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at all you start to get angry, why because salt cyst stones? that's where the doctor does it too. an ultrasound is pointless. we shouldn't be doing this. if you want to check the kidneys, you don’t need an ultrasound ultrasound when an ultrasound when you have stones, yes, yes ultrasound when you had a severe infection, look at the expansion of the pelvis, that there is some kind, but only ultrasound visualize gross changes. but when you have bricks into stones there, these are gross changes, when your kidneys of the pelvis are destroyed, gross changes are destroyed. i started by saying that in european countries, in developed countries, 10 to 20% of people have that initial degree of chronic kidney disease and no one knows about it. and you don't hear about it. here, hear what risk factors, who needs to be checked, and then i will say that do not forget the ultrasound. you about this ultrasound should do something that affects the early stages. at an early

stage, your kidneys will be normal on ultrasound, ideal, all you need to do is a urine test and a blood test to see the amount of albumin in the urine protein, we will multiply the minvore and creatinine in the blood one by the other and get the glomerular filtration data 90% gorgeous. everything is lower, this is already a violation of the function, a violation of the function. functions, if i put it here now, what analyzer will you bring me daily urine and a blood test. every tenth minimum will have a violation. you don't know this for every tenth person, but over the years it will backfire on you. why am i saying, who needs to be checked every year for a urine test for albuminuria and cretinin and calculate for all people 50 plus all hypertensive patients. here are the brothers and sisters of hypertension, we are 50% of the population. each of you once a year should do this diabetes with high sugar. but god himself told you to. about a diabetic

everyone knows, but on dialysis due to chronic insufficiency, there are more hypertensive patients than diabetics people who had some kind of infection in childhood urinary glamerolonephritis people who have urolithiasis, yes, who have urolithiasis , a disease people who take drugs that can act on the ground. you know, the most harmless drugs can act on the kidneys, for example, such as omeprazole, we all get heartburn by drinking prozol about zol. surely , you still need to keep track of the mass of drugs that excreted by the kidneys, which are not fantastic, well, here are direct nephrotoxic antibiotics. well, for example, what is the most common drug group of drugs leads to kidney problems, kidney failure, which you do not even know, here you are people with a headache to take you all have a headache. here you are all taking non -steroidal anti-inflammatory drugs and their name is legion there. yes, there are about 20 well-known females of them, and

disteroid anti-inflammatory drugs are generally traded. it's you in the mail right like this. here you hit, every time. just don't know about it. why am i saying this, because i'm exactly the same, i once did not understand this epidemic, because you still don't feel it. you feel great. you are healthy. you are bricks. you can break. you can eat everything, drink, drink, everything is fine, but your postal function does not look perfect. everything is fine. you see, when the critigen moves in, here are the indicators by 10-15%. it’s just you know how the norms are sufficient there in some units, but you have it a little higher you seemed 120? well 120 guess what, the big difference is 50% of kidney function is lost by this late when you look at the cover. well, let's ask me something else. let's say, please, here it is considered that if the lower back hurts, then, there may be a problem with the kidneys. here's how to figure it out. how to understand that the problem is in the kidneys, the kidneys do not

hurt, the lower back hurts for a large bunch of reasons, you need all the higher skeletal pain. the only thing is when the lower back hurts. this is when a stone comes, but there it hurts not only the lower back is given in the fah scrotum, and there the pain is such that a person climbs the wall, one of the strongest. eh, more or less, this is already a purulent process. this is the inflammation of saw jade, when there is inflammation and so on. that's all that's definitely not enough taking away. she never hurts. no, symptoms. no, that's the problem with you hypertension and children. check if you have high blood sugar. children. check you gave birth had kidney disease go check you are 50 years old. and children. do you want to check for medicines? check my kidneys. yes, why, but dr. myasnikov said that he said daughter i'm happy to have an ultrasound and you will come for an ultrasound well if it's free, huh? will you come again rain? and when you don't need a second visit, you don't need another, he sewed dr. myasnikov and you. with

