Background: Functional constipation is a common condition in early childhood, with an estimated global prevalence of approximately 3%. In Mongolia, functional constipation has been increasingly diagnosed among young children, particularly those aged 2–6 years. The condition is associated with abdominal pain, bloating, painful defecation, stool retention behaviors, and long-term physical and psychological complications. Although pediatric Tuina massage is widely used in Traditional Chinese Medicine as a non-pharmacological intervention, evidence regarding its effectiveness remains limited in the local context. Aim: To evaluate the effectiveness of therapeutic massage on stool frequency and stool consistency in children with functional constipation. Materials and Methods: A randomized controlled study was conducted between May and December 2025 at the “Bomborduk” Pediatric Traditional Medicine Center. Sixty children diagnosed with functional constipation (ICD-10 K59.04) were randomly assigned to a therapeutic massage group (n=30) or an exercise therapy group (n=30). Outcomes were assessed at baseline and after one month using the Constipation Assessment Scale (CAS) and the Bristol Stool Form Scale. Result: The mean age of participants was 3.75±0.94 years, with no significant difference between groups. In the massage therapy group, CAS scores decreased from 8.23±2.39 to 3.17±2.36, while Bristol Stool scores improved from 1.33±0.48 to 3.00±0.87. Improvements were significantly greater in the massage group compared with the exercise therapy group (p < 0.05). Conclusion Therapeutic massage is a safe and effective non-pharmacological intervention that significantly improves stool consistency and reduces constipation severity in children with functional constipation.

Background: In the treatment of early gastric cancer, patients suitable for endoscopic submucosal dissection (ESD) are selected on the basis of endoscopic findings and biopsy results, while the final diagnosis is confirmed by examination of the resected specimen. Aim: To examine the discrepancies between clinical and pathological findings before and after ESD. Materials and Methods: We retrospectively identified 335 lesions treated by ESD for early gastric cancer at the National Cancer Center between 2020 and 2025, compared the endoscopic, biopsy and pathological findings, and identified the factors associated with discrepancy. Result: At least one of the three pre-treatment parameters was discordant in 175 lesions (52.2%). Of the 249 lesions judged to be ulcer-free on endoscopy, 51 (20.5%) were ulcerated histologically, while 28 lesions were overestimated (P<0.05). Underestimation of ulceration was more likely in lesions located in the upper or middle third of the stomach (OR 2.17, 95% CI 1.22–3.99) and in lesions measuring ≥20 mm (OR 1.68, 95% CI 1.00–2.84). Of the 110 lesions diagnosed as high-grade dysplasia on biopsy, 36 (32.7%) contained adenocarcinoma in the resected specimen, one of which was of undifferentiated type. Of the remaining 18 undifferentiated lesions, 6 (33.3%) had been diagnosed as differentiated type before treatment. Submucosal and lymphovascular invasion were associated with a tumor size of ≥20 mm (OR 3.58 and 3.15) and undifferentiated histology (OR 4.47 and 7.56); all P<0.01. Conclusion A significant discrepancy was observed between the pre- and post-ESD clinicopathological findings.

Background: CagA (cytotoxin-associated gene A protein) is an oncoprotein produced by Helicobacter pylori, a bacterium implicated in gastric carcinogenesis. CagA has been identified in all H. pylori strains isolated from patients with gastric cancer. To date, comparative studies investigating the genetic diversity of the cagA gene at the international level remain limited, and its pathogenic mechanisms have not yet been fully elucidated. Aim: To characterize the global and regional diversity of the cagA gene in H. pylori, and to evaluate the relationship of its prevalence and genotypic variants with gastric cancer. Materials and Methods: This molecular epidemiological study analyzed 9,276 H. pylori genomes from human hosts across 93 countries that were publicly available in international databases as of November 2024, together with 300 newly generated whole-genome sequences of H. pylori isolates from the Mongolian population that had not previously been deposited in public databases. To determine the genetic diversity of this oncogene, comprehensive genome bioinformatics analyses were performed, including genomic, phylogenetic, genotypic, and in silico protein analyses. Result: After quality control, 7,150 H. pylori genomes were included in the final analysis. Overall, 80.9% (n=5,783) of H. pylori strains were found to harbor the cagA gene, with the highest prevalence observed in Asia and the lowest in Europe. Maximum-likelihood phylogenetic analysis revealed substantial genotypic diversity of cagA and marked geographic variation in its distribution. Specifically, five distinct CagA protein types were identified, two of which represented previously undescribed novel types. The distribution of CagA types was found to correlate more strongly with the incidence of gastric cancer than the mere presence of cagA-positive H. pylori. Conclusion The majority of H. pylori strains in human populations worldwide harbor the CagA oncoprotein, with an overall prevalence of approximately 81%. Differences among CagA types may contribute to regional variation in gastric cancer risk. The diversification and evolutionary changes of the cagA gene may reflect recent processes of genetic admixture, which in turn shape its geographic and ethnic distribution as well as its pathogenic potential.

