<?xml version='1.0' encoding='utf-8'?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.2 20190208//EN" "http://jats.nlm.nih.gov/publishing/1.2/JATS-journalpublishing1.dtd">
<article article-type="research-article" dtd-version="1.2" xml:lang="ru" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><front><journal-meta><journal-id journal-id-type="issn">2687-0940</journal-id><journal-title-group><journal-title>Актуальные проблемы медицины</journal-title></journal-title-group><issn pub-type="epub">2687-0940</issn></journal-meta><article-meta><article-id pub-id-type="doi">10.52575/2687-0940-2026-49-2-121-130</article-id><article-id pub-id-type="publisher-id">283</article-id><article-categories><subj-group subj-group-type="heading"><subject>ВНУТРЕННИЕ БОЛЕЗНИ</subject></subj-group></article-categories><title-group><article-title>Оценка влияния синдрома раздражённого кишечника на выраженность фиброза печени у пациентов с хроническим персистирующим гепатитом</article-title><trans-title-group xml:lang="en"><trans-title>Evaluation of the Influence of Irritable Bowel Syndrome on the Severity of Liver Fibrosis in Patients with Chronic Persistent Hepatitis&lt;br /&gt;
&amp;nbsp;</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><name-alternatives><name xml:lang="ru"><surname>Гриднев</surname><given-names>Владислав Игоревич</given-names></name><name xml:lang="en"><surname>Gridnev</surname><given-names>Vladislav I.</given-names></name></name-alternatives><email>iam@vgridnev.ru</email></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="ru"><surname>Соцкая</surname><given-names>Яна Анатольевна</given-names></name><name xml:lang="en"><surname>Sotskaya</surname><given-names>Yana A.</given-names></name></name-alternatives><email>not@mail.ru</email></contrib></contrib-group><pub-date pub-type="epub"><year>2026</year></pub-date><volume>49</volume><issue>2</issue><fpage>0</fpage><lpage>0</lpage><self-uri content-type="pdf" xlink:href="/media/journal-medicine/2026/2/121-130.pdf" /><abstract xml:lang="ru"><p>Цель. Изучить взаимосвязь между синдромом раздражённого кишечника (СРК) и развитием фиброза печени у пациентов с хроническим персистирующим гепатитом, а также оценить роль СРК как потенциального фактора прогрессирования данного заболевания. Материалы и методы. Обследовано 69 человек (18&amp;ndash;59 лет): 36 мужчин и 33 женщины с ХПГ. Первую группу составили 35 больных с ХПГ и СРК, вторую &amp;ndash; 34 пациента с ХПГ без СРК. Проводили УЗИ брюшной полости и транзиентную эластографию (датчик LFP -5, система Mindray Hepatus 6). Степень фиброза оценивали по шкале METAVIR. Результаты. У пациентов с ХПГ и СРК значимо чаще выявлялись выраженные изменен ия гепатобилиарной системы. При УЗИ частота признаков поражения печени в группе с коморбидной патологией в 1,9 раза выше, чем при изолированном ХПГ. Выводы. Наличие коморбидной патологии в виде синдрома раздражённого кишечника у пациентов с хроническим персистирующим гепатитом может служить маркером повышенного риска прогрессирования заболевания печени и требует более тщательного мониторинга с использованием инструментальных методов, в первую очередь ультразвукового исследования, для своевременной диагностики осложнений.