Department of Gastroenterology and Nutritiology

Yuri Kharitonovich Marahovsky
head of the department, Doctor of Medical Sciences

Address:  Minsk, Uborevicha Street, 73 (10th City Clinical Hospital)
Telephones: (+375 17)341-24-98, 341-23-99

Staff of the department

  • Yuliya Viktorovna Gorgun - professor of the department, Doctor of Medical Sciences
  • Galina Anatolievna Karaseva - Associate Professor, Candidate of Medical Sciences
  • Dmitry Nikolaevich Ulasevich - Associate Professor, Candidate of Medical Sciences
  • Olga Maryanovna Zharskaya - assistant, Candidate of Medical Sciences
  • Alina Yurievna Yaroshevich - leading laboratory assistant
  • Larisa Yurievna Sergienya - laboratory assistant

The Department of Gastroenterology and Nutrition of Belarusian Medical Academy of Postgraduate Education was founded in 1980 and carries out advanced training and retraining of physicians on the specialties «Gastroenterology», «Nutrition Science». The teaching staff is represented by the following specialists: Doctor of Medical Sciences and professor (Y.H. Marahovsky), Doctor of Medical Sciences and Associate Professor (Y.V. Gorgun), Candidate of Medical Sciences and Associate Professor (G.P.Karaseva), Candidate of Medical Sciences (D.N. Ulasevich), and a physician (S.A. Vasilevskaya).

For the last 5 years all teachers of the department have undergone advanced training courses at BelMAPE and international courses and conferences.

History of the department

The department was founded at Belarusian State Institute of Advanced Medical Training in 1980. Clinical base of the department until 1999 had been Gastroenterology Division of Minsk Regional Clinical Hospital, since 2000 clinical base of the department is the 1st Minsk Clinical Hospital.

Practically, in the Republic of Belarus there has been created a unique educational unit which is considered to be a leading one in the training on gastroenterology and nutrition. Main fields of scientific activities of the department are the following ones: study of mechanisms of formation, development and progressing of chronic diseases of digestive system with the focus on clinical and             pathophysiological peculiarities, which help to provide the development of standardized approaches in the strategy of medical care aimed at the development of its quality.

From 1980 to 2000 the department had been headed by professor I.N. Bronovets.  The main issue of his scientific activities was determination of peculiarities of functional condition of cardiovascular system in patients suffered from chronic diseases of biliary tracts and liver.

Since 2000 the department has been managed by Y.H. Marahovsky, Doctor of Medical Sciences. His Doctoral thesis revealed the issue of identification of regularities of gallstone formation and formations of chronic cholecystitis which helped to formulate vesicular-lypoperoxide hypothesis of gallstone formation and offer optimized variants of early diagnostics of this disease. Y.H.Marakhovsky published more than 250 works, among them there are 6 monographs, 35 articles republican editions, 28 in international editions.

From the time of its foundation and until 1999 staff of the department was represented by the following specialists: M.N.Sakovich, Associate Professor, assistants V.N.Khomich, G.A.Karaseva, D.N.Ulasevich, senior laboratory assistants A.V.Yaroshevich and V.V.Ermak.

The staff of the department has been gradually expanded by new-comers - specialists of the department who have recently carries out theses and successfully defend theses. Thus, G.A.Karaseva, assistant of the department, defended Candidate’s thesis in 1994 on the topic «Evaluation of immune system indicators of lypoperoxide homeostasis and their correction in patients with ulcer disease» and in 2000 she was appointed to the post of Associate Professor of the department. In 1999 D.N. Ulasevich defended Candidate’s thesis on the topic «Indicators of lipid metabolism in patients who suffer from chronic cholecystitis and their changes at treatment» and became assistant of the department.

Since 2000 two assistants, - Y.S.Kravchenko and Y.V.Gorgun, started to work at the department Topic of their theses were the following ones: « Clinicodiagnostic aspects of Zhylber syndrome» and «Computer – tomography characteristics and insuliproducing function of pancreatic gland». 

The department has its own devices for computer intragastric pH measurement, which helps to evaluate genetic polymorphism of metabolism of proton pump inhibitors.

A significant component in improvement of educational process is the information support of the department trough data base on gastrointestinal pathology, computer programs “TELEGASTRO”, “GIVEN”, “DATAGATE”, works of 17 European gastroenterology weeks, 10th, 11th and 12th World Gastroenterology Congresses, video materials on gastrointestinal endoscopy with the durations of 27 hours, constant access to Internet since 1999.

