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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Annals of the Russian academy of medical sciences</journal-id><journal-title-group><journal-title xml:lang="en">Annals of the Russian academy of medical sciences</journal-title><trans-title-group xml:lang="ru"><trans-title>Вестник Российской академии медицинских наук</trans-title></trans-title-group></journal-title-group><issn publication-format="print">0869-6047</issn><issn publication-format="electronic">2414-3545</issn><publisher><publisher-name xml:lang="en">"Paediatrician" Publishers LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">1219</article-id><article-id pub-id-type="doi">10.15690/vramn1219</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>INTERNAL DISEASES: CURRENT ISSUES</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>АКТУАЛЬНЫЕ ВОПРОСЫ ВНУТРЕННИХ БОЛЕЗНЕЙ</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">The pathomorphosis of inflammatory bowel diseases</article-title><trans-title-group xml:lang="ru"><trans-title>Патоморфоз воспалительных заболеваний кишечника</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Maev</surname><given-names>Igor V.</given-names></name><name xml:lang="ru"><surname>Маев</surname><given-names>Игорь Вениаминович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD, Professor</p></bio><bio xml:lang="ru"><p>д.м.н., профессор, академик РАН</p></bio><email>igormaev@rambler.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Shelygin</surname><given-names>Yurii A.</given-names></name><name xml:lang="ru"><surname>Шелыгин</surname><given-names>Юрий Анатольевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD, Professor</p></bio><bio xml:lang="ru"><p>д.м.н., профессор, академик РАН</p></bio><email>info@gnck.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0769-8176</contrib-id><contrib-id contrib-id-type="spin">2596-5555</contrib-id><name-alternatives><name xml:lang="en"><surname>Skalinskaya</surname><given-names>Maria I.</given-names></name><name xml:lang="ru"><surname>Скалинская</surname><given-names>Мария Игоревна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Associate Professor</p></bio><bio xml:lang="ru"><p>к.м.н., доцент</p></bio><email>mskalinskaya@yahoo.com</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2533-8118</contrib-id><contrib-id contrib-id-type="spin">9333-8673</contrib-id><name-alternatives><name xml:lang="en"><surname>Veselov</surname><given-names>Alexey V.</given-names></name><name xml:lang="ru"><surname>Веселов</surname><given-names>Алексей Викторович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD</p></bio><bio xml:lang="ru"><p>к.м.н.</p></bio><email>info@gnck.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Skazyvaeva</surname><given-names>Ekaterina V.</given-names></name><name xml:lang="ru"><surname>Сказываева</surname><given-names>Екатерина Васильевна</given-names></name></name-alternatives><bio xml:lang="en"><p>MD, PhD</p></bio><bio xml:lang="ru"><p>к.м.н., доцент</p></bio><email>skazyvaeva@yandex.ru</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3525-3289</contrib-id><contrib-id contrib-id-type="spin">6634-0342</contrib-id><name-alternatives><name xml:lang="en"><surname>Rasmagina</surname><given-names>Irina A.</given-names></name><name xml:lang="ru"><surname>Расмагина</surname><given-names>Ирина Алексеевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>resident in the specialty gastroenterology of the department of propaedeutics of internal diseases, gastroenterology and nutrition CM. Ryssa</p></bio><bio xml:lang="ru"><p>ординатор по специальности гастроэнтерология кафедры пропедевтики внутренних болезней, гастроэнтерологии и диетологии им. С.М. Рысса </p></bio><email>mskalinskaya@yahoo.com</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8834-0912</contrib-id><contrib-id contrib-id-type="spin">3599-4519</contrib-id><name-alternatives><name xml:lang="en"><surname>Komarova</surname><given-names>Diana A.</given-names></name><name xml:lang="ru"><surname>Комарова</surname><given-names>Диана Андреевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>medical student</p></bio><bio xml:lang="ru"><p>студент лечебного факультета </p></bio><email>mskalinskaya@yahoo.com</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6151-2021</contrib-id><contrib-id contrib-id-type="spin">5283-2032</contrib-id><name-alternatives><name xml:lang="en"><surname>Bakulin</surname><given-names>Igor G.</given-names></name><name xml:lang="ru"><surname>Бакулин</surname><given-names>Игорь Геннадьевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD, Professor</p></bio><bio xml:lang="ru"><p>д.м.н., профессор</p></bio><email>igbakulin@yandex.ru</email><xref ref-type="aff" rid="aff3"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">A.I. Yevdokimov Moscow State University of Medicine and Dentistry</institution></aff><aff><institution xml:lang="ru">Московский государственный медико-стоматологический университет имени А.