</p></abstract><trans-abstract xml:lang="en"><p>Objective. The study is focused on exploring the relationship between irritable bowel syndrome (IBS) and the development of liver fibrosis in patients with chronic persistent hepatitis, as well as evaluating the role of IBS as a potential factor in the progression of this disease. Materials and Methods. We examined 69 patients aged 18&amp;ndash;59 years, including 36 men (52 %) and 33 women (48 %), with chronic persistent hepatitis (CPH). The patients were divided into two groups: Group 1, 35 patients with CPH combined with irritable bowel syndrome (IBS); Group 2, 34 patients with CPH without IBS. The instrumental methods used for the study included ultrasound diagnostics of the abdominal organs. To achieve the study&amp;#39;s objectives, the degree of liver fibrosis was determined using transient elastography with the LFP-5 transducer of the Mindray Hepatus 6 ultrasound system. Fibrosis was assessed using the METAVIR scale. Results. The study revealed a statistically significant pattern: patients with chronic hepatic pulmonary disease (CHP) combined with IBS significantly more often exhibited more pronounced pathological changes in the hepatobiliary system. The ultrasound detection rate of liver damage in patients with comorbid pathology (CHP + IBS) was 1.9 times higher than in patients with isolated CHP. Conclusions. The presence of comorbid pathology in the form of irritable bowel syndrome in patients with chronic persistent hepatitis can serve as a marker of an increased risk of liver disease progression and requires more careful monitoring using instrumental methods, primarily ultrasound, for the timely diagnosis of complications.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>хронический гепатит</kwd><kwd>синдром раздраженного кишечника</kwd><kwd>дисбиоз</kwd><kwd>фиброз</kwd></kwd-group><kwd-group xml:lang="en"><kwd>chronic hepatitis</kwd><kwd>irritable bowel syndrome</kwd><kwd>dysbiosis</kwd><kwd>fibrosis</kwd></kwd-group></article-meta></front><back><ref-list><title>Список литературы</title><ref id="B1"><mixed-citation>Список литературы</mixed-citation></ref><ref id="B2"><mixed-citation>Голованова Е.В. 2021. Как повысить эффективность лечения больных с синдромом раздраженного кишечника? Медицинский Совет. (5): 134&amp;ndash;140. https://doi.org/10.21518/2079-701X-2021-5-134-140</mixed-citation></ref><ref id="B3"><mixed-citation>Жирков И.И., Гордиенко&amp;nbsp;А.В., Павлович&amp;nbsp;И.М., Голофеевский&amp;nbsp;В.Ю., Маковеева&amp;nbsp;О.В. 2020. Неинвазивные методы диагностики стеатоза при неалкогольной жировой болезни печени. Экспериментальная и клиническая гастроэнтерология. 174(5): 61&amp;ndash;66. https://doi.org/10.31146/1682-8658-ecg-177-5-61-66</mixed-citation></ref><ref id="B4"><mixed-citation>Здравоохранение в России. 2025: Стат. сб./ Росстат. М., 2025. 149. URL: https://www.rosstat.gov.ru/storage/mediabank/Zdravooxran_2025.pdf (дата обращения: 05.04.2026)</mixed-citation></ref><ref id="B5"><mixed-citation>Минушкин&amp;nbsp;ОН. 2023. Синдром раздраженного кишечника и СРК-подобный синдром: современные представления, диагностика, лечебные подходы. Медицинский Совет. (13): 96&amp;ndash;101.&amp;nbsp;https://doi.org/10.21518/ms2022-058</mixed-citation></ref><ref id="B6"><mixed-citation>Пахомова И.Г. 2023. Болевой абдоминальный синдром у пациентов с синдромом раздраженного кишечника: особенности подбора терапии. Медицинский Совет. (18): 101&amp;ndash;107. https://doi.org/10.21518/ms2023-360</mixed-citation></ref><ref id="B7"><mixed-citation>Соловьева Ю.А. 2020. Неинвазивные методы диагностики фиброза печени. Вестник Северо-Восточного федерального университета имени М.