The department has its own modern examination technologies, technologies of treatment and standardized evaluation of clinical manifestations of diseases, for example, sonographic research of stomach motor function, sonographic evaluation of column condition, record of standardized evaluation of severity of inflammatory bowel diseases and postosystem encephalopathy,  standardized evaluation of bowels inflammatory diseases on the basis of program complex «Expert and diagnostic complex of evaluation of liver chronic virus diseases (development of the department).

Scientific issues of greater interest until 1998 were the following ones: clinical biochemical evaluation of chronic cholecystitis and clinical peculiarities of hypolactasia in Belarus, evaluation of the effectiveness of calorie restriction diet therapy at gastroenterological pathology.

Since 1999 main scientific fields of the department were the following ones:

  1. Creation of home countries’ import-replacement equipment for functional diagnostics in gastroenterology.

Thus, in 2000 the department finished the development and created microprocessor computer device for intragastric рН-metry (acidogastrometer – ACM-01) and this year the department started to work out national tube primary transformers for рН-metry. In 2001 the department started to work out scientific and practical program on intaluminal tonometry (Topic «ТОН» approved by the State Committee of Science and Technology of Belarus).

  1. Creation of national gastroenterology drugs.

In 1999 the department finished creation of national antiacid drug GEFAL, industrial production of which was started in 2000 by JSC «Belmedpreparaty», the drug has a Certificate of Registration in the Russian Federation. In 2010 the drug occupied about 85% of the Republican market among drugs of this group.  

In 2010 a drug, solution for infusions, Gepavil, was registered.

Pathophysiological and clinical basics of standardization and optimization of gastroenterology diseases.

On the basis of existing internationally-accented standards of medical specialized gastroenterology care there have been worked out standardized technologies of evaluation of severity of bowels inflammatory diseases, optimized for practical healthcare of the Republic of Belarus, of malabsorption syndrome, liver cirrhosis, functional dyspepsia, gastroesophageal reflux disease, which are being implemented into practical work of basic establishments of the department.

  1. Value of food intolerance in the development of multisystemic pathology.

Scientific performance in preparing of scientific staff at the department has the following dynamics: in 1980-1990 the department prepared 2 scientific Candidate’s theses, in 1991-1999– additionally two scientific works under supervision of professor I.N.Bronovets.  

Scientific performance on the international level is represented by participation of the staff in the most important international seminars, symposia and conferences. Thus, in 1997 staff of the department made their speech at international symposium on bowels inflammatory diseases ( Basel and  Warsaw), in 1998 - at  international congress on gastroenterology, coloproctology and hepathology (Vienna),  in 1999 – at the 7th European Gastroenterology Week (Rome),  in 2000 – at Russian Gastroenterology Week (Moscow), in 2001 – at the 9th European Gastroenterology Week (Amsterdam) and Russian Gastroenterology Week (Moscow). Reports made by staff of the department are noted for their high scientific level.

Academic standing of the department can also be explained by the participation of professor I.N.Bronovets in editorial board of the journal «Healthcare of Belarus» and Y.H. Marakhovsky in editorial boards of the following journals: «Medicine», «Actual issues of Gastroenterology» (edition of CIS-countries),  «Russian Journal on Gastroenterology, Coloproctology and Hepathology»,  «World J Gastoenterology” (World journal on gastroenterology). Y.H. Marakhovsky is a member of scientific committee of the World Gastroenterology Association, until 2009 he was a member of the expert board of the Highest Attestation Committee of Belarus and Chairperson of the Expert Board in Clinical Medicine.  