carnot, ultrasound means ultrasound. and what are you thinking about al-buminuria? let's ask me something. now. good morning. kindly tell me, please, here my husband drinks water from the tap. and i only drink boiled, because i heard that the water is from the tap. maybe, yes, nothing while alive. so i think, let it continue to have fun after all switches to filtered or boiled water. well , it is clear that if you drink water with a high calcium content of some salts, but in fact , if you have a healthy person, your kidney is the most regulated, it is regulated. and in principle, there should be changes in urodynamics. why do i say a lot of water there must be the same acid it was believed that the balance, because some salts with acids among the urine are deposited, and some are alkaline. here a person eats a lot of grass, let's say. she has an alkaline environment, certain stones formed and so on and so forth. well , he drinks, she likes him drinking. i don't know if

all of us would be transplanted to bottled water. we all drink this lida water for another 2 liters. how much does a can of water cost? is it good for another five-liter? and then he says you need to know you need melt water from there from some mountain. it costs the price of armenian cognac . okay, in our time and glass. anything you remember would be good, because it's a serious problem. they don't know, nobody tells you, i said, so be careful to your health. it will still be good for many . you have questions. now they will answer, because the rubric time. ask a doctor. good morning. and i have such a question. my son, he is 29 years old, and against the background of complete well-being in health, and a month ago there was an intestinal obstruction and hmm . so he was taken to the

hospital in a serious condition. well, it turned out that after the conservative. well, he's got probing treatments and enemas. uh, obstruction of the 12th intestine. so one after the other went, and she dealt with, so, uh, why this happened no one could answer. how did this happen, i have a question. could this never happen again? or is it some kind of symptom of something, well, serious no, well, usually in children , they still have more ascetics, the intestines are less fixed, then what happens. well, you know, this is a tube, yes, a tube, when the intestines, as you know, that's like a sock. this is how one is wrapped in the other, and then there really is liquid, and so on, and we try to straighten this fold. if no, we operate, yes, you can repeat. yes, it may not happen again, as luck would have it, rather no than yes. well, that is something that may not happen again. this is also an option. yes, it happened

once and that's it. well, most likely it will. that is, it is rare when it repeats, thank you alexander leonidovich yes, good morning, who cares? i would like to hear your opinion. for what question? i have had a pacemaker for 10 years already, even 11 already. and of course, the date is approaching closer when you need to change it. the question is, how much more difficult is the repeated operation to replace pacemaker and how much more traumatic for the surgeon and how much more traumatic this operation for me no at all you made me happy. thank you. we are doing it to the hospital for me at all, no way at all. well, they are already taking it out, rearranging the catheter and putting it in. no, good morning. good

my grandson, and he is 8 years old, often has acute pain in the abdomen in the abdomen in the stomach, the antispasmodics do not help, there are no painkillers either, we call an ambulance sometimes they take him on a drip, they said, we might have pancreatitis, but they did an abdominal ultrasound sing hollows, everything is in order. the analyzes were good too . well, this is after the acute phase. uh, we did tests going on. this is 3-4 times a year. here is the next question. maybe he'll outgrow it all. yes, it is a fairly typical condition here, and there is no surgical pathology behind it. so i understand your concern. i understand in russia an ambulance and not a tail belly. but this happens quite often in children. this is the type, as we even talk about a nominal migraine. so behind these there is one normal tests are normal nothing. no not required. this is one variety.

this is the name of the abdominal migraine in children. there it is necessary to deal with stress, give calming and so on. take me, but i'm just saying that it's most likely here, thank you very much. questions to all health, good luck. next on the program is an unusual reason for a lingering cough, who are interested in continuing the crisis in ukraine for the sake of weakening russia against the content that today's ukraine produces i don't think the ukrainian people like it in mariupol thousands of dews evidence. just collect. listen to what people say. and what then that tomorrow my head is just spinning from our partners. guys, don't dig a hole in russia, you'll get there yourself.

