Children's medical and diagnostic center of gastroenterology. Center for Pediatric Gastroenterology, Morozov Children's Clinical Hospital. During the reception

This is a specialist who deals with the diagnosis, treatment and prevention of the pathology of the digestive tract in children. Diseases of the digestive system are among the most common today. Their causes are varied: from unbalanced nutrition to stress, and the child's body is least protected from the effects of these factors. That is why the consultation of a pediatric gastroenterologist is necessary in case of any problems associated with the digestive system.

If you are looking for a pediatric gastroenterologist in Moscow, please contact the CELT multidisciplinary clinic. We employ leading domestic specialists who have extensive experience and have all the means to determine the cause of the disease, correctly diagnose and prescribe effective treatment.

Why is it necessary to contact a pediatric gastroenterologist?

A good pediatric gastroenterologist is essential for many young patients with digestive problems. It is no secret that childhood has its own anatomical and physiological characteristics. This rule also applies to the gastrointestinal tract. Therefore, it is obvious that the child should be consulted by a specialist in pediatric practice.

When is it necessary to contact a pediatric gastroenterologist?

A number of clinical manifestations should be the reason for visiting a pediatric gastroenterologist:

• pain in the abdomen of varying intensity, different nature and any localization;
• nausea and vomiting;
• heartburn and belching;
• loss of appetite;
• bad breath;
• stool disorders: constipation, diarrhea;
• flatulence, increased gas formation in the abdomen

An urgent consultation also requires a suspicion of bleeding from the gastrointestinal tract, which manifests itself in the form of vomiting with an admixture of blood, black stools, stools with an admixture of blood. Such situations are rare, but should be regarded as life-threatening, and therefore immediately managed in a hospital setting!

During the reception

At the consultation, a pediatric gastroenterologist conducts an initial examination and listens to complaints that are available. It is very good if the parents bring to the consultation the data of all diagnostic studies, if any have been carried out before, as well as the previous conclusions of the specialists. This will save both time and money. In order to make a diagnosis, pediatric gastroenterologists at the CELT clinic conduct a comprehensive examination, which is prescribed based on the specific clinical situation and may include the following:

• ultrasound examination of the abdominal cavity;
• x-ray examination;
• endoscopic examination (gastroscopy);
• blood, urine, stool tests.

If the situation requires it, a pediatric gastroenterologist can join forces with other specialists in pediatric practice (neurologist, surgeon, endocrinologist, otolaryngologist, dentist, pediatrician) to jointly evaluate the results of a diagnostic examination and draw up an individual treatment program.

CELT multidisciplinary clinic: we will take care of your baby's health!

As part of the Moscow healthcare reform, the City Center for Children's Gastroenterology was organized on the basis of the Department of Gastroenterology of the Morozov Children's Hospital, the tasks of which are:

• providing specialized, high-tech care to children and adolescents with diseases of the gastroenterological profile: inflammatory bowel disease - Crohn's disease, ulcerative colitis; short bowel syndrome, stoma, etc.;
• improving the system of medical care for children;
• coordination of activities of institutions of different levels;
• introduction of new effective diagnostic, surgical and therapeutic techniques;
• ensuring the rehabilitation and social adaptation of children with gastroenterological pathology;
• Information support.

Morozov Children's Clinical Hospital is responsible for drug supply and proper use of high-tech, effective and expensive drug Remicade (infliximab) in children with IBD. The Center produces prescriptions, and special conditions have been created for the correct and safe administration of the drug (anticytokine therapy). The state of the immunological status of patients with IBD is monitored in accordance with the developed modern treatment standards. The Center carries out consultative and diagnostic work on the complex therapy of severe, resistant to standard therapy, inflammatory bowel diseases in children.

The center provides medical care to children and adolescents with diseases that lead to the formation of a stoma.
The Center hosts:

• medical consultation;
• individual selection of modern stoma care products;
• issuing preferential prescriptions for stoma care products;
• educate the patient and their relatives on the use of the recommended stoma care products.

