Etiopathogenetic aspects of formation of functional diseases of the gastrointestinal tract: an emphasis on changes of intestinal permeability

Irritable bowel syndrome (IBS) and functional dyspepsia (FD) are known to be among the most common digestive pathologies. In present paper, the literature data have been analyzed related to the study of intestinal permeability disorders as an etiopathogenetic factor in the development of functional gastrointestinal diseases. The intestinal mucosa is a barrier, performing many functions, and above all a protective function, which is to prevent the transition of intrinsic substances into the internal environment of the body. Recently, more and more scientific evidence has been accumulating that impaired permeability of the intestinal mucosa is an important factor in the development and progression of functional diseases of the gastrointestinal tract, in particular, IBS and FD. In these pathologies, the weakening of the barrier function of the intestinal mucosa is observed, which is the result of changes in the number of proteins of tight cell contacts, which affects the change in permeability, thus stimulating the transition of pathogenic factors from the intestinal lumen into the intestinal mucosa and causing activation of immunocompetent cells. In the pathogenesis of IBS the main place is given to the activation of mast cells in the mucosa of both small and large intestine, and in FD — to mast cells and eosinophils of the duodenal mucosa. Mast cells, which are cells of the immune system, in response to activation, produce certain inflammatory cytokines, the action of which is aimed at changing the sensitivity of nerve endings in the mucosa, causing the phenomenon of visceral hypersensitivity and changes in the tone and motor function of the gastrointestinal tract.Correction of the changes in intestinal permeability of the gastrointestinal mucosa at this stage of development of medical science is potentially one of the pathogenetic areas in the treatment of IBS and FD. Необходимо провести исследования эффективности препаратов, влияющих на функционирование кишечной стенки, относительно нормализации кишечной проницаемости при заболеваниях ЖКТ. Further researches are needed to study the efficacy of medications affecting the functions of intestinal wall, in regards intestinal permeability at gastrointestinal diseases.