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two special offers that will be an integral part in creating your unforgettable look with a choice you can't go wrong. after all, the presented products are classics for many years. hurry offer is limited. good morning. unfortunately, with age, we accumulate certain diseases, some make themselves felt immediately, and some sneak up quietly and imperceptibly. how often do we pay attention to the fact that we ourselves or our loved ones are coughing, usually a mild cough. he always has an explanation. i caught a cold, i had a cold, my throat got sick, and a respiratory infection has joined, but the cough continues. indeed, a cough can be

quite a dangerous symptom. therefore, patients with a long-term chronic cough go to a pulmonologist. and if the pulmonologist is competent. not finding his reasons, then he will refer them to another specialist. and if not really, then excluding all the causes from the lung disease, he will simply let go and say it will pass by itself. can it be associated with the pathology of the gastrointestinal tract ? this is what we will talk about today, our viewer olga, who cannot cope with coughs for a long time, turned to us. let's find out her story 55 years, tver olga dedicated her whole life to working as a teacher. now she has retired, but she continues to teach, well, i work with kids, that is, i help my granddaughters and it happens that i can also help someone with my experience, but in the last couple of years it has become more difficult for olga to worry about bouts of severe coughing cough occurs after food during

sleep. here at night i sleep coughing god maybe sometimes i laugh, i didn’t get sick there, that is, there would be no such symptoms, which is connected precisely with a cold. and porridge comes up all the time. now, if there is a problem, that is, when i am in charge of the children, i naturally should not cough. olga tried to get rid of the cough on her own. be sure to drink herbs used folk methods, but all in vain, of course, i hope that coming to this program to you. i will understand how to treat this cough, how to deal with it? olga we have studios, come to us, please, good morning. hello hello olga, how long have you been tormented by a cough? this problem arose a long time ago, but for the last 3 years a cough has arisen. eh, sometimes surprisingly more often. it occurs at night, suddenly i suddenly start to cough, and the cough is dry in the morning, it also occurs and they get sick. i don't smoke at all. i lead a healthy lifestyle. the only thing is, but lately it has become

difficult for me, that is, some other symptoms of heartburn appear. you know, i get heartburn, and then i start to cough, which helps, maybe, uh, drink a glass of water. becomes easier. i tried different herbs from the stool of things, the same plantain, uh, there mother stepmother decoction, uh, solo. but it also didn’t help, but olga tells a straight-forward classic picture of a cough associated with the pathology of the upper gastrointestinal tract with gastroesophageal reflux, so i want to invite our expert doctor adilyevna kolokolnikova, a gastroenterologist, head of the gastroenterology department, to the studio. good morning. good morning olga grandfather. that gastroenterological problems can affect the oral cavity and dentists very often refer a gastroenterologist. i know this, but how can a pulmonologist send a

monologue to a gastroenterologist and not a urologist or a neurologist or even an almologist, because sometimes the reflux is so powerful that bile acid and gastric juice are thrown up the back wall, very high. let's stream the characteristic signs of gastric cough, that is, when the cough is associated with the pathology of the gastrointestinal tract occurs after eating. yes , it can occur after eating, but sometimes it is not. associates the patient with food intake. he just coughs most of the time because we eat. we do quite often. it seems, of course, often happens after waking up. do you like yes, and even during sleep. why do we lie and lie during sleep, and those people who have imperfections. this is the closing mechanism between the esophagus and stomach. gastric juice with hydrochloric acid

. yes and cause here is this irritation. and this one an endless cough is enough to make a person cough; antitussives do not help. it is true that the remedies do not help, despite the fact that you have been drinking various herbs. i'm trying to say these herbs can increase peristalsis. the boat and provoke even more very often, but they use various drugs that, on the contrary , really cause hyperproduction of the mucosa. and here is this hyperproduction, these drugs, and this hyperproduction of mucous membranes, which also affects the mucous membrane, of course, and consequently causes even more accumulation. here is this aggressive liquid and its entry into the upper esophagus and into the pharynx. may be accompanied by heartburn and belching of the fields behind the sternum, but this is exactly what olga was talking about that she had heartburn, yes, for any specialist to whom the patient comes and who actively asks him, do you have burns, but no do you burp with air, if you have any

