Значение пробиотиков в современных алгоритмах терапии синдрома раздраженного кишечника
Значение пробиотиков в современных алгоритмах терапии синдрома раздраженного кишечника
Андреев Д.Н., Маев И.В. Значение пробиотиков в современных алгоритмах терапии синдрома раздраженного кишечника. Consilium Medicum. 2023;25(5):336–342. DOI: 10.26442/20751753.2023.5.202131
Andreev DN, Maev IV. The role of probiotics in current algorithms for the treatment of irritable bowel syndrome: A review. Consilium Medicum. 2023;25(5):336–342. DOI: 10.26442/20751753.2023.5.202131
Значение пробиотиков в современных алгоритмах терапии синдрома раздраженного кишечника
Андреев Д.Н., Маев И.В. Значение пробиотиков в современных алгоритмах терапии синдрома раздраженного кишечника. Consilium Medicum. 2023;25(5):336–342. DOI: 10.26442/20751753.2023.5.202131
Andreev DN, Maev IV. The role of probiotics in current algorithms for the treatment of irritable bowel syndrome: A review. Consilium Medicum. 2023;25(5):336–342. DOI: 10.26442/20751753.2023.5.202131
Синдром раздраженного кишечника (СРК) является крайне распространенным заболеванием, поражающим лиц трудоспособного возраста и значительно снижающим качество жизни. Многими авторитетными специалистами высказано предположение, что микрофлора толстой кишки у пациентов с СРК характеризуется дисбиозом, что приводит к увеличению ферментации, избыточному газообразованию и развитию характерных для заболевания симптомов. На сегодняшний день альтерации кишечной микробиоты рассматриваются как один из основных механизмов генеза СРК, что определяет необходимость использования пробиотиков с доказанной эффективностью как важную часть комплексной терапии данного заболевания. Определенные пробиотические штаммы (включая штаммы Bifidobacterium longum 35624 и Saccharomyces boulardii CNCM I-745) доказали свою эффективность в нормализации частоты и консистенции стула у пациентов с СРК, регрессе абдоминальной боли, а также нормализации качества жизни.
Irritable bowel syndrome (IBS) is a widespread disease that affects working-age people and significantly reduces their quality of life. Many experts have suggested that the colon microflora in patients with IBS is characterized by dysbiosis, which leads to increased fermentation, excessive gas formation, and symptoms typical of the disease. Currently, alterations of the intestinal microbiota are considered one of the main mechanisms of IBS development, which warrants the use of probiotics with proven effectiveness as a part of the complex therapy. Certain probiotic strains (including Bifidobacterium longum 35624 and Saccharomyces boulardii CNCM I-745) have been shown to be effective in normalizing stool frequency and consistency in IBS patients, regressing abdominal pain, and normalizing quality of life.
1. Маев И.В., Андреев Д.Н., Баркалова Е.В., Кучерявый Ю.А. Функциональные заболевания пищеварительной системы. М.: Группа Ремедиум, 2022 [Maev IV, Andreev DN, Barkalova EV, Kucheriavyi IuA. Funktsional'nye zabolevaniia pishchevaritel'noi sistemy. Moscow: Gruppa Remedium, 2022 (in Russian)].
2. Drossman DA, Hasler WL. Rome IV-Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology. 2016;150(6):1257-61.
3. Lacy BE, Mearin F, Chang L, et al. Bowel Disorders. Gastroenterology. 2016;150:1393-407.
4. Самсонов А.А., Андреев Д.Н., Дичева Д.Т. Синдром раздраженного кишечника с позиций современной гастроэнтерологии. Фарматека. 2014;18:7-14 [Samsonov AA, Andreev DN, Dicheva DT. Sindrom razdrazhennogo kishechnika s pozitsii sovremennoi gastroenterologii. Farmateka. 2014;18:7-14 (in Russian)].