К. Аммосова. Vestnik of North-Eastern Federal University. Серия &amp;laquo;Медицинские науки. Medical Sciences&amp;raquo;. (4): 45&amp;ndash;54. https://doi.org/10.25587/SVFU.2020.21.4.005</mixed-citation></ref><ref id="B8"><mixed-citation>Abi-Aad S.J., Lovell M., Khalaf R.T., Sokol R.J. 2025. Pathogenesis and Management of Intestinal Failure-Associated Liver Disease. Seminars in liver disease. 45(1): 66&amp;ndash;80. https://doi.org/10.1055/a-2545-7370</mixed-citation></ref><ref id="B9"><mixed-citation>Anis M.A., Shahid Y., Majeed A.A., Abid S. 2025. Microbiome and Gut-Liver Interactions: From Mechanisms to Therapies. World Journal of Gastroenterology. 31(40): 111409. https://doi.org/10.3748/wjg.v31.i40.111409</mixed-citation></ref><ref id="B10"><mixed-citation>Cheng Z., Yang L., Chu H. 2025. The Role of Gut Microbiota, Exosomes, and their Interaction in the PATHOGENESIS of ALD. Journal of Advanced Research. 72: 353&amp;ndash;367. https://doi.org/10.1016/j.jare.2024.07.002</mixed-citation></ref><ref id="B11"><mixed-citation>Costa C.F.F.A., Sampaio-Maia B., Araujo R., Nascimento D.S., Ferreira-Gomes J., Pestana M., Azevedo&amp;nbsp;M.J., Alencastre I.S. 2022. Gut Microbiome and Organ Fibrosis. Nutrients. 14(2): 352. https://doi.org/10.3390/nu14020352</mixed-citation></ref><ref id="B12"><mixed-citation>Cui C., Gao S., Shi J., Wang K. 2025. Gut-Liver Axis: The Role of Intestinal Microbiota and Their Metabolites in the Progression of Metabolic Dysfunction-Associated Steatotic Liver Disease. Gut and Liver. 19(4): 479&amp;ndash;507. https://doi.org/10.5009/gnl240539</mixed-citation></ref><ref id="B13"><mixed-citation>Gudan A., Jamioł-Milc D., Hawryłkowicz V., Skonieczna-Żydecka K., Stachowska E. 2022. The Prevalence of Small Intestinal Bacterial Overgrowth in Patients with Non-Alcoholic Liver Diseases: NAFLD, NASH, Fibrosis, Cirrhosis-A Systematic Review, Meta-Analysis and Meta-Regression. Nutrients. 14(24): 5261. https://doi.org/10.3390/nu14245261</mixed-citation></ref><ref id="B14"><mixed-citation>Laivacuma S., Oblate O., Derovs A. 2025. Gut Microbiota and the Gut-Liver Axis in Liver Disease: From Chronic Viral Hepatitis to Cirrhosis, Hepatocellular Carcinoma, and Microbiome-Based Therapies. Microorganisms. 13(5): 1053. https://doi.org/10.3390/microorganisms13051053</mixed-citation></ref><ref id="B15"><mixed-citation>Liu S., Yang X. 2023. Intestinal Flora Plays a Role in the Progression of Hepatitis-Cirrhosis-Liver Cancer. Frontiers in Cellular and Infection Microbiology. 13: 1140126. https://doi.org/10.3389/fcimb.2023.1140126</mixed-citation></ref><ref id="B16"><mixed-citation>Schnabl B., Damman C.J., Carr R.M. 2025. Metabolic Dysfunction-Associated Steatotic Liver Disease and the Gut Microbiome: Pathogenic Insights and Therapeutic Innovations. The Journal of Clinical Investigation. 135(7): e186423. https://doi.org/10.1172/JCI186423</mixed-citation></ref><ref id="B17"><mixed-citation>Shu W., Shanjian C., Jinpiao L., Qishui O. 2022. Gut Microbiota Dysbiosis in Patients with Hepatitis B Virus-Related Cirrhosis. Annals of hepatology. 27(2): 100676. https://doi.org/10.1016/j.aohep.2022.100676</mixed-citation></ref><ref id="B18"><mixed-citation>Simon E., Călinoiu L.F., Mitrea L., Vodnar D.C. 2021. Probiotics, Prebiotics, and Synbiotics: Implications and Beneficial Effects against Irritable Bowel Syndrome. Nutrients. 13(6): 2112. https://doi.org/10.3390/nu13062112</mixed-citation></ref><ref id="B19"><mixed-citation>Smith M.L., Wade J.B., Wolstenholme J., Bajaj J.S. 2024. Gut Microbiome-Brain-Cirrhosis Axis. Hepatology (Baltimore, Md.). 