The medical staff of the Center for Pediatric Gastroenterology:

Skvortsova Tamara Andreevna - Head of the Center for Pediatric Gastroenterology and the Center for Allergic Healthcare, Morozovskaya Children's Clinical Hospital of the Children's Health Department, Candidate of Medical Sciences, gastroenterologist, chief freelance pediatric gastroenterologist in Moscow
Glazunova Lyudmila Vladislavovna - pediatrician, gastroenterologist, deputy head of the gastroenterological service of the Morozov Children's Hospital
Mukhina Tatyana Fedorovna - pediatrician, gastroenterologist of the highest category
Goryacheva Olga Aleksandrovna – pediatrician, gastroenterologist, candidate of medical sciences
Sarycheva Alexandra Andreevna – pediatrician, gastroenterologist

A gastroenterologist deals with problems with the esophagus, stomach, intestines, pancreas, gall bladder, biliary tract, liver, duodenum. The following diseases are treated by specialists:

• Gastritis
• Gastroduodenitis
• stomach ulcer
• Duodenal ulcer
• Allergic diseases (food allergy)
• Giardiasis of the intestine
• pancreatitis
• Cholecystitis
• Colitis
• Constipation
• Hepatitis
• Diarrhea
• Dysbacteriosis
• Flatulence
• Colitis
• Esophagitis
• Diseases of the biliary system and gallbladder

A high-class pediatric gastroenterologist will definitely take an interest in the details of the child’s lifestyle and nutrition, discuss the exact diet with the parents, find out everything about the state of the baby’s digestive system, prescribe the necessary tests and studies, and, based on the full picture, make an expert opinion.

Methods of gastroenterological diagnostics

Our clinic uses the following methods of gastroenterological diagnostics:

functionaldiagnostics:

13-C urease breath test

• Primary non-invasive diagnosis of H. pylori infection in the gastrointestinal tract in diseases of the stomach and duodenum
• The presence of acid-dependent and H. pylori-associated diseases in the family (among cohabitants)
• Monitoring the effectiveness of eradication therapy
• Screening examinations for hereditary burden for diseases of the gastrointestinal tract
• Oncological alertness of the patient
• Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs)

Endoscopy- this is a group of methods that allow you to visually assess the state of internal organs in real time, as well as, if necessary, to carry out a number of additional diagnostic and therapeutic manipulations, united by a single concept "endoscopy"(from the Latin endos - inside, scopia - to examine). Endoscopy subdivided depending on the studied organs:

• Esophagogastroduodenoscopy(EGDS) - examination of the esophagus, stomach and duodenum. Sometimes done in combination with jeunoscopy- inspection of the initial sections of the small intestine
• Rectosigmoscopy- examination of the rectum and sigmoid colon
• Colonoscopy- Examination of the colon and terminal ileum

Esophagogastroduodenoscopy

The main indications for this method of endoscopic examination are:

• Detection of malformations and anomalies in the development of the baby, suspicions of internal bleeding
• In infants and young children, suspicion of congenital and acquired malformations of organs: underdevelopment or absence of an organ or part of an organ, abnormal communications between various organs, abnormal narrowing (for example, esophagus, junction of the stomach into the intestines), which may be manifested by frequent persistent regurgitation infant, respiratory problems, poor weight gain, etc.
• In older children, inflammatory diseases come first (gastroduodenitis - inflammation of the gastric mucosa, duodenum, etc.) and various digestive disorders, manifested in most cases by abdominal pain of a different nature, as well as nausea, vomiting, belching, heartburn and etc. Often, chronic digestive disorders in children are directly related to Helicobacter pylori infection (bacteria that play a leading role in the development of chronic gastritis, duodenal ulcers of the stomach). During endoscopy, signs of the presence of this infection in the stomach can be detected, and a biopsy (taking a sample) of the gastric mucosa allows for rapid diagnosis of the disease.
• It is not uncommon for a child, out of curiosity, to take into his mouth and swallow various objects (coins, buttons, small parts of toys, batteries, pins, etc.). In most cases, removal of foreign bodies from the gastrointestinal tract is possible only with the help of endoscopic techniques.