5. Canavan C, West J, Card T. Review article: the economic impact of the irritable bowel syndrome. Aliment Pharmacol Ther. 2014;40(9):1023-34. DOI:10.1111/apt.12938
6. Oka P, Parr H, Barberio B, et al. Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2020;5(10):908-17. DOI:10.1016/S2468-1253(20)30217-X
7. Sperber AD, Bangdiwala SI, Drossman DA, et al. Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study. Gastroenterology. 2021;160(1):99-114.e3. DOI:10.1053/j.gastro.2020.04.014
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9. Ford AC, Marwaha A, Lim A, Moayyedi P. Systematic review and meta-analysis of the prevalence of irritable bowel syndrome in individuals with dyspepsia. Clin Gastroenterol Hepatol. 2010;8(5):401-9. DOI:10.1016/j.cgh.2009.07.020
10. Маев И.В., Умярова Р.М., Андреев Д.Н., и др. Сочетание функциональной диспепсии и синдрома раздраженного кишечника при использовании Римских критериев IV пересмотра: метаанализ. Медицинский Совет. 2021;(5):12-20 [Maev IV, Umyarova RM, Andreev DN, et al. Overlap of functional dyspepsia and irritable bowel syndrome by revised Rome IV criteria: meta-analysis. Medical Council. 2021;(5):12-20 (in Russian)]. DOI:10.21518/2079-701X-2021-5-12-20
11. Андреев Д.Н., Бордин Д.С., Вьючнова Е.С., и др. Частота сочетания функциональной диспепсии и синдрома раздраженного кишечника: метаанализ исследований с использованием римских критериев III–IV пересмотра. Терапевтический архив. 2022;94(9):1099-108 [Andreev DN, Bordin DS, Vyuchnova ES, et al. Prevalence of combination of functional dyspepsia and irritable bowel syndrome: a meta-analysis of studies using the Rome III–IV Criteria. Terapevticheskii Arkhiv (Ter. Arkh.). 2022;94(9):1099-108 (in Russian)]. DOI:10.26442/00403660.2022.09.201849
12. Ивашкин В.Т., Маев И.В., Шелыгин Ю.А., и др. Диагностика и лечение синдрома раздраженного кишечника (Клинические рекомендации Российской гастроэнтерологической ассоциации и Ассоциации колопроктологов России). Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2021;31(5):74-95 [Ivashkin VT, Maev IV, Shelygin YuA, et al. Diagnosis and Treatment of Irritable Bowel Syndrome: Clinical Recommendations of the Russian Gastroenterological Association and Association of Coloproctologists of Russia. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2021;31(5):74-95 (in Russian)]. DOI:10.22416/1382-4376-2021-31-5-74-95
13. Маев И.В., Черемушкин С.В., Кучерявый Ю.А., Андреев Д.Н. Синдром раздраженного кишечника с позиций современной фундаментальной и клинической медицины. М.: Прима Принт, 2019 [Maev IV, Cheremushkin SV, Kucheriavyi IuA, Andreiev DN. Sindrom razdrazhennogo kishechnika s pozitsii sovremennoi fundamental'noi i klinicheskoi meditsiny. Moscow: Prima Print, 2019 (in Russian)].
14. Drossman DA, Tack J. Rome Foundation Clinical Diagnostic Criteria for Disorders of Gut-Brain Interaction. Gastroenterology. 2022;162(3):675-9. DOI:10.1053/j.gastro.2021.11.019
15. Althani AA, Marei HE, Hamdi WS, et al. Human Microbiome and its Association With Health and Diseases. J Cell Physiol. 2016;231(8):1688-94. DOI:10.1002/jcp.25284
16. Hall AB, Tolonen AC, Xavier RJ. Human genetic variation and the gut microbiome in disease. Nat Rev Genet. 2017;18(11):690-9. DOI:10.1038/nrg.2017.63
17. Toribio-Mateas M. Harnessing the Power of Microbiome Assessment Tools as Part of Neuroprotective Nutrition and Lifestyle Medicine Interventions. Microorganisms. 2018;6(2):35. DOI:10.3390/microorganisms6020035
18. Pozuelo M, Panda S, Santiago A, et al. Reduction of butyrate- and methane-producing microorganisms in patients with Irritable Bowel Syndrome. Sci Rep. 2015;5:12693. DOI:10.1038/srep12693
19. Pittayanon R, Lau JT, Yuan Y, et al. Gut Microbiota in Patients With Irritable Bowel Syndrome – A Systematic Review Gastroenterology. Gastroenterology. 2019;157(1):97-108.