80(2): 465&amp;ndash;485. https://doi.org/10.1097/HEP.0000000000000344</mixed-citation></ref><ref id="B20"><mixed-citation>Tilg H., Adolph T.E., Trauner M. 2022. Gut-Liver Axis: Pathophysiological Concepts and Clinical Implications. Cell Metabolism. 34(11): 1700&amp;ndash;1718. https://doi.org/10.1016/j.cmet.2022.09.017</mixed-citation></ref><ref id="B21"><mixed-citation>Wang Y., Bai Z., Sun J., Gong Q., Miao W., Niu Z., Li X., Xu J., Lai Z. 2025. Intestinal Congestion-Driven Gut Dysbiosis: A Cross-Disease Hemodynamic Mechanism in Liver Cirrhosis and Heart Failure. Journal of Translational Medicine. 24(1): 79. https://doi.org/10.1186/s12967-025-07547-3</mixed-citation></ref><ref id="B22"><mixed-citation>Yan Y., Zeng J., Xing L., Li C. 2021. Extra- and Intra-Cellular Mechanisms of Hepatic Stellate Cell Activation. Biomedicines. 9(8): 1014. https://doi.org/10.3390/biomedicines9081014</mixed-citation></ref><ref id="B23"><mixed-citation>References</mixed-citation></ref><ref id="B24"><mixed-citation>Golovanova E.V. 2021. How to Improve Effectiveness of Treatment of Patients with Irritable Bowel Syndrome? Meditsinskiy sovet = Medical Council. (5): 134&amp;ndash;140 (in Russian). https://doi.org/10.21518/2079-701X-2021-5-134-140</mixed-citation></ref><ref id="B25"><mixed-citation>Zhirkov I.I., Gordienko A.V., Pavlovich I.M., Golofeevsky V.Yu., Makoveeva O.V. 2020. Noninvasive Methods of Diagnosis of Steatosis in Non-Alcoholic Fatty Liver Disease. Experimental and Clinical Gastroenterology. 174(5): 61&amp;ndash;66 (in Russian). https://doi.org/10.31146/1682-8658-ecg-177-5-61-66</mixed-citation></ref><ref id="B26"><mixed-citation>Healthcare in Russia. 2025: Stat.sb./ Rosstat. M., 2025. 149. URL: https://www.rosstat.gov.ru/storage/mediabank/Zdravooxran_2025.pdf (date of access: 05.04.2026).</mixed-citation></ref><ref id="B27"><mixed-citation>Minushkin O.N. 2023. Irritable Bowel Syndrome and IBS-like Syndrome: Current Concepts, Diagnosis, Treatment Approaches. Meditsinskiy sovet = Medical Council. (13): 96&amp;ndash;101 (in Russian). https://doi.org/10.21518/ms2022-058</mixed-citation></ref><ref id="B28"><mixed-citation>Pakhomova I.G. 2023. Abdominal Pain Syndrome in Patients with Irritable Bowel Syndrome: Features of Selection of Therapy. Meditsinskiy sovet = Medical Council. (18): 101&amp;ndash;107 (in Russian). https://doi.org/10.21518/ms2023-360</mixed-citation></ref><ref id="B29"><mixed-citation>Soloveva Y.A. 2020. Non-Invasive Diagnosis of Liver Fibrosis.&amp;nbsp;Vestnik of North-Eastern Federal University. Medical Sciences. (4): 45&amp;ndash;54. https://doi.org/10.25587/SVFU.2020.21.4.005</mixed-citation></ref><ref id="B30"><mixed-citation>Abi-Aad S.J., Lovell M., Khalaf R.T., Sokol R.J. 2025. Pathogenesis and Management of Intestinal Failure-Associated Liver Disease. Seminars in liver disease. 45(1): 66&amp;ndash;80. https://doi.org/10.1055/a-2545-7370</mixed-citation></ref><ref id="B31"><mixed-citation>Anis M.A., Shahid Y., Majeed A.A., Abid S. 2025. Microbiome and Gut-Liver Interactions: From Mechanisms to Therapies. World Journal of Gastroenterology. 31(40): 111409. https://doi.org/10.3748/wjg.v31.i40.111409</mixed-citation></ref><ref id="B32"><mixed-citation>Cheng Z., Yang L., Chu H. 2025. The Role of Gut Microbiota, Exosomes, and their Interaction in the PATHOGENESIS of ALD. Journal of Advanced Research. 