#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Effect of a synbiotic, ColonFit, in patients with irritable bowel syndrome, functional constipation and functional diarrhea


Authors: Kroupa R. 1;  Jarkovský J. 2;  Packová B. 1;  Doležalová Š. 2;  Junková H. 3;  Benedíková V. 4;  Dolina J. 1
Authors‘ workplace: Interní gastroenterologická klinika LF MU a FN Brno 1;  Institut bio statistiky a analýz, LF MU, Brno 2;  Gastroenterologická ambulance, SPEA Olomouc 3;  Gastroenterologie, Poliklinika Rychnov nad Kněžnou, s. r. o. 4;  Gastroenterologická ambulance, Poliklinika Veselí nad Moravou 5
Published in: Gastroent Hepatol 2020; 74(6): 535-542
Category: Clinical and Experimental Gastroenterology: Original Article
doi: https://doi.org/10.48095/ccgh2020535

Overview

Background: Supplementary dietary fiber and probiotics may improve bowel symptoms due to changes in microbiome and fermentation. The aim of the study was the evaluation of symbiotic with psyllium, ColonFit, in patients with functional colonic diseases.

Patients and Methods: A prospective observational study in patients with irritable bowel syndrome, functional constipation and functional diarrhea for a 4-week intake of ColonFit 10 g daily. The type and severity of bowel symptoms (scale 1–5), number and consistency of stool and quality of life features were analyzed in subgroups according to dominant initial symptoms.

Results: Complete data were available from 110 patients (mean age 49.9 ± 15.3 years, 58.2% females). Constipation related symptoms were predominant in 46 (41.8%) patients, diarrhea in 28 (25.5%) and mixed type in the rest. The symptoms in constipation predominant group were more severe than in others. The significant change in softening of stool consistency (from 1.9 to 3.8 in Bristol stool scale; p < 0.001), an increase in spontaneous bowel movements (from 3.1 to 5.6× weekly; p = 0,001) and reduction of incomplete bowel movements of 40% and abdominal pain of 42% were observed in constipated patients. The reduction in a number of bowel movement per week (from 17.8 to 13.6; p = 0.001) and improvement of abdominal cramps by 27% and reduction of dietary limitations by 30% were recorded in diarrhea subgroup. The beneficial effect lasted for a two-week follow up after the discontinuation of ColonFit use.

Conclusion: The ColonFit use was most beneficial in constipated patients. The improvement of several symptoms was observed in other subtypes of irritable bowel syndrome without any worsening of troubles. The use of the combination of psyllium, inulin and probiotics may offer an effective alternative for the management of functional bowel diseases.

Keywords:

syndrom dráždivého tračníku – vláknina – probiotika – synbiotika – obstipace – průjem – funkční střevní poruchy


Sources

1. Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology 2006; 130 (5): 1377–1390. doi: 10.1053/j.gastro.2006.03.008.

2. Mearin F, Lacy BE, Chang L et al. Bowel disorders. Gastroenterology 2016; S0016-5085 (16) 00222-5. doi: 10.1053/j.gastro.2016.02.031.

3. Seifert B, Tachecí I, Bureš J et al. Dráždivý tračník. Doporučený dia gnostický a terapeutický postup pro všeobecné praktické lékaře 2019. [online]. Dostupné z: https: //www.svl.cz/files/files/Doporucene-postupy/2017/DP-Drazdivy-tracnik.pdf.

4. Tack J, Stanghellini V, Mearin F et al. Economic burden of moderate to severe irritable bowel syndrome with constipation in six European countries. BMC Gastroenterol 2019; 19 (1): 69. doi: 10.1186/s12876-019-0985-1.

5. Ford AC, Lacy BE, Talley NJ. Irritable bowel syndrome. N Engl J Med 2017; 376 (26): 2566– –2578. doi: 10.1056/NEJMra1607547.

6. Juřica J, Kroupa R. Farmakoterapie dráždivého tračníku. Prakt Lékáren 2017; 13 (2): 52–59.

7. de Vries J, le Bourgot C, Calame W et al. Effects of b-fructans fiber on bowel function: a systematic review and meta-analysis. Nutrients 2019; 11 (1): 91. doi: 10.3390/nu11010091.

8. Erdogan A, Rao SS, Thiruvaiyaru D et al. Randomised clinical trial: mixed soluble/insoluble fibre vs. psyllium for chronic constipation. Aliment Pharmacol Ther 2016; 44 (1): 35–44. doi: 10.1111/apt.13647.

9. Ford AC, Moayyedi P, Lacy BE et al. American College of Gastroenterology monograph on the management of irritable bowel syndrome and chronic idiopathic constipation. Am J Gastroenterol 2014; 109 (Suppl 1): S2–S26; doi: 10.1038/ajg.2014.187.

10. Shulman RJ, Hollister EB, Cain K et al. Psyllium fiber reduces abdominal pain in children with irritable bowel syndrome in a randomized, double-blind trial. Clin Gastroenterol Hepatol 2017; 15 (5): 712–719. doi: 10.1016/j.cgh.2016.03.045.