20. Tap J, Derrien M, Törnblom H, et al. Identification of an Intestinal Microbiota Signature Associated With Severity of Irritable Bowel Syndrome. Gastroenterology. 2017;152(1):111-23.e8.
21. Pimentel M, Lembo A. Microbiome and Its Role in Irritable Bowel Syndrome. Dig Dis Sci. 2020;65(3):829-39. DOI:10.1007/s10620-020-06109-5
22. Chen B, Kim JJ, Zhang Y, et al. Prevalence and predictors of small intestinal bacterial overgrowth in irritable bowel syndrome: a systematic review and meta-analysis. J Gastroenterol. 2018;53(7):807-18.
23. Klem F, Wadhwa A, Prokop LJ, et al. Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis. Gastroenterology. 2017;152(5):1042-54.e1.
24. Маев И.В., Шпектор А.В., Васильева Е.Ю., и др. Новая коронавирусная инфекция COVID-19: экстрапульмональные проявления. Терапевтический архив. 2020;92(8):4-11 [Maev IV, Shpektor AV, Vasilyeva EYu, et al. Novel coronavirus infection COVID-19: extrapulmonary manifestations. Terapevticheskii Arkhiv (Ter. Arkh.). 2020;92(8):4-11 (in Russian)]. DOI:10.26442/00403660.2020.08.000767
25. Oshima T, Siah KTH, Yoshimoto T, et al. Impacts of the COVID-19 pandemic on functional dyspepsia and irritable bowel syndrome: A population-based survey. J Gastroenterol Hepatol. 2021;36(7):1820-7. DOI:10.1111/jgh.15346
26. Ghoshal UC, Ghoshal U, Rahman MM, et al. Post-infection functional gastrointestinal disorders following coronavirus disease-19: A case-control study. J Gastroenterol Hepatol. 2022;37(3):489-98. DOI:10.1111/jgh.15717
27. Zuo T, Zhang F, Lui GCY, et al. Alterations in Gut Microbiota of Patients With COVID-19 During Time of Hospitalization. Gastroenterology. 2020;159(3):944-55.e8. DOI:10.1053/j.gastro.2020.05.048
28. Yeoh YK, Zuo T, Lui GC, et al. Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19. Gut. 2021;70(4):698-706. DOI:10.1136/gutjnl-2020-323020
29. Fani M, Mostamand J, Fani M, et al. The effect of aerobic exercises among women with mild and moderate irritable bowel syndrome: A pilot study. J Bodyw Mov Ther. 2019;23(1):161-5.
30. Hajizadeh Maleki B, Tartibian B, Mooren FC, et al. Low-to-moderate intensity aerobic exercise training modulates irritable bowel syndrome through antioxidative and inflammatory mechanisms in women: Results of a randomized controlled trial. Cytokine. 2018;102:18-25.
31. Zhou C, Zhao E, Li Y, et al. Exercise therapy of patients with irritable bowel syndrome: A systematic review of randomized controlled trials. Neurogastroenterol Motil. 2019;31(2):e13461.
32. Dionne J, Ford AC, Yuan Y, et al. A Systematic Review and Meta-Analysis Evaluating the Efficacy of a Gluten-Free Diet and a Low FODMAPs Diet in Treating Symptoms of Irritable Bowel Syndrome. Am J Gastroenterol. 2018;113(9):1290-300.
33. Poynard T, Regimbeau C, Benhamou Y. Meta-analysis of smooth muscle relaxants in the treatment of irritable bowel syndrome. Aliment Pharmacol Ther. 2001;15(3):355-61.
34. Martínez-Vázquez MA, Vázquez-Elizondo G, González-González JA, et al. Effect of antispasmodic agents, alone or in combination, in the treatment of Irritable Bowel Syndrome: systematic review and meta-analysis. Rev Gastroenterol Mex. 2012;77(2):82-90.