Background: According to the 2024 national health statistics of Mongolia, colorectal cancer accounts for 5.1% of all newly diagnosed cancers, with 74.1% detected at an advanced stage. Although population-based screening programs have recently been implemented, no studies have established a risk factor–based scoring system with an optimal cut-off value or evaluated its clinical utility in resource-limited settings in Mongolia. Aim: To develop a modified APCS (mAPCS) scoring system and evaluate its clinical applicability for colorectal cancer screening. Materials and Methods: A hospital-based prospective cross-sectional study was conducted between December 2024 and February 2026 at the outpatient clinics of the Mongolian National University of Medical Sciences and the Mongolia–Japan Hospital. A total of 447 eligible participants were enrolled. Anthropometric measurements (height and weight) were obtained, and six categories of questionnaires (demographic data, APCS risk score, behavioral factors, medical history, and medication use) were administered. Eleven participants declined colonoscopy; therefore, 436 participants underwent colonoscopic examination, with histopathological evaluation performed when indicated. Results: A total of 436 participants were included, of whom 282 (64.7%) were female, with a mean age of 54.8±11.5 years. Colorectal adenomas (advanced and non-advanced) and colorectal cancer were detected in 199 (45.6%) participants. Among them, 43 (21.6%) had advanced colorectal neoplasia. Multivariable regression analysis identified age ≥55 years (OR 4.8), BMI ≥28 kg/m² (OR 3.6), and a family history of colorectal cancer (OR 3.1) as independent risk factors for advanced neoplasia. The optimal cut-off value for the mAPCS score was 4, with an overall diagnostic accuracy of 41.7% (sensitivity 97.7%, specificity 35.6%). Conclusions 1. Age ≥55 years, BMI ≥28 kg/m², and a family history of colorectal cancer were identified as independent risk factors for advanced colorectal neoplasia. At a cut-off value of ≥4, the mAPCS scoring system demonstrated high sensitivity (97.7%), low specificity (35.6%), high negative predictive value (99.2%), and low positive predictive value (14.2%). 2. Therefore, the mAPCS scoring system may serve as a useful tool for risk stratification and efficient allocation of limited resources in colorectal cancer screening.

Introduction: According to epidemiological studies conducted in Mongolia over the past decade, diseases of the digestive system have consistently ranked second in terms of morbidity and fourth in mortality. With the rapid advancement of technology, sedentary lifestyles and unhealthy living habits have become more prevalent among the population, leading to a trend of digestive disorders affecting younger age groups. Therefore, investigating the prevalence, pathological changes, and risk factors associated with gallbladder and pancreatic diseases among university students has become the rationale for this study. Objective: To study the prevalence of gallbladder and pancreatic disorders and determine some of the associated risk factors. Methodology: 200 students from the first to sixth year were selected through random sampling based on the WHO age classification. Data collection included a structured questionnaire and ultrasound examination using the SUN-800D device. Diagnostic criteria followed the national clinical guidelines for acute cholecystitis. Results: Out of 200 participants, 120 (60%) were female and 80 (40%) were male. Among them, 128 students (64%) reported skipping breakfast regularly, and 147 (73.5%) did not consume an adequate amount of fluids daily. Ultrasound examinations revealed that 104 students (52%) had some form of gallbladder or pancreatic abnormality. Additionally, gallstones were detected in 1 student (0.5%), and gallbladder polyps were found in 5 students (2.5%). Conclusion Gallbladder and pancreatic abnormalities were observed in 52% of the participants. Among the associated risk factors, 64% of students reported skipping breakfast, and 73.5% had inadequate daily fluid intake. The ultrasound findings showed that 47% had biliary sludge, 32% had gallbladder kinking, and 48.5% had increased pancreatic echogenicity.