Esophagogastroduodenoscopy is performed on an empty stomach using flexible endoscopes of small diameter, specially adapted for children. The child before the study should not take food and liquid for 5-6 hours. Of great importance is the psychological preparation of the child before the study. The pediatric gastroenterologist who prescribed EGDS, as well as the child's parents, should explain in an accessible form that the study is painless, although it may cause some discomfort. The procedure itself takes an average of 1-2 minutes. The child is placed on the treatment table on the left side, the rules of behavior during the procedure are explained (the child is advised to breathe calmly and evenly, not to swallow, so that saliva drips onto the towel, emphasis is placed on the painlessness of the procedure). After psychological preparation, children quite easily agree to endoscopy and tolerate it well. The nurse gives the child a special mouthpiece that protects the endoscope from the child's teeth and holds it during the entire examination. Anesthesia, both local and general, is carried out in rare cases for special indications - with an extremely inadequate reaction of the child to the procedure. After examining the child, you can immediately feed, give water. If local anesthesia was performed, eating should be delayed for 30-40 minutes. The study is generally well tolerated by children, most of them agree to repeat the procedure if necessary.

Colonoscopy

The study of the colon and the terminal ileum in children, unlike adults, is performed under general anesthesia. The staff of the department in which the child lies is engaged in preparation for it. Psychological preparation boils down to the fact that the baby is explained that during the study he will sleep and will not feel anything. Indications for colonoscopy are:

• Blood in the stool
• Suspicion of bleeding
• Foreign bodies
• Structural anomalies
• Clarification of the level and nature of inflammation
• Collection of material for biopsy
• Diagnosis and removal of polyps

The study, appointed by a pediatric gastroenterologist, lasts from 15 to 40 minutes. The condition for success is good preparation of the intestines with enemas or medicines, which is carried out by medical professionals.

Ultrasound examination of the abdominal organs

This method is one of the few instrumental studies that can be performed without any fear on patients of any age, even children!

The capabilities of modern equipment have brought ultrasound diagnostics to a high level and allow us to assess the state of the child's body with high accuracy.

Ultrasonic waves reflected from the organs, allow you to give accurate information about the size and density of organs, structure, wall thickness. Ultrasound diagnostics has been used in the practice of pediatricians and pediatric gastroenterologists for over 20 years and is a safe examination even for babies. The method of ultrasound examination is based on the ability of various tissues of the human body to transmit vibrations of supersonic waves in different ways. Special equipment sends a high-frequency sound wave into the cavity of the patient under study, when it is reflected from the organ under study, creating an echo that is picked up by the scanning sensor. After special processing, the organ under study is reflected on the monitor of the device in the form of a graphic picture.

With the help of ultrasound, it is possible to study the features of the anatomical structure and functional activity of the digestive organs without damaging the integrity of the skin. This diagnostic method is the most effective, painless and safe. Ultrasound of the abdominal organs for children is actively used in neonatology, surgery, oncology, gastroenterology and endocrinology:

• To determine the size, shape and localization of any of the abdominal organs
• Studying the homogeneity and structure of their tissues
• Identification of existing developmental anomalies, injuries, inflammatory processes and tumor-like formations

Indications and contraindications for ultrasound

First of all, ultrasound scanning is an examination that, for the purpose of mandatory medical examination, is carried out for children at the decreed time. For newborn babies, a diagnostic procedure is prescribed to exclude congenital malformations of the digestive tract that require urgent surgical intervention:

• Atresia of the bile ducts
• Congenital pyloric stenosis or hepatitis
• Damage to the parenchymal tissue of organs
• Reactive pancreatitis

During schooling and especially at adolescence, gastroenterologists prescribe ultrasound to diagnose cholecystitis, biliary tract dysfunction, cholelithiasis, and pancreatitis. Performing an examination of internal organs is necessary in emergency situations - if you suspect an injury, abscess, appendicitis.