35. Маев И.В., Самсонов А.А., Андреев Д.Н. Современный алгоритм ведения пациентов с синдромом хронического запора с позиций внедрения новых фармакологических препаратов. Фарматека. 2012;13:37-43 [Maiev IV, Samsonov AA, Andreiev DN. Sovremennyi algoritm vedeniia patsiientov s sindromom khronicheskogo zapora s pozitsii vnedreniia novykh farmakologicheskikh preparatov. Farmateka. 2012;13:37-43 (in Russian)].
36. Ford AC, Quigley EM, Lacy BE, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014;109(10):1547-61. DOI:10.1038/ajg.2014.202
37. Zhang Y, Li L, Guo C, et al. Effects of probiotic type, dose and treatment duration on irritable bowel syndrome diagnosed by Rome III criteria: a meta-analysis. BMC Gastroenterol. 2016;16(1):62.
38. Sun JR, Kong CF, Qu XK, et al. Efficacy and safety of probiotics in irritable bowel syndrome: A systematic review and meta-analysis. Saudi J Gastroenterol. 2020;26(2):66-77. DOI:10.4103/sjg.SJG_384_19
39. McFarland LV, Karakan T, Karatas A. Strain-specific and outcome-specific efficacy of probiotics for the treatment of irritable bowel syndrome: A systematic review and meta-analysis. EClinicalMedicine. 2021;41:101154. DOI:10.1016/j.eclinm.2021.101154
40. Ивашкин В.Т., Маев И.В., Алексеева О.П., и др. Определение показаний к назначению пробиотиков у пациентов с синдромом раздраженного кишечника (обзор литературы и резолюция Совета экспертов). Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2022;32(2):9-18 [Ivashkin VT, Maev IV, Alekseeva OP, et al. Determination of Probiotics Prescription Indications in Patients with Irritable Bowel Syndrome (Materials of the Expert Council and Literature Review). Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2022;32(2):9-18 (in Russian)]. DOI:10.22416/1382-4376-2022-32-2-9-18
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43. Chan WW, Grover M. The COVID-19 Pandemic and Post-Infection Irritable Bowel Syndrome: What Lies Ahead for Gastroenterologists. Clin Gastroenterol Hepatol. 2022;20(10):2195-7. DOI:10.1016/j.cgh.2022.05.044
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1. Maev IV, Andreev DN, Barkalova EV, Kucheriavyi IuA. Funktsional'nye zabolevaniia pishchevaritel'noi sistemy. Moscow: Gruppa Remedium, 2022 (in Russian).
2. Drossman DA, Hasler WL. Rome IV-Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology. 2016;150(6):1257-61.
3. Lacy BE, Mearin F, Chang L, et al. Bowel Disorders. Gastroenterology. 2016;150:1393-407.
4. Samsonov AA, Andreev DN, Dicheva DT. Sindrom razdrazhennogo kishechnika s pozitsii sovremennoi gastroenterologii. Farmateka. 2014;18:7-14 (in Russian).
5. Canavan C, West J, Card T. Review article: the economic impact of the irritable bowel syndrome. Aliment Pharmacol Ther. 2014;40(9):1023-34. DOI:10.1111/apt.12938
6. Oka P, Parr H, Barberio B, et al. Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2020;5(10):908-17. DOI:10.1016/S2468-1253(20)30217-X
7. Sperber AD, Bangdiwala SI, Drossman DA, et al. Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study. Gastroenterology. 2021;160(1):99-114.e3. DOI:10.1053/j.gastro.2020.04.014
8. Andreyev DN, Zaborovsky AV, Trukhmanov AS, et al. Evaluation of the functional gastrointestinal diseases concept from standpoints of Rome IV (2016) diagnostic criteria (review). Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2017;27(1):4-11 (in Russian).