72: 353&amp;ndash;367. https://doi.org/10.1016/j.jare.2024.07.002</mixed-citation></ref><ref id="B33"><mixed-citation>Costa C.F.F.A., Sampaio-Maia B., Araujo R., Nascimento D.S., Ferreira-Gomes J., Pestana M., Azevedo&amp;nbsp;M.J., Alencastre I.S. 2022. Gut Microbiome and Organ Fibrosis. Nutrients. 14(2): 352. https://doi.org/10.3390/nu14020352</mixed-citation></ref><ref id="B34"><mixed-citation>Cui C., Gao S., Shi J., Wang K. 2025. Gut-Liver Axis: The Role of Intestinal Microbiota and Their Metabolites in the Progression of Metabolic Dysfunction-Associated Steatotic Liver Disease. Gut and Liver. 19(4): 479&amp;ndash;507. https://doi.org/10.5009/gnl240539</mixed-citation></ref><ref id="B35"><mixed-citation>Gudan A., Jamioł-Milc D., Hawryłkowicz V., Skonieczna-Żydecka K., Stachowska E. 2022. The Prevalence of Small Intestinal Bacterial Overgrowth in Patients with Non-Alcoholic Liver Diseases: NAFLD, NASH, Fibrosis, Cirrhosis-A Systematic Review, Meta-Analysis and Meta-Regression. Nutrients. 14(24): 5261. https://doi.org/10.3390/nu14245261</mixed-citation></ref><ref id="B36"><mixed-citation>Laivacuma S., Oblate O., Derovs A. 2025. Gut Microbiota and the Gut-Liver Axis in Liver Disease: From Chronic Viral Hepatitis to Cirrhosis, Hepatocellular Carcinoma, and Microbiome-Based Therapies. Microorganisms. 13(5): 1053. https://doi.org/10.3390/microorganisms13051053</mixed-citation></ref><ref id="B37"><mixed-citation>Liu S., Yang X. 2023. Intestinal Flora Plays a Role in the Progression of Hepatitis-Cirrhosis-Liver Cancer. Frontiers in Cellular and Infection Microbiology. 13: 1140126. https://doi.org/10.3389/fcimb.2023.1140126</mixed-citation></ref><ref id="B38"><mixed-citation>Schnabl B., Damman C.J., Carr R.M. 2025. Metabolic Dysfunction-Associated Steatotic Liver Disease and the Gut Microbiome: Pathogenic Insights and Therapeutic Innovations. The Journal of Clinical Investigation. 135(7): e186423. https://doi.org/10.1172/JCI186423</mixed-citation></ref><ref id="B39"><mixed-citation>Shu W., Shanjian C., Jinpiao L., Qishui O. 2022. Gut Microbiota Dysbiosis in Patients with Hepatitis B Virus-Related Cirrhosis. Annals of hepatology. 27(2): 100676. https://doi.org/10.1016/j.aohep.2022.100676</mixed-citation></ref><ref id="B40"><mixed-citation>Simon E., Călinoiu L.F., Mitrea L., Vodnar D.C. 2021. Probiotics, Prebiotics, and Synbiotics: Implications and Beneficial Effects against Irritable Bowel Syndrome. Nutrients. 13(6): 2112. https://doi.org/10.3390/nu13062112</mixed-citation></ref><ref id="B41"><mixed-citation>Smith M.L., Wade J.B., Wolstenholme J., Bajaj J.S. 2024. Gut Microbiome-Brain-Cirrhosis Axis. Hepatology (Baltimore, Md.). 80(2): 465&amp;ndash;485. https://doi.org/10.1097/HEP.0000000000000344</mixed-citation></ref><ref id="B42"><mixed-citation>Tilg H., Adolph T.E., Trauner M. 2022. Gut-Liver Axis: Pathophysiological Concepts and Clinical Implications. Cell Metabolism. 34(11): 1700&amp;ndash;1718. https://doi.org/10.1016/j.cmet.2022.09.017</mixed-citation></ref><ref id="B43"><mixed-citation>Wang Y., Bai Z., Sun J., Gong Q., Miao W., Niu Z., Li X., Xu J., Lai Z. 2025. Intestinal Congestion-Driven Gut Dysbiosis: A Cross-Disease Hemodynamic Mechanism in Liver Cirrhosis and Heart Failure. Journal of Translational Medicine. 24(1): 79. https://doi.org/10.1186/s12967-025-07547-3</mixed-citation></ref><ref id="B44"><mixed-citation>Yan Y., Zeng J., Xing L., Li C. 2021. Extra- and Intra-Cellular Mechanisms of Hepatic Stellate Cell Activation. Biomedicines. 9(8): 1014. https://doi.org/10.3390/biomedicines9081014</mixed-citation></ref></ref-list></back></article>