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Colegio de Medicina Interna de México.

2017, Número 4

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Med Int Mex 2017; 33 (4)


Experiencia clínica con un simbiótico (Bifidobacterium longum AW11- Fos cc. Actilight) en el alivio del estreñimiento y otros síntomas digestivos

Valdovinos-Díaz MÁ, Abreu AAT, Frati-Munari AC

Idioma: Español
Referencias bibliográficas: 68
Paginas: 476-486
Archivo PDF: 255.03 Kb.


RESUMEN

Antecedentes: el estreñimiento, la distensión y el dolor abdominales son muy prevalentes en la población general y representan un reto terapéutico. Los probióticos han mostrado ser efectivos en el control de estos síntomas.
Objetivo: investigar la utilidad clínica de la administración del simbiótico Bifidobacterium longum AW11 (5×109 UFC) y fructo-oligosacáridos de cadena corta (Fos cc. Actilight 2.5 g) en el alivio del estreñimiento y otros síntomas digestivos.
Pacientes y Método: estudio abierto observacional en el que se incluyeron pacientes con síntomas digestivos de más de seis meses de evolución, sin enfermedad orgánica que explicara sus síntomas y que recibieron tratamiento con el simbiótico, un sobre diario durante ocho semanas. La intensidad y frecuencia de los síntomas se evaluaron mediante un cuestionario y las características de las evacuaciones mediante la escala de Bristol al inicio, a las cuatro y a las ocho semanas de tratamiento.
Resultados: se incluyeron 361 pacientes con síntomas digestivos. El promedio de la duración de los síntomas fue de 2.3±4.9 años, 96% tenía estreñimiento, 79% cumplió con criterios de síndrome de intestino irritable y 16% de estreñimiento funcional (Roma III). El número de evacuaciones semanales se incrementó de 3.8±3.3 iniciales a 5.9±3.0 en la semana 8 (p‹0.00001). También mejoraron significativamente: el número de evacuaciones espontáneas completas, la consistencia de las heces (escala de Bristol) y la sensación global de bienestar y disminuyeron significativamente el esfuerzo al defecar, la distensión abdominal subjetiva, la frecuencia de dolor abdominal y la sensación de malestar abdominal. La proporción de pacientes totalmente satisfechos se incrementó de 6% al inicio a 78% en la semana 8.
Conclusiones: la administración diaria del simbiótico con B. longum y Fos cc. es eficaz para aliviar el estreñimiento y el dolor y la distensión abdominales.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Tap J, Mondot S, Levenez F, Pelletier E, Towards the human intestinal microbiota phylogenetic core. Envirom Microbiol 2009;11:2574-84.

  2. DuPont AW, DuPont HL. The intestinal microbiota and chronic disorders of the gut. Nat Rev Gastroenterol Hepatol 2011;8:523-531.

  3. Ballal SA, Gallini CA, Segata N, Huttenhower C, Garrett WS. Host and gut microbiota symbiotic factors: lessons from inflammatory bowel disease and successful symbionts. Cel Microbiol 2011;13:508-17.

  4. Drossman DA, Li Z, Andruzzi E, et al. U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci 1993;38:1569-80.

  5. Markert C, Suarez-Hitz K, Ehlert U, Nater UM. Distress criterion influences prevalence rates of functional gastrointestinal disorders. BMC Gastroenterol 2014;14:215-222.

  6. Lindberg G, Hamid S, Maltfertheiner P, et al. Guías mundiales de la Organización Mundial de Gastroenterología. Estreñimiento una perspectiva mundial. WGO nov 2010;1-15.

  7. Remes Troche JM, Tamayo De la Cuesta JL, Raña Garibay R, Huerta Iga F, Suarez Moran E, Schmulson M. Guías de diagnóstico y tratamiento del estreñimiento en México. A) Epidemiología (meta-análisis de la prevalencia), fisiopatología y clasificación. Rev Gastroentrerol Mex 2011;76:126-132.

  8. Remes Troche JM, Carmona Sánchez R, Abreu y Abreu AT, et al. Guias de diagnóstico y tratamiento del estreñimiento en México. B) Abordaje diagnóstico. Rev Gastroenterol Mex 2011;76:133-40.

  9. Schmulson Wasserman M, Francisconi F, Olden K, et al. Consenso latinoamericano de estreñimiento crónico. Gastroenteroil Hepatol 2008;31:59-74.

