rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2016-382-389rsp-2264Research ArticleПЕРЕДОВАЯLEADING ARTICLEКоморбидная патология пищеварительной системы у больных ревматическими заболеваниями: не только НПВП-гастропатияDigestive comorbidity in patients with rheumatic diseases: Not only NSAID-induced gastropathyКаратеевА. Е.KarateevA. E.

115522 Москва, Каширское шоссе, 34А 

34A, Kashirskoe Shosse, Moscow 115522 

aekarateev@rambler.ruГонтаренкоН. В.GontarenkoN. V.

115522 Москва, Каширское шоссе, 34А 

34A, Kashirskoe Shosse, Moscow 115522 

ЦурганА. В.TsurganA. V.

115522 Москва, Каширское шоссе, 34А 

34A, Kashirskoe Shosse, Moscow 115522 

ФГБНУ Научно- исследовательский институт ревматологии им. В.А. Насоновой, МоскваРоссияV.A. Nasonova Research Institute of Rheumatology, MoscowRussian Federation201618102016544382389Copyright © Каратеев А.Е., Гонтаренко Н.В., Цурган А.В., 20162016Каратеев А.Е., Гонтаренко Н.В., Цурган А.В.Karateev A.E., Gontarenko N.V., Tsurgan A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/2264

Коморбидная патология пищеварительной системы – серьезная проблема, существенно отягощающая течение ревматических заболеваний. Заболевания желудочно-кишечного тракта (ЖКТ), печени и панкреатобилиарной системы могут создавать угрозу жизни и существенно ухудшать ее качество. Частота многих заболеваний пищеварительной системы, таких как язва желудка (в том числе ее осложненные формы), желчнокаменная болезнь, острый панкреатит, при ревматических заболеваниях (по крайней мере при ревматоидном артрите) существенно выше, чем в популяции. Наличие этой коморбидной патологии создает значительные проблемы при проведении активной противоревматической терапии. Ревматологи хорошо знакомы с вопросами профилактики осложнений со стороны ЖКТ, возникающих при использовании нестероидных противовоспалительных препаратов. Однако новое время определяет новые проблемы. Широкое использование иммуносупрессивных средств и генно-инженерных биологических препаратов требует тщательного контроля осложнений, связанных с поражением печени и кишечника. В настоящем обзоре рассмотрена взаимосвязь ревматологической патологии и противоревматической терапии с такими коморбидными заболеваниями, как желчнокаменная болезнь, острый панкреатит, вирусные гепатиты В и С, дивертикулы кишечника. 

Digestive comorbidity is a serious problem that significantly aggravates the course of rheumatic diseases. Diseases of the gastrointestinal tract (GIT), liver, and pancreatobiliary system may present a threat to life and substantially worsen its quality. The incidence of many digestive diseases, such as gastric ulcer (including its complicated forms), cholelithiasis, and acute pancreatitis, in patients with rheumatic diseases (at least in those with rheumatoid arthritis) is considerably higher than in the population. The presence of this comorbidity poses substantial challenges during active anti-rheumatic therapy. Rheumatologists are very familiar with issues in the prevention of GIT complications due to the use of nonsteroidal anti-inflammatory drugs. However, new time presents new challenges. The widespread use of immunosuppressive agents and biologic agents requires careful monitoring of complications associated with liver and bowel diseases. This review considers a relationship of rheumatic diseases and anti-rheumatic therapy to comorbidities, such as cholelithiasis, acute pancreatitis, viral hepatitis B and C, and intestinal diverticula. 

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The authors declare that there are no conflicts of interest present.