И. Евдокимова</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">State research center of coloprotology named after A.N. Ryzhikh</institution></aff><aff><institution xml:lang="ru">Государственный научный центр колопроктологии имени А.Н. Рыжих</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">North-Western State Medical University n.a. I.I. Mechnikov</institution></aff><aff><institution xml:lang="ru">Северо-Западный государственный медицинский университет имени И.И. Мечникова</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2020-03-14" publication-format="electronic"><day>14</day><month>03</month><year>2020</year></pub-date><pub-date date-type="pub" iso-8601-date="2020-03-30" publication-format="electronic"><day>30</day><month>03</month><year>2020</year></pub-date><volume>75</volume><issue>1</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>27</fpage><lpage>35</lpage><history><date date-type="received" iso-8601-date="2019-10-05"><day>05</day><month>10</month><year>2019</year></date><date date-type="accepted" iso-8601-date="2020-03-10"><day>10</day><month>03</month><year>2020</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2020, "Paediatrician" Publishers LLC</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2020, Издательство "Педиатръ"</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="en">"Paediatrician" Publishers LLC</copyright-holder><copyright-holder xml:lang="ru">Издательство "Педиатръ"</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/" start_date="2021-03-30"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://vestnikramn.spr-journal.ru/jour/about/submissions</ali:license_ref></license></permissions><self-uri xlink:href="https://vestnikramn.spr-journal.ru/jour/article/view/1219">https://vestnikramn.spr-journal.ru/jour/article/view/1219</self-uri><abstract xml:lang="en"><p>Inflammatory bowel diseases (IBD) are immune-mediated diseases and usually manifest at a young age. They are requires in a long-term treatment or surgery with a high probability of surgical intervention. IBDs are accompanied by a decrease in working capacity, impaired quality of life and social disadaptation. However, timely diagnosis with using modern diagnostic methods, the use of evidence-based immunosuppressive and biological therapy significantly changed the pathomorphosis of this disease. But despite the achievements of the pharmacotherapy, the incidence and prevalence of IBD are still increasing, a demand for surgery remains both for Crohn`s disease and ulcerative colitis throughout all the period of illness. At the same time there is a trend towards the variability of symptoms, mismatch of the clinical symptoms with the real severity of inflammation, increase of a number of patients with extraintestinal manifestations and resistance to induction and maintenance therapies. In addition to this, the observation of this group of patients is complicated due to the difficulty of the early diagnosis and differential analysis of IBD, the need of early induction treatment according to the guidelines and the lack of adherence to the therapy.</p></abstract><trans-abstract xml:lang="ru"><p>Воспалительные заболевания кишечника (ВЗК) относятся к иммуноопосредованным заболеваниям, которые обычно манифестируют в молодом возрасте, требуют пожизненной патогенетической терапии с частым решением вопроса о хирургическом вмешательстве, что сопровождается снижением трудоспособности, нарушением качества жизни и социальной дезадаптации. Однако своевременная диагностика с использованием современных диагностических методов, применение иммуносупрессивной и биологической терапии привели к значительному, с позиции доказательной медицины, патоморфозу данных заболеваний. Несмотря на достижения фармакотерапии, отмечается рост заболеваемости и распространенности ВЗК, сохраняется потребность в хирургических вмешательствах как при болезни Крона, так и при язвенном колите на протяжении всего периода заболевания, но при этом отмечается трансформация течения ВЗК в сторону большей вариабельности симптоматики, несоответствия клинических симптомов с реальной тяжестью воспаления, роста доли пациентов с внекишечными проявлениями и резистентностью к препаратам индукционной и базисной терапии. Вместе с тем существуют проблемы при курации пациентов данной категории: трудности в ранней диагностике и дифференциальной диагностике ВЗК, наличие опыта и навыков диагностики внекишечных проявлений, необходимость раннего и своевременного начала терапии с учетом существующих рекомендаций, недостаточная приверженность пациентов к терапии и др.</p></trans-abstract><kwd-group xml:lang="en"><kwd>inflammatory bowel disease (IBD)</kwd><kwd>Crohn’s disease</kwd><kwd>ulcerative colitis</kwd><kwd>IBD pathomorphosis</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>воспалительные заболевания кишечника</kwd><kwd>болезнь Крона</kwd><kwd>язвенный колит</kwd><kwd>патоморфоз воспалительных заболеваний кишечника</kwd></kwd-group><funding-group><award-group><award-id></award-id></award-group></funding-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Ng SC, Shi HY, Hamidi N, et al. 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