Clinical Center of the First Moscow Medical University named after. Sechenov – gastroenterology

Detailed information can be obtained on the website http://sechenovclinic.ru

Address:

st. Bolshaya Pirogovskaya, 6, building 1, metro station "Sportivnaya"

Department of Gastroenterology

The department works closely with the Department of Propaedeutics of Internal Diseases of the Faculty of Medicine of the First Moscow State Medical University named after. I.M. Sechenov. Rounds in the department are conducted by the head of the department of propaedeutics of internal diseases, academician of the Russian Academy of Medical Sciences, professor, doctor of medical sciences. Ivashkin V.T. The department employs a professor, doctor of medical sciences. Sheptulin A.A., professor, doctor of medical sciences Trukhmanov A.S., Associate Professor, Ph.D. Lapina T.L., associate professor, candidate of medical sciences Okhlobystin A.V.

The department has a staffing capacity of 30 beds. There are single and double rooms of superior comfort.

The following describes the types of assistance provided.

Diagnosis and treatment of esophageal diseases

• Detection of GERD, including in patients with atypical symptoms, individual selection of therapy, also in patients with a lack of effectiveness of existing treatment.
• Carrying out a differential diagnosis in patients with complaints of chest pain.
• Diagnosis of achalasia cardia, cardiospasm, esophagospasm, esophageal lesions in systemic diseases.
• Monitoring and correction of therapy using modern techniques - daily pH and impedance measurements of the esophagus, study of the motor function of the esophagus (including high-resolution HRM).
• Diagnosis of Barrett's esophagus with the development of an individual treatment plan for patients.

Diagnosis and treatment of H. pylori infection

In most cases, patients for whom eradication of H. pylori is indicated have a history of previous courses of treatment for H. pylori. The department uses methods to monitor the effectiveness of eradication therapy, including the “gold standard” - a breath test with 13C-labeled urea. Modern regimens of both standard therapy and second- and third-line therapy have been introduced into clinical practice, in accordance with international recommendations.

Treatment of gastric and duodenal ulcers

• Conducting a differential diagnostic search to exclude symptomatic ulcers.
• Carrying out individual selection of antiulcer therapy and assessing its effectiveness.

Diagnosis and management of patients with autoimmune and atrophic gastritis

An algorithm for diagnosing and managing patients with various types of gastritis, including autoimmune and atrophic, has been developed and put into practice. Patients undergo a study of serum atrophy markers (pepsinogens, gastrin-17), determination of antibodies to parietal cells and intrinsic factor, regular morphological monitoring, and prevention of the development of megaloblastic anemia.

Treatment of patients with disease of the operated stomach

• Rehabilitation of patients after gastric resection.
• For patients with recurrent ulcers of the gastric stump and anastomosis, the causes of relapse of the disease are identified, incl. using methods of daily pH-metry, assessing the presence of H. pylori infection, after which pathogenetic treatment is selected.
• The trophological status of patients is determined and, if necessary, nutritional support is provided.
• A differential diagnosis of anemia is carried out in patients after gastric resection with the determination of individual drug therapy tactics.

Diagnosis and treatment of diseases accompanied by chronic diarrhea, malabsorption syndrome and protein-losing enteropathy

To determine the cause of chronic diarrhea and malabsorption syndrome, methods are used to determine serum markers of celiac disease, breath tests to determine enzymatic deficiency, fecal markers of inflammation, computer enterocolonography with oral and intravenous contrast, morphological examination of biopsies of the small and large intestine, including immunohistochemical studies. Depending on the established diagnosis, etiotropic and pathogenetic treatment and nutritional support are provided.

Diagnosis and treatment of functional diseases of the gastrointestinal tract (functional dyspepsia, irritable bowel syndrome)

Patients are examined to exclude organic pathology of the gastrointestinal tract. After a diagnosis of a functional disease is established, an individual treatment plan for patients is developed depending on the dominant symptoms.

Diagnostic methods

On the basis of the diagnostic department,

• endoscopic examinations of the upper and lower gastrointestinal tract using modern technologies;
• ultrasound examination of the abdominal organs;
• ultrasound cholecystography;
• Dopplerography of abdominal vessels;
• computed tomography of the abdominal organs with/without intravenous contrast;
• computed enterocolonography with oral contrast;
• daily pH-metry of the esophagus (diagnosis of GERD, individual selection of therapy for GERD and assessment of its effectiveness);
• joint pH- and impendancemetry of the esophagus (determination of the physical properties of reflux and the type of reflux in GERD);
• study of the motor function of the esophagus, HRM (diagnosis of disorders of the motor function of the esophagus, lesions of the esophagus in systemic diseases);
• high-resolution anorectal manometry HRAM (study of the functional state of the sphincter apparatus of the rectum, intestinal sensitivity, diagnosis of dyssynergia of the pelvic floor muscles, identification of secondary motility disorders, examination before and after surgical treatment of the anorectal region, exclusion of Hirschsprung's disease);
• biofeedback therapy (for patients with constipation, fecal incontinence).

Diseases

• nonspecific ulcerative colitis, Crohn's disease;
• liver cirrhosis of various etiologies;
• chronic hepatitis of various etiologies (including viral);
• gastroesophageal reflux disease;
• chronic gastritis;
• peptic ulcer of the stomach and duodenum;
• chronic pancreatitis, chronic cholecystitis, cholangitis;
• irritable bowel syndrome;
• diverticular disease.

Research not required by the medical standard is carried out on a commercial basis.

The department is equipped with electromyographic equipment for studying the kinetics of the stomach and intestines and an apparatus for measuring pH in the esophagus and various parts of the stomach (both once and during daily monitoring)

Patients in the department have the opportunity to receive highly qualified advice from specialists in other fields through the MMA Consultative Center named after. I.M. Sechenov: ophthalmologist, neurologist, psychoneurologist, surgeon, dermatologist, endocrinologist, gynecologist, urologist, phthisiatrician, infectious disease specialist, oncologist.

Consultations with specialists are also carried out within the framework provided for by the medical standard of the underlying disease.

The patient can also, if necessary, receive highly specialized consultation and treatment in the physiotherapy department of the Hospital Therapy Clinic.