• Discomfort and pain in the abdomen
• Nausea
• Heaviness and tension in the right hypochondrium
• Frequent vomiting
• Halitosis (bad breath)
• Bitter taste in the mouth
• sour burp
• Flatulence
• Stool disorders
• Jaundice of the sclera and skin
• Sudden change in body weight
• Rashes on the skin

Rules for preparing for the procedure

Ultrasound examination does not cause any discomfort or fear in children. However, it is necessary to prepare for it in advance and not feed the baby on the eve of the procedure. The period of hunger should be: for an infant - 3 hours, for a baby up to three years of age - 4 hours, for a child over three years old - 6 hours. An important condition for the informativeness of the diagnostic procedure is the absence of accumulation of gases in the abdominal cavity.

Therefore, to improve the visualization of the organs under study, preliminary preparation is required:

• A nursing mother should stop eating foods that contribute to the formation of gases in the intestines - legumes, raw vegetables, black bread, confectionery, pastry, juices, milk
• A young child does not need to drink juices and feed fruit or vegetable puree
• Older children should follow a special diet for three days, excluding flatulence and constipation. The diet should include lean meat (boiled, baked or steamed), boiled eggs, cereals, cheese

Radiationdiagnostics

CT (computed tomography), MRI (magnetic resonance imaging), abdominal ultrasound are often used to examine the pancreas, bile ducts, liver, and mesenteric lymph nodes.

Children's gastroenterological CHECK-UP

Our clinic provides a unique opportunity to conduct a children's gastroenterological CHECK-UP.

This is a comprehensive medical research program that includes a basic conversation with a pediatric gastroenterologist (conducted to collect differential diagnostics, familiarize the doctor with anamnesis, and prepare an examination program). Then the necessary laboratory tests are carried out. The doctor sums up, explains the results of the examinations, gives medication recommendations and talks about lifestyle, diet, diet, after which he issues a final written conclusion.

The comprehensive diagnostic program includes an appointment with a specialist, as well as:

• Ultrasound of the abdominal organs (liver, gallbladder, pancreas, spleen)
• General urine analysis
• Clinical blood test
• Coprogram
• Determination of the presence of Giardia Lamblia antigens in feces (express method)
• Research on enterobiasis

Immunoserology (blood from a vein):

• Antibodies to Toxocara Ig G
• Antibodies to amoeba Ig G (Entamoeba hystolitica)
• Antibodies to Toxoplasma gondii Ig G
• Determination of antibodies to Trichinella spp
• Determination of class G antibodies (Ig G) to Ascaris Lumbricoides
• Comprehensive study of feces for eggs, helminth larvae, protozoa

celiac disease This is a hereditary disease that occurs in children due to intolerance to gluten contained in certain cereals (such as wheat, rye, oats, barley). The body does not absorb this protein from many products (baked goods, cereals, sausages, sweets). Irritation of the intestinal mucosa leads to diarrhea, symptoms of intoxication and exhaustion of the body. As a result, the development of children is disturbed, they suffer physically, there are deviations in the functioning of the nervous system.

The peculiarity is that most often the disease does not manifest itself immediately after birth, but later, when children begin to be given, in addition to breast milk, additional nutrition. Cereals, milk mixtures contain gluten, in addition, it can be present in the form of additives in other baby food products. When the first signs of pathology appear, even experienced pediatric gastroenterologists do not immediately make the correct diagnosis, since similar manifestations also occur with dyspepsia. However, with celiac disease, conventional medications do not help improve digestion.

Unlike other intestinal diseases, celiac disease is incurable. There are periods of exacerbation and remission (temporary relief of symptoms). You can save a child from suffering only by completely excluding foods containing harmful protein from his diet. At the same time, the effect of toxins formed during the breakdown of gluten stops, the condition of the intestines and the whole organism is completely restored.

Surveys:

• Family history taking, anthropomeria
• GI of the abdominal organs
• Blood test for antibodies to endomysium, tissue translutaminase, to gliadin
• Coprogram
• Endoscopy with histological examination of the biopsy of the small intestine mucosa

• A wide range of instrumental, laboratory and genetic studies.
• Gastroscopy in the state of medical sleep under the supervision of experienced anesthesiologists.
• Diagnostics and treatment according to international standards accepted in leading clinics in Western Europe and the USA.

