COMORBIDITY AND POLYMORBIDITY IN CHILDREN

Traditionally, in domestic pediatrics, the clinical diagnosis includes the main disease and its complications, as well as concomitant diseases. Several competing serious diseases can be the main ones. Unfortunately, it is extremely rare for specialists to pay attention to the coexistence of a whole spectrum of diseases in one patient and deal mainly with the treatment of a specific disease. It has been proven that in the presence of comorbidity, in order to establish the correct diagnosis, the patient must follow certain rules: among the complex of diseases, it is necessary to first of all identify the disease that requires priority treatment, because it significantly worsens the patient's quality of life, reduces his work capacity, or can provoke dangerous complications, and take into account cases in which the main disease is not one, but several. In the case of the establishment of several main diseases, one speaks of polymorbidity - the presence of several pathologies in an individual, which have a synchronous course in different phases and stages of their development, both related and unrelated to each other in terms of pathogenesis and genetics. Comorbid and polymorbid pathologies complicate the course of the main disease, strengthen the clinical implementation, make it more dangerous for the patient's health and life, contribute to the development of various complications. The presence of comorbidity in a patient is a problem of modern medicine. In most cases, a number of accompanying pathologies can be corrected and treated with timely diagnosis and compliance with the algorithms for providing medical care. International and national clinical recommendations have been created to manage the risks of developing complications and prescribe effective therapy in the presence of concomitant diseases, which outline algorithms for clinical and instrumental assessment of the development of complications, offer scales and indices. When studying comorbid and polymorbid pathology in children with chronic constipation caused by congenital lengthening of the colon, it was established that their number increases during the progression of the underlying disease, burdening the general condition of the child and worsening the prognosis. All this greatly complicates diagnosis, requires the use of a complex and individual approach to the diagnostic and treatment process. The concept of comorbidity and polymorbidity is of great importance not only for the differential diagnosis of coexisting conditions and the study of their impact on the course of chronic constipation and the quality of life of patients, but also for understanding the unifying etiological and pathogenetic mechanisms for choosing the most effective approaches to their correction and treatment.