Функциональные расстройства органов пищеварения у детей. Рекомендации Общества детских гастроэнтерологов, гепатологов и нутрициологов. Часть 1

Функциональные расстройства органов пищеварения у детей. Рекомендации Общества детских гастроэнтерологов, гепатологов и нутрициологов. Часть 2

Objective of the research: to determine clinical and epidemiological features of the course of the new coronavirus infection (COVID-19) caused by SARS-CoV-2 in children in the Russian Federation (RF). Materials and methods: a retrospective analysis of all confirmed COVID-19 cases in children in the first half of 2020 in the Russian Federation was performed. Information about patients (age, sex, examination date, place of residence, disease severity final diagnosis, etc.) was taken from the database containing the Rospotrebnadzor report form № 970 «Information on cases of infectious diseases in persons with suspected new coronavirus infection» January – June 2020 across the Russian Federation. Research results were processed using the IBM SPSS Statistics 26 program. To assess the differences in nominal indicators (proportions), the Pearson χ2 test was used. The results were considered statistically significant at p0,05). In children, the maximum number of cases is registered in family foci – 75%. Upper respiratory tract infections were diagnosed in 72,1% of patients. The proportion of pneumonia was 1,8%, and 2/3 of children were over 3 years old (p<0,001). In almost 1/3 of patients, the infection course had no clinical manifestations. 18,2% of children at the disease onset had increased body temperature, while only 3,5% of children had hyperthermia above 390 C. Cough was registered in 50,8% of cases. Rhinitis/rhinopharyngitis developed only in every 4th child. Symptoms pathognomonic for COVID-19, such as loss of smell (anosmia) and taste (ageusia), were recorded only in 17% of cases. 41,3% of patients received treatment in a hospital, and among them children under 3 years of age predominated. Conclusion: in children in the RF, the new coronavirus infection COVID-19 is generally favorable.

   Aim: to optimize outcomes of the treatment and prevention of gastrointestinal diseases in adults and children.   Key points. The Methodological Guidelines contain sections on the terminology, classification, mechanisms of action, requirements for sale in the Russian Federation, requirements for proving the efficacy and safety of probiotics, prebiotics, synbiotics and metabiotics, as well as functional foods enriched with them. An overview of relevant data allowing to include these drugs and products in the treatment an d prevention of gastrointestinal diseases in adults and children is presented.   Conclusion. The clinical efficacy of probiotics, prebiotics, synbiotics and metabiotics depends on the specificity and quantity of their components, the dosage form, the regimen and duration of treatment. Products and functional foods with proven efficacy and safety are recommended for the treatment and prevention of gastrointestinal diseases in adults and children.

The authors present current data on the etiology, pathogenesis, clinical manifestations of celiac disease in children of different ages, associated diseases, laboratory and instrumental diagnostics, diet therapy, additional treatment methods, vaccination, and follow-up of children with celiac disease based on the developed clinical guidelines “Celiac Disease. Children”.

Inflammatory bowel disease (IBD) is a group of severe systemic diseases with a multiple intestinal and extraintestinal manifestations (EIM). EIM can affect any organ systems, determine the course, therapy and prognosis of the underlying disease. The frequency of EIM (6–80%) differs significantly in studies depending on the cohort of patients (number, age of patients, IBD phenotype). In 6–10% of children EIM are the first symptoms of the disease. The classification of EIM most often depends on the activity of the disease in the intestine. The most commonly affected «target organs» in children and adults are joints, skin and mucous membranes, eyes, and the hepatobiliary system. Physical development delay is specific for children IBD, not always reversible. The article highlights the incidence of ulcerative colitis and Crohn’s disease EIM in children and adults, analyzes the basics of epidemiology, pathogenesis, clinical manifestations, approaches to the diagnosis and treatment of arthritis, growth disorders, mucocutaneous, ocular and hepatobiliary EIM of IBD in children. Therapy of EIM associated with IBD activity is aimed at controlling the underlying disease and includes a wide range of drugs, ФНОα antagonists are the most effective. The treatment protocols for other EIM are not standardized in either adult or pediatric practice and are significantly less successful.