Main courses of advanced training:

  1. Diagnostics and treatment of gastroenterology diseases at the 10th Minsk Clinical Hospital.
  2. Diagnostics and treatment of acid-related diseases (gastroduadenal ulcers, dyspepsia, gastroesophageal reflux, chronic gastritis) of digestive organs
  3. Clinical pathophysiological standardization of medical care at digestive system diseases
  4. General therapy hepatology
  5. General therapy coloproctology
  6. General therapy enterology
  7. Clinical gastroenterology: basics of therapeutic management of gastroenterological diseases
  8. General therapeutic biliopancreotology
  9. Gastroenterological aspects of sonography: clinical-sonographic differentiated diagnostics of gastrointestinal pathology
  10. Gastroenterological aspects of diagnostic endoscopy of  alimentary tract:
  11. clinical-endoscopy parallels in differentiated diagnostics and standardization of medical care at gastrointestinal pathology
  12. Functional diseases of digestive organs
  13. General clinical nutritiology
  14. General clinical nutritiology for the teaching staff
  15. General clinical dietology
  16. Gastroenterological pathology in clinic of internal diseases

 

Academic work

Main form of training in 2011-2015 was courses of advanced training with duration of two weeks (0, 5 months). One significant peculiarity of the department is carrying out one-week off-site advanced training courses. Amount of off-site courses: in 2011 – 1, in 2012 -2, in 2013 – 2, in 2014 -2, in 2015 – 3, totally -10 for the whole period.

In accordance with the approved programs target groups of the trainees are the following ones: general practitioners, general practice doctors, gastroenterologists, infectionists, recreation therapists. Group formation is carried out upon requests of healthcare establishments.  The department can’t influence on group membership.

The efficiency of the classes is evaluated by the testing of the trainees. The department carries out an introductory testing on the first day of the courses and a final testing at the end of the courses. The testing contains 100 separate questions with answers.  Comparison of test results helps to evaluate the efficiency of training.  

Clinical-preventive and consulting activities

Results of the department’s work in figures: consultations - 13095, 2124 of the consultations were made at Minsk Regional Clinical Hospital, 183 – in other healthcare establishments; diagnostic researches - 6071 cases; 44 emergency and 14 planned call-outs, 124 talks at seminars, conferences for practical healthcare, 23 methods have been implemented into the practice of healthcare.

With the assistance of the department, in 2014 Ministry of Healthcare created the Republican Center of Gastroenterology.

The Republican Center of Gastroenterology carries out the following:

  • Republican consultations,
  • Curating of patients with rare and genetic diseases of digestive organs (in accordance with the list approved by the Ministry of Health of the Republic of Belarus),
  • Creation of data base of patients with rare and genetic diseases of digestive organs
  • Functional research methods
  • In-patient examination and treatment of patients in accordance with established evidences.

Role of the department:

  • Head – specialist of the department (Associate Professor Y.V. Gorgun),
  • The department prepared a specialist-gastroenterologist for republican visits,
  • The department carries out consultations (everyday consultations) and if it is possible organizes a visit (with the presence of clinical residents),
  • The department has implemented functional research methods of the basis of the analysis of expiratory air at Consultation and Diagnostic Room of the Republican Center of Gastroenterology.

The department carries out a huge amount of organizational and methodological and consulting work.

Staff of the department are experts/members of the following commissions of the Ministry of Health of the Republic of Belarus:

  • Problem commission on gastroenterology – 2 persons;
  • Commission on drugs - 2 persons;
  • Commission on registration and realization of nutrition supplements - 2 persons,
  • Commission on food label in relation to special nutritious, dietary and prophylactic qualities – 3 persons,
  • Commission on evaluation of medical and preventive properties of mineral water – 1 person).

The department actively carries out work on promotion of healthy way of life: lectures -44, interviews - 56, answers for questions - 72, seminars -11, discussions – 12.

Scientific and research work

Staff of the department successfully carries out a number of tasks of scientific works, financed from the budget. 9 tasks have been completed.

Since 2014 the department successfully carries out the scientific work «Development of variants of rational pharmacotherapy of the main social and demographically important diseases of digestive organs in adults» (State registration: № 20130896 of 11.06.2013), the financing of which is carried out on budget basis.

The results of the researches are implemented into practice. Thus, two drugs, worked out by the department are successfully produced and disposed, - Gepavil and Gepavilag. The developed drugs (Gepavil and Gepavilag) are actively used in the Republic.

Staff of the department has taken part in world congress on gastroenterology (Pyongyang), four European congresses of gastroenterology (Prague, Amsterdam, Vienna, Barcelona), in four international seminars, 59 republican seminars, 29 of them were organized by the department.

Publications: 1 patent, 24 articles in journals, 8 of them are at international publications; 15 theses, 8 of them in materials about international conferences, 3 monographs; 9            instructions for use, approved by the Ministry of Health of the Republic of Belarus, two program complexes.

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