9. Ford AC, Marwaha A, Lim A, Moayyedi P. Systematic review and meta-analysis of the prevalence of irritable bowel syndrome in individuals with dyspepsia. Clin Gastroenterol Hepatol. 2010;8(5):401-9. DOI:10.1016/j.cgh.2009.07.020
10. Maev IV, Umyarova RM, Andreev DN, et al. Overlap of functional dyspepsia and irritable bowel syndrome by revised Rome IV criteria: meta-analysis. Medical Council. 2021;(5):12-20 (in Russian). DOI:10.21518/2079-701X-2021-5-12-20
11. Andreev DN, Bordin DS, Vyuchnova ES, et al. Prevalence of combination of functional dyspepsia and irritable bowel syndrome: a meta-analysis of studies using the Rome III–IV Criteria. Terapevticheskii Arkhiv (Ter. Arkh.). 2022;94(9):1099-108 (in Russian). DOI:10.26442/00403660.2022.09.201849
12. Ivashkin VT, Maev IV, Shelygin YuA, et al. Diagnosis and Treatment of Irritable Bowel Syndrome: Clinical Recommendations of the Russian Gastroenterological Association and Association of Coloproctologists of Russia. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2021;31(5):74-95 (in Russian). DOI:10.22416/1382-4376-2021-31-5-74-95
13. Maev IV, Cheremushkin SV, Kucheriavyi IuA, Andreiev DN. Sindrom razdrazhennogo kishechnika s pozitsii sovremennoi fundamental'noi i klinicheskoi meditsiny. Moscow: Prima Print, 2019 (in Russian).
14. Drossman DA, Tack J. Rome Foundation Clinical Diagnostic Criteria for Disorders of Gut-Brain Interaction. Gastroenterology. 2022;162(3):675-9. DOI:10.1053/j.gastro.2021.11.019
15. Althani AA, Marei HE, Hamdi WS, et al. Human Microbiome and its Association With Health and Diseases. J Cell Physiol. 2016;231(8):1688-94. DOI:10.1002/jcp.25284
16. Hall AB, Tolonen AC, Xavier RJ. Human genetic variation and the gut microbiome in disease. Nat Rev Genet. 2017;18(11):690-9. DOI:10.1038/nrg.2017.63
17. Toribio-Mateas M. Harnessing the Power of Microbiome Assessment Tools as Part of Neuroprotective Nutrition and Lifestyle Medicine Interventions. Microorganisms. 2018;6(2):35. DOI:10.3390/microorganisms6020035
18. Pozuelo M, Panda S, Santiago A, et al. Reduction of butyrate- and methane-producing microorganisms in patients with Irritable Bowel Syndrome. Sci Rep. 2015;5:12693. DOI:10.1038/srep12693
19. Pittayanon R, Lau JT, Yuan Y, et al. Gut Microbiota in Patients With Irritable Bowel Syndrome – A Systematic Review Gastroenterology. Gastroenterology. 2019;157(1):97-108.
20. Tap J, Derrien M, Törnblom H, et al. Identification of an Intestinal Microbiota Signature Associated With Severity of Irritable Bowel Syndrome. Gastroenterology. 2017;152(1):111-23.e8.
21. Pimentel M, Lembo A. Microbiome and Its Role in Irritable Bowel Syndrome. Dig Dis Sci. 2020;65(3):829-39. DOI:10.1007/s10620-020-06109-5
22. Chen B, Kim JJ, Zhang Y, et al. Prevalence and predictors of small intestinal bacterial overgrowth in irritable bowel syndrome: a systematic review and meta-analysis. J Gastroenterol. 2018;53(7):807-18.
23. Klem F, Wadhwa A, Prokop LJ, et al. Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis. Gastroenterology. 2017;152(5):1042-54.e1.