  10. Marteau P, Guyonnet D, Lafaye de Micheaux P, Gelu S. A randomized, double-blind, controlled study and pooled analysis of two identical trials of fermented milk conteinin probiotic Bifidobacterium lactis CNCM I-2494 in healthy women reporting minor digestive symptoms. Neurogastroenterol Motil 2013;25:331-e252.

  11. Guyonnet D, Woodcock A, Stefani B, Trevisan C, Hall C. Fermented milk containing Bifidobacterium lactis DN-173 010 improved self-reported digestive comfort amongst a general population of adults. A randomized, open-label, controlled pilot study. J Digest Dis 2009;10:61-70.

  12. Agrawal A, Houghton LA, Morris J, Reilly B, et al. Clinical trial: the effects of a fermented milk product containing Bifidobacterium lactis DN-1 73 010 on abdominal distention and gastrointestinal transit in irritable bowel syndrome with constipation. Aliment Phramacol Ther 2009;29:104-14.

  13. Guyonnet D, Chassany O, Ducrotte P, et al. Effect of a fermented milk containing Bifidobacterium animalis DN-173 010 on the health-related quality of life and symptoms in irritable bowel syndrome in adults in primary care: a multicentric, randomized, double-blind, controlled trial. Aliment Pharmacol Ther 2007;26:475-86.

  14. Colecchia A, Vestito A, Larocca A, et al. Effect of a symbiotic preparation on the clinical manifestations of irritable bowel syndrome, constipation-variant: results of a multicenter study. Minerva Gastroenterol Dietol 2006;52:349-58. Digest Liver Dis 2006;38(Suppl 1):S86.

  15. Dughera L, Elia C, Navino M, et al. Effect of symbiotic preparations on constipated irritable bowel syndrome. Acta Biomed 2007;78:11-6.

  16. Quigley E, Fried M, Gwee S, et al. Guías mundiales de la Organización Mundial de Gastroenterología. Síndrome de intestino irritable: una perspectiva mundial. WGO Apr 2009;1-22.

  17. Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 1997;32:920-4.

  18. Parés D, Comas M, Dorcaratto D, et al. Adaptation and validation of the Bristol scale stool form translated into the Spanish language among health professionals and patients. Rev Esp Enferm Dig 2009;101:312-6.

  19. Ford AC, Quigley EM, Lacy BE, Lembo AJ, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol 2014;109:1547-61.

  20. Nikfar S, Rahimi R, Rahimi F, Derakhshani S, Abdollahi M. Efficacy of probiotics in irritable bowel syndrome: a metaanalysis of randomized, controlled trials. Dis Colon Rectum 2008;51:1775-80.

  21. Krumbeck JA, Maldonado-Gomez MX, Ramer-Tait AE, Hutkins RW. Prebiotic and synbiotics: dietary strategies for improving gut health. Curr Opin Gastroenterol 2016;32:110-9.

  22. Moayyedi P, Ford AC, Talley NJ, Cremonini F, et al. The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut 2010;59:325-32.

  23. Hoveyda N, Heneghan C, Mahtani KR, Perera R, et al. A systematic review and meta-analysis: probiotics in the treatment of irritable bowel syndrome. BMC Gastroenterology 2009;9:15.

  24. McFarland LV, Dublin S. Meta-analysis of probiotics for the treatment of irritable bowel syndrome. World J Gastroenterol 2008;14:2650-61.

  25. Ortiz-Lucas M, Tobías A, Saz P, Sebastian JJ. Effect of probiotic species on irritable bowel syndrome symptoms: A bring up to date met-analysis. Rev Esp End Dig 2013;105:19-36.

  26. Miller LE, Ouwehand AC. Probiotic supplementation decreases intestinal transit time: meta-analysis of randomized controlled trials. World J Gastroenterol 2013;19:4718-25.

  27. Distrutti E, Monaldi L, Ricci P, Fiorucci S. Gut microbiota role in irritable bowel syndrome: New therapeutic strategies. World J Gastroenterol 2016;22:2219-41.

  28. Rajilic-Stojanovic M, Biagi E, Heilig HG, Kajander K, et al. Global and deep molecular analysis of microbiota signatures in fecal samples from patients with irritable bowel syndrome. Gastroenterology 2011;141:1792-801.

  29. Kim G, Deepinder F, Morales W, Hwang L, et al. Methanobrevibacter smithii is the predominant methanogen in patients with constipation-predominant IBS and methane in breath. Dig Dis Sci 2012;57:3213-8.