Children often complain of abdominal discomfort, heartburn, nausea, sore throat, and sometimes dizziness. These symptoms may be manifestations of a disease such as (reflux of acidic contents from the stomach into the esophagus). Reflux can also be manifested by unusual symptoms: recurrent runny nose, hoarseness, coughing, frequent sighing.

Increasingly, children are diagnosed with malabsorption syndrome - a syndrome of malabsorption in the small intestine of certain foods, which is accompanied by diarrhea or constipation, discomfort, bloating, sometimes skin rashes, impaired growth and weight gain.

Changes in the structure and size of the pancreas, an inflection in the gallbladder are often detected. By themselves, they are not a cause for concern, but in combination with complaints of abdominal pain, changes in appetite, stool, indicators of the physical development of the child, they require additional examination to identify the cause of indigestion.

IMPORTANT! Acute and sudden abdominal pain, vomiting, diarrhea, the appearance of blood in the stool - this is an occasion to urgently contact a pediatrician.

While periodically occurring, associated or not associated with food intake, the appearance of pain at night, a feeling of nausea, a decrease in the activity of the child most often involves a planned additional examination.

The Children's Clinic uses a wide range of instrumental and laboratory studies, as well as genetic tests:

• Ultrasound with diagnostic tests;
• x-ray studies;
• gastroscopy (endoscopic examination of the esophagus, stomach, duodenum and small intestine) for children, if necessary with a simultaneous biopsy of the mucosa and removal of foreign bodies;
• breath test for the presence (HELIK-SCAN);
• colonoscopy with biopsy of the intestinal mucosa.

Gastroscopy can also be done for children at the EMC Children's Clinic in Moscow at the same time and in a state of medical sleep under the supervision of experienced anesthesiologists.

A pediatric gastroenterologist performs diagnostics and treatment in accordance with international standards adopted in leading clinics in Western Europe and the USA. Parents receive the most detailed information about the disease, about the causes of its occurrence. A child with suspected gastroenterological pathology is first examined by a pediatrician to make a preliminary diagnosis. When the profile of the disease is confirmed, the small patient is referred for a consultation with a pediatric gastroenterologist.

Treatment of diseases of the digestive system is not only taking medications. Daily routine, balanced and healthy nutrition, physical activity - all this is not only necessary, but also individually for each child. Recovery of digestive function is a long process. Parents often have questions and difficulties, so our doctors are always open for dialogue and are in touch with parents on any issue.

A pediatric gastroenterologist consults young patients at the EMC Children's Clinic at the address: Moscow, st. Trifonovskaya, 26.

The study of the problems of the pathology of the gastrointestinal tract at the Moscow Research Institute of Pediatrics and Pediatric Surgery is associated with the name of Professor M.B. Kuberger, who for 15 years headed the clinical diagnostic department he created, where scientific research in the field of pediatric gastroenterology began in 1982. Much attention was paid to the study of the role of atopy in the pathology of the gastrointestinal tract (D.M.S., Prof. A.A. Cheburkin), the autonomic nervous and immune systems (D.M.S., Prof. A.I. Khavkin) and pyloric Helicobacter pylori (MD, Prof. A.A. Korsunsky). Unique studies were devoted to the study of celiac disease in children (MD, Prof. Yu.A. Izachik). Monographs were published on celiac disease (1991) and functional pathology of the digestive system (1992).

Since 2000, a gastroenterological day hospital has been established with an endoscopy and functional diagnostics room. Under the guidance of Doctor of Medical Sciences, Prof. A.I. Khavkin carries out medical, scientific, organizational and methodological work. Scientific activities included the study of immunopathological processes in diseases of the upper gastrointestinal tract (MD Volynets G.V.), the study of the pathology of the anorectal zone, the problem of chronic constipation (MD Babayan M.L.), the study of functional disorders digestive organs, acid-dependent diseases, disorders of the intestinal microecology (Zhihareva N.S., Candidate of Medical Sciences Rachkova N.S., Candidate of Medical Sciences Blat S.F.). Currently, the issues of enteral, tube, parenteral nutrition and rational nutrition are being studied, including children with rare hereditary pathologies (acidemia, organic aciduria, etc.) (PhD Komarova O.N.)