BACKGROUND Helicobacter pylori (H.pylori), the main cause of gastric and duodenal ulcer, is considered as a type 1 carcinogen. The primary prevention of gastric cancer is eradicating chronic H.pylori infection. However, the antimicrobial eradication rates are decreasing as low as 80% in some countries, less than 70% in Europe and are inversely correlated with antibiotic resistance rates reported worldwide. The current international guidelines recommended several regimens with higher success rate including sequential, combined, bismuth-containing and resistance-guided treatment and states that the local susceptibility testing in H.pylori should be studied. The research data that is covering correlation between H.pylori associated gastric changes and precancerous diseases, evaluation of H.pylori eradication rate are sparse in Mongolia. METHODS Totally, 495 eligible candidates were enrolled into this study. 225 patients who visited to endoscopy unit, received gastroscopy with multiple biopsies for rapid urease test, histology and H.pylori culturing. Out of these, 131 (52.2%) patients were positive for H.pylori infection. These were further tested for antibiotic resistance. 76 patients were treated with targeted therapy based on antibiotic resistance testing. Another 270 eligible patients with confirmed H.pylori associated gastritis were randomized into the following 1st line therapy regimen groups clarithromycin-based triple therapy (CBTT, n=90); bismuth-based quadruple therapy (BBQT, n=90) and sequential therapy (ST, n=90). In 43 patients that were not responded to 1st line therapy, levofloxacin-based triple therapy (LBTT) was prescribed as a second line treatment. Eradication rates were assessed using H.pylori stool antigen test 28 days of therapy just subsequent to termination of treatment. RESULTS During the gastroscopy, presence of active gastritis, nodular change and atrophy were 32.9%, 12% and 52.9% respectively. Epigastric pain was reported in 73.3%, 62.2%, 60-80% and 41.3% of patients with normal mucosa, nodular change, stomach and duodenal ulcer and antral atrophy (p<0.05). Abdominal fullness was more common among patients with extensive gastric atrophy (69.2%, p<0.05). In <40 age group gastritis was predominantly in the prepylori, while in the >50 age group it was predominantly the corpus region. H.pylori resistance rates to amoxicillin, clarithromycin, metronidazole and more than 2 antibiotics were 8.4%, 37.4%, 74% and 30.5%. On ITT analysis, eradication rates of 1st line H.pylori targeted treatment, CBTT, BBQT and ST were 92.1%, 71.1%, 87.8% and 67.8% (p<0.0001); on PP analysis, that were 94.6%, 72.7%, 89.8% and 68.5% (p<0.0001) respectively. Eradication rates of 2nd line treatment LBTT were 55.8% and 60% by ITT and PP analysis. Higher side-effects were reported during the second line treatment. CONCLUSION H.pylori infection rate was high among the dyspeptic patients resulting chronic gastritis and atrophic change. H.pylori resistance rate to metronidazole and clarithromycin was high. Among 1st line therapies; the eradication rates of CBTT and ST were poor, while BBQT and Targeted therapy had a higher success rate. 2nd line therapy showed higher failure rate.

Purpose:To identify theeffect of Antacid calcium-preparation on gastroeosophageal reflux disease by using pH meterfor 24 hour monitoring analysis. Study methodology:A randomly controlled test was used for the study. Study objects were administered Antacid calcium-6 preparation and their gastric acidity level was identified by pH monitoring analysis for 24 hours. Theimpact of preparation in regards with before and after treatment and their relationship were analysed by t-test. Results:The 24-hour pH meter analysis of Antacid calcium-6 preparation indicated that before administration of preparation the gastroeosophageal pH=5,75±0,14, which has increased after the administration to pH=9,7±0,02 and the average duration was 7,8±0,09 days. In other words, the alkalinizing effect was statistically significant (p<0.001). Also, According to the criteria developed by the DeMeester, the daily prevalence of reflux, the prevalence of reflux that continued for more than five minutes and the DeMeester index indicated that the preparation was significantly efficient (p=0.041). The neutrialising effect of the preparation was established by using the criteria method developed by G.A. Agafonova and A.P. Kholopov (1984), and after administering the preparation, the gastric level was pH=4,6±1,5 indicating that the preparation had a neutralising effect. The average duration for neutralization was 19,3±0,9 hours. Conclusion: Аntacid calcium-6 preparation was effective in neutralising the gastric acidity and it was appropriate for treatment of GERD, chronic gastritis.