  30. Symons P, Jones MP, Kellow JE. Symptom provocation in irritable bowel syndrome. Effect of differing doses of fructose-sorbitol. Scand J Gastroenterol 1992;27:940-4.

  31. Min YW, Park SU, Yang YS, Kim YH, et al. Effect of compositeyogurt enriched with acacia fiber and Bifidobacterium lactis. World J Gastroenterol 2012;18:4563-9.

  32. Tsuchiya J, Barreto R, Okura R, Kawakita S, et al. Singleblindfollow- up study on the effectiveness of a symbiotic preparation in irritable bowel syndrome. Chin J Dig Dis2004;5:169-74.

  33. Rogha M, Esfahani MZ, Zargarzadeh AH. The efficacy of a synbiotic containing Bacillus coagulans in treatment of irritable bowel syndrome: a randomized placebocontrolled trial. Gastroenterol Hepatol From Bed Bench 2014;7:156-63.

  34. Amenta M, Cascio MT, Di Fiore P, Venturini I. Diet and chronic constipation. Benefits of oral supplementation with symbiotic zir fos (Bifidobacterium lomgum W11 + FOS Actilight). Acta Biomed 2006;77:157-62.

  35. Tap J, Mondot S, Levenez F, Pelletier E, Towards the human intestinal microbiota phylogenetic core. Envirom Microbiol 2009;11:2574-84.

  36. DuPont AW, DuPont HL. The intestinal microbiota and chronic disorders of the gut. Nat Rev Gastroenterol Hepatol 2011;8:523-531.

  37. Ballal SA, Gallini CA, Segata N, Huttenhower C, Garrett WS. Host and gut microbiota symbiotic factors: lessons from inflammatory bowel disease and successful symbionts. Cel Microbiol 2011;13:508-17.

  38. Drossman DA, Li Z, Andruzzi E, et al. U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci 1993;38:1569-80.

  39. Markert C, Suarez-Hitz K, Ehlert U, Nater UM. Distress criterion influences prevalence rates of functional gastrointestinal disorders. BMC Gastroenterol 2014;14:215-222.

  40. Lindberg G, Hamid S, Maltfertheiner P, et al. Guías mundiales de la Organización Mundial de Gastroenterología. Estreñimiento una perspectiva mundial. WGO nov 2010;1-15.

  41. Remes Troche JM, Tamayo De la Cuesta JL, Raña Garibay R, Huerta Iga F, Suarez Moran E, Schmulson M. Guías de diagnóstico y tratamiento del estreñimiento en México. A) Epidemiología (meta-análisis de la prevalencia), fisiopatología y clasificación. Rev Gastroentrerol Mex 2011;76:126-132.

  42. Remes Troche JM, Carmona Sánchez R, Abreu y Abreu AT, et al. Guias de diagnóstico y tratamiento del estreñimiento en México. B) Abordaje diagnóstico. Rev Gastroenterol Mex 2011;76:133-40.

  43. Schmulson Wasserman M, Francisconi F, Olden K, et al. Consenso latinoamericano de estreñimiento crónico. Gastroenteroil Hepatol 2008;31:59-74.

  44. Marteau P, Guyonnet D, Lafaye de Micheaux P, Gelu S. A randomized, double-blind, controlled study and pooled analysis of two identical trials of fermented milk conteinin probiotic Bifidobacterium lactis CNCM I-2494 in healthy women reporting minor digestive symptoms. Neurogastroenterol Motil 2013;25:331-e252.

  45. Guyonnet D, Woodcock A, Stefani B, Trevisan C, Hall C. Fermented milk containing Bifidobacterium lactis DN-173 010 improved self-reported digestive comfort amongst a general population of adults. A randomized, open-label, controlled pilot study. J Digest Dis 2009;10:61-70.

  46. Agrawal A, Houghton LA, Morris J, Reilly B, et al. Clinical trial: the effects of a fermented milk product containing Bifidobacterium lactis DN-1 73 010 on abdominal distention and gastrointestinal transit in irritable bowel syndrome with constipation. Aliment Phramacol Ther 2009;29:104-14.

  47. Guyonnet D, Chassany O, Ducrotte P, et al. Effect of a fermented milk containing Bifidobacterium animalis DN-173 010 on the health-related quality of life and symptoms in irritable bowel syndrome in adults in primary care: a multicentric, randomized, double-blind, controlled trial. Aliment Pharmacol Ther 2007;26:475-86.