The employees of the department carry out educational and methodological work: lecturing for practitioners, participating in the organization of schools and conferences dedicated to pediatric gastroenterology, co-authored the monographs "Pharmacotherapy in pediatric gastroenterology", "Microecology of the gastrointestinal tract".

Medical assistance is provided to children under 18 years of age with various diseases of the gastrointestinal tract, liver and biliary tract. At the same time, 15-20 children from Moscow and the Moscow region are examined and treated in the department, as well as assistance is provided to children with gastroenterological pathologies from other regions of Russia in a round-the-clock hospital (places in the allergology department). In the structure of the department, endoscopic studies are carried out using tests for H. pylori and studies of lactase activity in the biopsy of the small intestine mucosa, daily pH-metry, computer electrogastrography, anorectal profilometry, and the HELIK respiratory test.

	Anatoly Ilyich Khavkin– head of the department, doctor of medical sciences, professor. In 1983 he graduated from the pediatric faculty of the 2nd MOLGMI. N.I. Pirogov. Then he studied in clinical residency at the Research Institute of Nutrition of the USSR Academy of Medical Sciences. After graduating in 1985, he joined the Moscow Research Institute of Pediatrics and Pediatric Surgery. In 1989 he defended his thesis for the degree of Candidate of Medical Sciences "Clinical and instrumental characteristics of gastroesophageal and duodenogastric reflux in children and their relationship with the functional state of the autonomic nervous system", and in 1993 a thesis for the degree of Doctor of Medical Sciences on the topic "Clinical variants and immunomorphological bases of the formation of chronic inflammatory diseases of the stomach and duodenum in children in the rationale for differentiated pathogenetic therapy." From 2000 to the present, he has been the head of the Department of Gastroenterology and Endoscopic Research Methods of the Institute. Since 2000, he has been combining work in the clinic with teaching activities. First, as a professor at the Department of Propaedeutics of Internal Diseases with a course of gastroenterology at the Faculty of Medicine of the Moscow State Medical University, and in 2011 as a professor at the Department of Dietology and Nutrition of the Russian National Research Medical University. N.I. Pirogov. Under the leadership of Anatoly Ilyich, 25 candidate and one doctoral dissertations were completed. He is the author and co-author of 12 monographs on various issues of gastroenterology and nutrition.
	Babayan Margarita Levonovna- candidate of medical sciences, pediatrician, gastroenterologist, doctor of the highest category In 1996 she graduated from the pediatric faculty of the Russian State Medical University (RSMU). From 1996 to 1998 she was trained in clinical internship at the Department of Children's Diseases N2 of the Russian State Medical University. Since 1998, she studied at the clinical postgraduate course at the same department. Completed dissertation work on the topic "Peculiarities of the state of connective tissue in the pathology of the upper digestive tract in children", which she successfully tested and defended in the period of 2000-2001. From 2001 to 2002 she worked as an assistant at the Department of Children's Diseases N2 of the Russian State Medical University. Since 2002 currently works in the department of gastroenterology and endoscopic research methods. Babayan M.L. owns modern methods of examining children, works with devices "Myograph" for peripheral electrogastroenterography, "Polygraph" for anorectal manometry. He is constantly engaged in medical diagnostic and advisory activities, actively participates in the work of scientific conferences and is the author of 67 publications, including the educational and methodological manual for doctors "Treatment of chronic constipation (clinic, diagnosis, treatment)".