The study’s goal was to determine efficiency of the Antacide Calcium-6 to Gastroeosophageal reflux disease (GERD) by radiological study. The material and methods are experimental study and we collected occasionally participants. The study was 2 stages. In the first stage, participants are given Antacide Calcium-6 p.o, and then monitored gastric acidity by pH monitoring for 24 hours. We evaluated how to effect to reflux condition in before and after treatment by relational groups t score. Also we determinate efficient to GERD by DeMeester score, G.A. Agafanova, A.P.Kholopov scores, time to neutralize gastric acidity by time to gastric acidity return normal. First stages results are this preparation alkalified eosophagus (р<0,001). The second stage: Participants are given Antacide calcium-6 for 21 days p.o (1 times per day, in 10 A.M, 1.5g) after collected GerdQ questions and did gastroeosophageal flexible endoscopy. Treatments results evaluated by GerdQ and Antacide calcium-6 decreased to gastro- eosophageal reflux by 72.1% (р<0,001). Eosophageal mucous membrande changes were 86.11% (n=31), gastric inflammation’s actitity was decreased 72.22% (n=26) by endoscopic examination. In conclusion, Antacid calcium-6 biological preparation has neutralizing actions to gastric acidity. Therefore this preparation is comfortable to treat GERD and chronic gastritis.

BACKGROUNDGastroesophageal reflux disease (GERD) is one of the most common digestive disorder in the world. In this study, we chose Calcitum-6 for GERD treatment and assessed itsimpact on the disease using modern laboratory and imaging study. Out main purpose was to investigate the impact of Calcitum-6 for GERD treatment using gastroscopy.METHODSWe selected 34 patients who meet the criteria of GERD for the study. All participants signed a consent form. After 21 days of treatment with Calcitum-6 patients underwentgastroscopy in the Teaching hospital of MNUMS.RESULTSSymptoms of GERD including heartburn and bitter taste were significantly reduced within 4.7±0.8 days after treatment. Symptoms of bile reflux, increased gastric acid and painwere reduced by 73.6%, 55.2%, and 69.8% (р=0.05), respectively, after the completion of 21 days treatment. Changes in esophageal mucosa were recovered in 83.87% (26) and relapse of gastritis was reduced in 65.52% (19) of all patients.CONCLUSIONSBased on our results, we conclude that using Calcitum-6 for the treatment of GERD shows significant reduction in symptoms of the disease.

IntroductionStructure and Function of the digestive organ diseases in that commonly occurred Peptic Ulcer Disease (PUD) is becoming one of the majority diseases in the population furthermore it is tending to increase and peptic ulcer malignity is in the fourth leading tumor which causes to death. Mongolian statistics data estimates that there are totally 355256 structures and function of the digestive organ diseases were registered in 2011. 25.2 % of stationary disease, 74.8% of is ambulatory diseases from them stationary disease of PUD are 3.74 %, ambulatory disease of PUD are 4.84%.PurposeTo define the types and needs of drugs which are used in the stationary and ambulatory treatment of patients who are suffering from peptic ulcerMaterial and MethodDiagnosis of PUD 2010-2012, The retrospective study has been done on the history of 393 stationary patients in the Gastroenterlogy Unit of Orkhon, Uvur-Khangai, Khovd, Dornod’s regional center for diagnosis and, State Central Clinical Hospital, Clinical Hospital-2, Hospital-3 named after Mr. Shastin, Hospitals in Songino-Khairkhan District and Nalaikh District but also 107 ambulatory patient’s substantial usage of prescribed drug treatments were compiled by cross sectional studies which is specifically developed study card. “The consumption method and morbidity method” by Hogerzell H.V., Jonathan D.Quick., James R.Rakin,(2005) was used due to identify drug needs as WHO advised.ResultsIn the study 500 people were above 20 and average age is 48.36±14.44. As a tertiary Level hospital 27, As a secondary Level hospital 18,Regional Center for Diagnosis 21, ambulatory treatment 22 kinds of drugs were used in PUD’s treatment. Omeprazolum 380, Metronidazolum 242, Sylcoseryl 227 were used. Peptic ulcer disease stationary treatment drug needs are not enough.Conclusions:1. As a tertiary Level hospital27, As a secondary Level hospital18 and Regional Center for Diagnosis used 21 kinds of drugs for PUD. 22 kinds of drugs were used for Peptic Ulcer Disease in an ambulatory2. Peptic ulcer disease stationary treatment drug needs are not enough.