discomfort behind the sternum and paying attention to this, you can figure out what the cause of the cough may be be, of course, a reflex here, let's just see what is happening and what is the mechanism for the occurrence of this cough. we have the contents of the stomach, yes, it contains enzymes, it contains total hydrochloric acid and is quite an aggressive environment, our stomach can withstand it perfectly. this is a natural environment. and here, here, there is such a muscular wife , a muscular sweater, which, in fact, does not allow this gastric contents to penetrate higher, that is, by reverse current, of course, the stomach moves and is normal even in a healthy a certain number of people can be thrown up with a knife. still, it prevents this and, accordingly. we have gastric contents slowly moving into the intestines. well, and so on, what happens when there is a pathology or inflammation or a lack of muscle in this

sprinter, or both, the contents enter the esophagus, the esophagus is not adapted to this, heartburn can react to this aggressive environment and we feel a lump behind the sternum, it seems for pain in the heart. sometimes even accompanied by a violation of the rhythm. that is, with this with various complaints, the patient may come further. throwing up into the oral cavity. this content can penetrate into the bronchi, indeed, first of all it penetrates. this content is from the upper parts of the pharynx to the pharynx to the larynx, trachea and causes this irritation. there are a huge number of receptors there. in the upper bronchi. well, probably everyone knows how much we cough, when we choke on something, there is a colossal irritation of reflexogenic umbrellas. and this is where this cough arises, which, by the way, is very difficult to cope with. he really nothing goes away, olga odelina. so what to do, you need to pay attention to those factors that lead to this problem most often, and this is still a lot of pressure in the manual cavity

, an overweight person experiences more pressure on the stomach, because his stomach, it turns out, is in a vice between anterior abdominal wall with fat and omentum. well, among other things, also increase the pressure in the abdominal cavity. maybe tight clothes tight belts. retracting yourself it, unfortunately provokes this cough look further olga is separate. what advice can we give to olga and, uh, to all those people who have this problem. the first recommendation is to still come to the doctor, what you need to pay attention to first of all for proper sleep, it is important to consider here that it is not enough to lift yourself up with pillows, because in this way we bend, and as if we are pulling a belt, increasing even more pressure on the anterior abdominal wall. we need to put two books. let's put bricks under the head of the bed so that the whole bed is slightly raised at the head. this is the first rule. and for some reason, we have here in the red zone, there is soda and a large

amount of water, probably, water is definitely needed at night, and it, of course, washes away this e -reflectuate that has flooded, but you don’t need to drink it at night, because that when we stretch the stomach, even with water the sphincter becomes even more open, so in no case should this be done. but about soda, never stop heartburn with soda, because this leads to even more production of hydrochloric acid and it is very difficult for us to continue. deal with what we can advise. what actions need to be taken, well, first of all , you need to deal with your weight. you need to move , you need to reduce the amount of food. we have a yardstick. our palms are folded tightly and this is the measure by which it is physiologically adapted to the stomach. now, if we eat as much as we can fit here in one meal, even junk food. you can sometimes, but our stomach can handle it, so the amount of food should not be very large.

what kind of food should we eat healthy, regardless from diseases, even if we have a reflex, no, we don't wear it. this beautiful body is still neat for many, many decades, so fermented milk products rich in fiber are healthy proteins. fruits can definitely increase acidity , you can definitely, the main thing is not to mix them with the main meal and not eat them at night, prokinetics and antacids. they are non- prescription. you can buy them at the pharmacy, but please be careful, uncontrolled. reception long two-three-four ten-year reception these drugs can harm you all. clear. thank you. let's go olga thank you very much for coming to us. i hope you take our advice and feel better. thank you very much, olga is single. thank you so much for being my true friends. today we will talk about such a strange, seemingly

symptom, as a constant cough associated with diseases of the gastrointestinal tract. and most importantly, tell you how to deal with it. and we wish you a good day and good mood. be healthy. with you was the program basically. minefields and stretch marks with surprises under the stretch marks even under these mines were installed.