11. Hungin APS, Mitchell CR, Whorwell P et al. Systematic review: probio tics in the management of lower gastrointestinal symptoms – an updated evidence-based international consensus. Aliment Pharmacol Ther 2018; 47 (8):  1054–1070. doi: 10.1111/apt.14539.

12. Martínek J. Zácpa a přežívající mýty. Laxativa. Gastroent Hepatol 2012; 66 (4): 249–255.

13. Dale HF, Rasmussen SH, Asiller ÖÖ et al. Probio tics in irritable bowel syndrome: an up-to-date systematic review. Nutrients 2019; 11 (9): 2048. doi: 10.3390/nu11092048.

14. McKenzie YA, Bowyer RK, Leach H et al. British Dietetic Association systematic review and evidence-based practice guidelines for the dietary management of irritable bowel syndrome in adults (2016 update). J Hum Nutr Diet 2016; 29 (5): 549–575. doi: 10.1111/jhn.12385.

15. Miller LE, Ouwehand AC, Ibarra A. Effects of probio tic-containing products on stool frequency and intestinal transit in constipated adults: systematic review and meta-analysis of randomized controlled trials. Ann Gastroenterol 2017; 30 (6): 629–639. doi: 10.20524/aog.2017.0192.

16. Suares NC, Ford AC. Systematic review: the effects of fibre in the management of chronic idiopathic constipation. Aliment Pharmacol Ther 2011; 33 (8): 895–901. doi: 10.1111/j.1365-2036. 2011.04602.x.

17. Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. JAMA 2015; 313 (9): 949–958. doi: 10.1001/jama.2015.0954.

18. Eswaran S, Muir J, Chey WD. Fiber and functional gastrointestinal disorders. Am J Gastroenterol 2013; 108 (5): 718–727. doi: 10.1038/ajg.2013.63.

19. Huang LS, Kong C, Gao RY et al. Analysis of fecal microbio ta in patients with functional constipation undergoing treatment with synbio tics. Eur J Clin Microbio l Infect Dis 2018; 37 (3): 555–563. doi: 10.1007/s10096-017-3149-7.

20. Tachecí I. Zácpa a její farmakoterapie v ordinaci praktického lékaře. Med Praxi 2019; 16 (2): 85–88. doi: 10.36290/med.2019.049.

21. Falt P, Urban O, Suchánek Š et al. Doporučené postupy České gastroenterologické společnosti ČLS JEP pro dia gnostickou a terapeutickou koloskopii. Gastroent Hepatol 2016; 70 (6): 523–538. doi: 10.14735/amgh2016csgh.info19.

22. Vork L, Weerts ZZ, Mujagic Z et al. Rome III vs. Rome IV criteria for irritable bowel syndrome: a comparison of clinical characteristics in a large cohort study. Neurogastroenterol Motil 2018; 30 (2): e13189. doi: 10.1111/nmo.13189.

23. Bharucha AE, Wald A. Chronic constipation. Mayo Clin Proc 2019; 94 (11): 2340–2357. doi: 10.1016/j.mayocp.2019.01.031.

24. Patrick DL, Drossman DA, Frederick IO et al. Quality of life in persons with irritable bowel syndrome: development and validation of a new measure. Dig Dis Sci 1998; 43 (2): 400–411. doi: 10.1023/a: 1018831127942.

25. Roalfe AK, Roberts LM, Wilson S. Evaluation of the Birmingham IBS symptom questionnaire. BMC Gastroenterol 2008; 8: 30. doi: 10.1186/1471-230X-8-30.

26. Cudmore S, Doolan A, Lacey S et al. A randomised, double-blind, placebo-controlled clin ical study: the effects of a synbio tic, Lepicol, in adults with chronic, functional constipation. Int J Food Sci Nutr 2017; 68 (3): 366–377. doi: 10.1080/09637486.2016.1244661.

27. Forssmann K, Meier L, Uehleke B et al. A non-interventional, observational study of a fixed combination of pepsin and amino acid hydrochloride in patients with functional dyspep sia. BMC Gastroenterol 2017; 17 (1): 123. doi: 10.1186/s12876-017-0675-9.

28. Ballou S, Beath A, Kaptchuk TJ et al. Factors associated with response to placebo in patients with irritable bowel syndrome and constipation. Clin Gastroenterol Hepatol 2018; 16 (11): 1738–1744.e1. doi: 10.1016/j.cgh.2018.04.009.

29. Ford AC, Moayyedi P. Meta-analysis: factors affecting placebo response rate in the irritable bowel syndrome. Aliment Pharmacol Ther 2010; 32 (2): 144–158. doi: 10.1111/j.1365- 2036.2010.04328.x.

Labels
Paediatric gastroenterology Gastroenterology and hepatology Surgery

Article was published in

Gastroenterology and Hepatology

Issue 6

2020 Issue 6

Most read in this issue
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#