin, triiodothyronine and thyroxin) and inhibits secretion of catabolic hormone hydrocortisone, drinking of mineral water can be helpful in activation and adjustment of compensatory and adaptive responses after cholecystectomy.

The main target for the action of mineral water in gastrointestinal diseases is the gastroenteropancreatic neuroendocrine system. The effect of oral mineral water is attributed both to physicochemical properties and the intelligence signal of mineral water.

Correlation between a degree of activation of hormonal secretion and the expression of a pathological process in the gastroduodenal area was established in patients with peptic ulcer, chronic gastroduodenitis with raised secretory gastric function and in patients after vagotomy. A sequence of involvement in the reaction to disease of the regulatory systems of the local (gastrin, serotonin and histamine mechanisms), systemic (enteroinsular axis) and organic (glucocorticoid and adrenal function of the adrenal glands) levels was revealed.

Drug and spa conservative treatment of postvagotomy aftereffects has been reviewed. The analysis covers the use of enzymes, cholinergic blocking agents, cyproheptadine hydrochloride, amitriptyline hydrochloride, L-Dopa, diphenoxylic acids and opioids in dumping syndrome; benzohexonium and metoclopramide in gastrostasis; diphenoacids and opioids in postvagotomy diarrhea. Oral and external use of mineral water and mud applications proved most beneficial spa treatment modalities.

The basal and food-stimulated gastrin secretion after selective proximal vagotomy, selective gastric vagotomy and truncular vagotomy was found to be elevated. Hypergastrinemia increased as gastric secretion was inhibited, thus attesting to the role of acid formation inhibition in the origin of the postvagotomy increase in the hormonal secretion. However the values of the intragastral pH being equal, the blood gastrin level was higher after vagotomy as compared to that seen in unoperated peptic ulcer patients. After vagotomy coupled with antrumectomy gastrin secretion remained at the level seen in the unoperated patients, indirect evidence for increased function of extraantral G cells. Inhibition of gastric secretion is no single cause of the postvagotomy hypergastrinemia, since the latter was essentially increased in the early postoperative times and in the presence of the vagotomy-induced disorders. It is concluded that increased secretion of gastrin after vagotomy secures trophic and compensatory-adaptation processes.

The level of gastrin, serotonin, insulin and cortisol in the blood was raised after different types of vagotomy. Raised hormone secretion depends on the time following operation, the severity of a pathological process, to a lesser degree, on the type of surgical intervention and nature of postvagotomic disturbance. Shifts in the hormonal apparatus are caused by operation and associated with it functional-morphological changes of the digestive organs, the preservation of preoperative changes and developing compensatory-adaptive reactions. An excess of intestinal hormone secretion in the postoperative period can be responsible for the development of pathological disorders, in particular the dumping syndrome.

It was established that non-operated patients with duodenal ulcer and patients after organ-saving operations associated with vagotomy show an essential increase of insulin and cortisol secretion and reveal a strict dependence of hormonal secretion on the severity of the pathological process and time after operation. The increased cortisol/insulin ratio correlated with a reduction of the body mass of patients.

Examinations of different patients with duodenal ulcer performed during one year revealed seasonal changes in the function of the regulatory systems. Secretion of histamine, serotonin, insulin, and hydrocortisone was increased in spring and reduced in autumn. Secretion of adrenalin, noradrenalin and acetylcholinesterase activity were high in summer and low in autumn. The acid-producing function of the stomach did not depend on the season. It is suggested that deviations in the activity of the regulatory systems in spring and autumn may cause seasonal exacerbations of duodenal ulcer.

It has been demonstrated that the basal gastrin level in the blood of patients with peptic ulcer of the duodenum is similar to that in normal subjects. Food stimulation raises blood gastrin in normal subjects and patients. However, in patients, the peak of the blood hormone rise is higher, with this rise lasting for a longer time. Besides, the total output of the hormone is greater. These changes are most marked during an incomplete disease remission, being less remarkable when exacerbation gets attenuated and during a complete remission. A correlation has been noticed between the acid-forming function of the stomach and basal blood gastrin level that increases as the acid content in gastric juice descends. In patients experiencing a complete remission and in those in the stage of an incomplete remission and attenuated exacerbation, a direct correlation was ascertained between the stimulated hypergastrinemia and duration of the intragastral pH elevation in response to food intake. It is suggested that in peptic ulcer of the duodenum, hypergastrinemia occurs as a defence reaction aimed at the activation of trophic processes in the mucous membrane of the gastroduodenal zone.

The paper presents a review of the data obtained on the shifts in alimentary function and in relevant regulatory hormonal system in response to a single and course intake of mineral water. It is established that mineral water is a load for alimentary tract, and brings about adaptive reactions when administered in courses. The author infers on the underlying factors contributing to therapeutic effect of crenotherapy. These factors are training effects, adaptive response, activation of repair processes.