  48. Colecchia A, Vestito A, Larocca A, et al. Effect of a symbiotic preparation on the clinical manifestations of irritable bowel syndrome, constipation-variant: results of a multicenter study. Minerva Gastroenterol Dietol 2006;52:349-58. Digest Liver Dis 2006;38(Suppl 1):S86.

  49. Dughera L, Elia C, Navino M, et al. Effect of symbiotic preparations on constipated irritable bowel syndrome. Acta Biomed 2007;78:11-6.

  50. Quigley E, Fried M, Gwee S, et al. Guías mundiales de la Organización Mundial de Gastroenterología. Síndrome de intestino irritable: una perspectiva mundial. WGO Apr 2009;1-22.

  51. Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 1997;32:920-4.

  52. Parés D, Comas M, Dorcaratto D, et al. Adaptation and validation of the Bristol scale stool form translated into the Spanish language among health professionals and patients. Rev Esp Enferm Dig 2009;101:312-6.

  53. Ford AC, Quigley EM, Lacy BE, Lembo AJ, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol 2014;109:1547-61.

  54. Nikfar S, Rahimi R, Rahimi F, Derakhshani S, Abdollahi M. Efficacy of probiotics in irritable bowel syndrome: a metaanalysis of randomized, controlled trials. Dis Colon Rectum 2008;51:1775-80.

  55. Krumbeck JA, Maldonado-Gomez MX, Ramer-Tait AE, Hutkins RW. Prebiotic and synbiotics: dietary strategies for improving gut health. Curr Opin Gastroenterol 2016;32:110-9.

  56. Moayyedi P, Ford AC, Talley NJ, Cremonini F, et al. The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut 2010;59:325-32.

  57. Hoveyda N, Heneghan C, Mahtani KR, Perera R, et al. A systematic review and meta-analysis: probiotics in the treatment of irritable bowel syndrome. BMC Gastroenterology 2009;9:15.

  58. McFarland LV, Dublin S. Meta-analysis of probiotics for the treatment of irritable bowel syndrome. World J Gastroenterol 2008;14:2650-61.

  59. Ortiz-Lucas M, Tobías A, Saz P, Sebastian JJ. Effect of probiotic species on irritable bowel syndrome symptoms: A bring up to date met-analysis. Rev Esp End Dig 2013;105:19-36.

  60. Miller LE, Ouwehand AC. Probiotic supplementation decreases intestinal transit time: meta-analysis of randomized controlled trials. World J Gastroenterol 2013;19:4718-25.

  61. Distrutti E, Monaldi L, Ricci P, Fiorucci S. Gut microbiota role in irritable bowel syndrome: New therapeutic strategies. World J Gastroenterol 2016;22:2219-41.

  62. Rajilic-Stojanovic M, Biagi E, Heilig HG, Kajander K, et al. Global and deep molecular analysis of microbiota signatures in fecal samples from patients with irritable bowel syndrome. Gastroenterology 2011;141:1792-801.

  63. Kim G, Deepinder F, Morales W, Hwang L, et al. Methanobrevibacter smithii is the predominant methanogen in patients with constipation-predominant IBS and methane in breath. Dig Dis Sci 2012;57:3213-8.

  64. Symons P, Jones MP, Kellow JE. Symptom provocation in irritable bowel syndrome. Effect of differing doses of fructose-sorbitol. Scand J Gastroenterol 1992;27:940-4.

  65. Min YW, Park SU, Yang YS, Kim YH, et al. Effect of compositeyogurt enriched with acacia fiber and Bifidobacterium lactis. World J Gastroenterol 2012;18:4563-9.

  66. Tsuchiya J, Barreto R, Okura R, Kawakita S, et al. Singleblindfollow- up study on the effectiveness of a symbiotic preparation in irritable bowel syndrome. Chin J Dig Dis2004;5:169-74.

  67. Rogha M, Esfahani MZ, Zargarzadeh AH. The efficacy of a synbiotic containing Bacillus coagulans in treatment of irritable bowel syndrome: a randomized placebocontrolled trial. Gastroenterol Hepatol From Bed Bench 2014;7:156-63.

  68. Amenta M, Cascio MT, Di Fiore P, Venturini I. Diet and chronic constipation. Benefits of oral supplementation with symbiotic zir fos (Bifidobacterium lomgum W11 + FOS Actilight). Acta Biomed 2006;77:157-62.




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