	Blat Svetlana Frantsevna– candidate of medical sciences, pediatrician, gastroenterologist In 1999 Graduated from the pediatric faculty of the Russian State Medical University. N.I. Pirogov, from 2002 to 2004. studied in clinical residency at the Department of Children's Diseases No. 2 with a course of gastroenterology and dietology of the FUV. RSMU im. N.I. Pirogov. From 2004 to 2010 studied in full-time, then in part-time postgraduate studies at the Department of Propaedeutics of Internal Diseases with a course of gastroenterology of the Federal State Institution "Moscow State University of Medicine and Dentistry", in 2010. where she defended her Ph.D. thesis on the topic: "Features of the treatment of chronic gastritis associated with Helicobacter pylori in adolescents." Since 2009 has a primary specialization in gastroenterology. Since 2007 worked as a pediatrician in the department of gastroenterology at the Federal State Institution Moscow Research Institute of Pediatrics and Pediatric Surgery, from 2010 to the present she has been working as a gastroenterologist in the department of gastroenterology of the institute. S.F. Blat is proficient in modern diagnostic methods (performs 24-hour pH metering, Helik breath test) and treats children with various diseases of the digestive system, is constantly engaged in medical diagnostic and advisory activities, actively participates in scientific conferences and is the author of 15 publications.
	Komarova Oksana Nikolaevna- Candidate of Medical Sciences, pediatrician, gastroenterologist, nutritionist. In 1998 she graduated from the Russian State Medical University (RSMU) with a degree in pediatrics. From 1998 to 2000 studied in the clinical residency of the Russian State Medical University, specializing in pediatrics. After completing the residency Komarova O.N. She was a postgraduate student of the department of baby nutrition of the State Research Institute of Nutrition of the Russian Academy of Medical Sciences. In March 2007, a candidate's thesis was defended on the topic "Clinical and pathogenetic substantiation of the use of Ω-3 class polyunsaturated fatty acids in the complex therapy of bronchial asthma in children", submitted for the degree of candidate of medical sciences in the specialty 14.00.09 - pediatrics. The dissertation work was performed at the clinical base of the Department of Pulmonology of the Federal State Institution "Moscow Research Institute of Pediatrics and Pediatric Surgery". Komarova O.N. underwent professional retraining in the specialty "dietology" in 2007, in the specialty "gastroenterology" in 2008, has a certificate of a dietitian, a gastroenterologist, certificates of advanced training in the cycle "Artificial nutrition of patients in intensive care", "Nutritive support in pediatric gastroenterology and hepatology. In "NIKI Pediatrics" Komarova O.N. Works as a nutritionist and gastroenterologist in the department of gastroenterology. Carries out consultative reception of inpatients on therapeutic (enteral, tube, parenteral nutrition) and rational nutrition, including children with rare hereditary pathologies (acidemia, organic aciduria, etc.) and outpatient admission of gastroenterological patients. Conducts examination and treatment of patients in a gastroenterological hospital with various pathologies of the gastrointestinal tract, diseases of the liver and biliary tract. Komarova O.N. actively participates in the work of scientific conferences and is the author of more than 25 publications.
	Naumova Alina Sergeevna- pediatrician-gastroenterologist. In 2008 she graduated from the Russian State Medical University (RSMU) with a degree in pediatrics. From 2010 to 2012 studied in clinical residency at the Federal State Institution "Moscow Research Institute of Pediatrics and Pediatric Surgery" with a degree in pediatrics. Naumova A.S. passed professional retraining in the specialty "gastroenterology" in 2013, has a certificate of a pediatrician, a gastroenterologist. In "NIKI Pediatrics" Naumova A.S. Works as a gastroenterologist in the department of gastroenterology. Carries out consultative reception of inpatient and outpatient patients of the gastroenterological profile. Conducts examination and treatment of patients in a gastroenterological hospital with various pathologies of the gastrointestinal tract, diseases of the liver and biliary tract. Owns modern methods of diagnosing the pathology of the gastrointestinal tract - conducts daily pH-metry. Takes part in scientific conferences.
	Murashkin Vitaly Yurievich- doctor - endoscopist, the highest category He began to work in his specialty in 1991. Conducts endoscopy of the upper and lower gastrointestinal tract, video capsule endoscopy. Similar posts The equation of a straight line with a slope: theory, examples, problem solving Using the preposition ‘By’ Given the vertices of a triangle abc find the equation of the side Im used to examples. We talk about the past. USED ​​TO and WOULD. Special questions c used to