24. Maev IV, Shpektor AV, Vasilyeva EYu, et al. Novel coronavirus infection COVID-19: extrapulmonary manifestations. Terapevticheskii Arkhiv (Ter. Arkh.). 2020;92(8):4-11 (in Russian). DOI:10.26442/00403660.2020.08.000767
25. Oshima T, Siah KTH, Yoshimoto T, et al. Impacts of the COVID-19 pandemic on functional dyspepsia and irritable bowel syndrome: A population-based survey. J Gastroenterol Hepatol. 2021;36(7):1820-7. DOI:10.1111/jgh.15346
26. Ghoshal UC, Ghoshal U, Rahman MM, et al. Post-infection functional gastrointestinal disorders following coronavirus disease-19: A case-control study. J Gastroenterol Hepatol. 2022;37(3):489-98. DOI:10.1111/jgh.15717
27. Zuo T, Zhang F, Lui GCY, et al. Alterations in Gut Microbiota of Patients With COVID-19 During Time of Hospitalization. Gastroenterology. 2020;159(3):944-55.e8. DOI:10.1053/j.gastro.2020.05.048
28. Yeoh YK, Zuo T, Lui GC, et al. Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19. Gut. 2021;70(4):698-706. DOI:10.1136/gutjnl-2020-323020
29. Fani M, Mostamand J, Fani M, et al. The effect of aerobic exercises among women with mild and moderate irritable bowel syndrome: A pilot study. J Bodyw Mov Ther. 2019;23(1):161-5.
30. Hajizadeh Maleki B, Tartibian B, Mooren FC, et al. Low-to-moderate intensity aerobic exercise training modulates irritable bowel syndrome through antioxidative and inflammatory mechanisms in women: Results of a randomized controlled trial. Cytokine. 2018;102:18-25.
31. Zhou C, Zhao E, Li Y, et al. Exercise therapy of patients with irritable bowel syndrome: A systematic review of randomized controlled trials. Neurogastroenterol Motil. 2019;31(2):e13461.
32. Dionne J, Ford AC, Yuan Y, et al. A Systematic Review and Meta-Analysis Evaluating the Efficacy of a Gluten-Free Diet and a Low FODMAPs Diet in Treating Symptoms of Irritable Bowel Syndrome. Am J Gastroenterol. 2018;113(9):1290-300.
33. Poynard T, Regimbeau C, Benhamou Y. Meta-analysis of smooth muscle relaxants in the treatment of irritable bowel syndrome. Aliment Pharmacol Ther. 2001;15(3):355-61.
34. Martínez-Vázquez MA, Vázquez-Elizondo G, González-González JA, et al. Effect of antispasmodic agents, alone or in combination, in the treatment of Irritable Bowel Syndrome: systematic review and meta-analysis. Rev Gastroenterol Mex. 2012;77(2):82-90.
35. Maiev IV, Samsonov AA, Andreiev DN. Sovremennyi algoritm vedeniia patsiientov s sindromom khronicheskogo zapora s pozitsii vnedreniia novykh farmakologicheskikh preparatov. Farmateka. 2012;13:37-43 (in Russian).
36. Ford AC, Quigley EM, Lacy BE, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014;109(10):1547-61. DOI:10.1038/ajg.2014.202
37. Zhang Y, Li L, Guo C, et al. Effects of probiotic type, dose and treatment duration on irritable bowel syndrome diagnosed by Rome III criteria: a meta-analysis. BMC Gastroenterol. 2016;16(1):62.
38. Sun JR, Kong CF, Qu XK, et al. Efficacy and safety of probiotics in irritable bowel syndrome: A systematic review and meta-analysis. Saudi J Gastroenterol. 2020;26(2):66-77. DOI:10.4103/sjg.SJG_384_19
39. McFarland LV, Karakan T, Karatas A. Strain-specific and outcome-specific efficacy of probiotics for the treatment of irritable bowel syndrome: A systematic review and meta-analysis. EClinicalMedicine. 2021;41:101154. DOI:10.1016/j.eclinm.2021.101154
40. Ivashkin VT, Maev IV, Alekseeva OP, et al. Determination of Probiotics Prescription Indications in Patients with Irritable Bowel Syndrome (Materials of the Expert Council and Literature Review). Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2022;32(2):9-18 (in Russian). DOI:10.22416/1382-4376-2022-32-2-9-18
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Авторы
Д.Н. Андреев*, И.В. Маев
ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России, Москва, Россия
*dna-mit8@mail.ru
________________________________________________
Dmitry N. Andreev*, Igor V. Maev
Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
*dna-mit8@mail.ru