РАЦИОНАЛЬНАЯ ФАРМАКОТЕРАПИЯ СИМПТОМАТИЧЕСКОЙ НЕОСЛОЖНЕННОЙ ДИВЕРТИКУЛЯРНОЙ БОЛЕЗНИ ТОЛСТОЙ КИШКИ

The article presents the results of long-term monitoring of patients diverticular disease of the colon to study the effectiveness of different groups of medicines on the basis of which the proposed rational scheme of treatment according to age of patients, duration of anamnesis of disease and presence of comorbidities. In the period 2003-2016 the study included 396 patients aged 24 to 89 years (mean age 61,4±9.3 years) with instrumental confirmed diverticula of the colon. A big problem in the elderly is polymorbidity and, as a result, forced polypragmasia. In our study of 295 patients over 60 years of age at the time of inclusion in the study had 4.7-5.2 diseases per 1 person. The most common were systemic atherosclerosis, constipation and hyperlipidemia. Constipation was detected in 193 patients (65.4%), hyperlipidemia - in 170 (57.6%). Drugs psillium and lactulose have long been widely known as effective laxatives with prebiotic properties and safe with long-term use. In our study, 120 patients took psyllium and 116-lactulose. For two years, we estimated the number of relapses of NSC (resumption of pain and symptoms of intestinal dyspepsia). It was found that in the psyllium group during the two-year follow-up period the number of recurrences was 20% less than in the lactulose group. Summary. The most effective drug for relief of abdominal pain syndrome in patients with diverticular disease of the colon in all age groups is trimebutin In the treatment of symptomatic diverticular disease of the colon in patients younger than 45 years, it is advisable to prescribe intestinal antiseptics (rifaximin, nifuroxazide) for at least 7 days from the moment of treatment. Patients over 75 years of age need normalization of the stool with the predominant use of laxatives with prebiotic action. When combined with diverticular disease and constipation hyperlipidemia drug of choice is psyllium (mukofalk, vibrolux). At presence at patients of senile age concomitant cardiovascular pathology with the purpose of correction of possible ischemia of the bowel wall at the microscopic level should be provided citoprotected drug of butyric acid