BACKGROUND Reflux esophagitis(RE) is a common digestive disorder, and its frequent recurrences cause significant physical pain and are financially burdensome to patients. However, studies on the natural history of tre...BACKGROUND Reflux esophagitis(RE) is a common digestive disorder, and its frequent recurrences cause significant physical pain and are financially burdensome to patients. However, studies on the natural history of treated RE are few. Although proton pump inhibitors(PPIs) as the first-line treatment provide notable symptomatic relief, disordered gut microbiota has been observed among PPI users. Probiotics are commonly administered to patients to regulate the disordered intestinal flora.AIM To evaluate the therapeutic effects in RE patients treated with a combination of esomeprazole and probiotics [Bacillus subtilis(B. subtilis) and Enterococcus faecium(E. faecium)].METHODS One hundred and thirty-four RE patients were randomized into two groups of 67 subjects each. The probiotics group was administered with esomeprazole 20 mg b.i.d. and live combined B. subtilis and E. faecium enteric-coated capsules 500 mg t.i.d. for eight weeks; the placebo group was administered with esomeprazole 20 mg b.i.d. and placebo for eight weeks. Subsequently, 12-wk follow-up was carried out on patients who achieved both endoscopic and clinical cure. Endoscopy,reflux diagnostic questionnaire(RDQ), gastrointestinal symptom rating scale(GSRS), and lactulose hydrogen breath test were performed to evaluate the therapeutic effects. A difference of P < 0.05 was considered statistically significant.RESULTSSixty-six patients in the probiotics group and 64 patients in the placebo group completed the 8-wk treatment. The healing rate and RDQ score had no significant difference between the two groups(P > 0.05). However, the GSRS diarrhea syndrome score was decreased significantly in the probiotics group(P = 0.002),and the small intestinal bacterial overgrowth negative rate in the probiotics group was significantly higher than that in the placebo group(P = 0.002). Of 114 endoscopically and clinically cured patients, 96 completed the follow-up. The logrank test showed that the time to relapse was shorter in the placebo group than in the probiotics gro展开更多
Inflammatory bowel diseases(IBD),Crohns disease and ulcerative colitis,are chronic conditions associated with high morbidity and healthcare costs.The natural history of IBD is variable and marked by alternating period...Inflammatory bowel diseases(IBD),Crohns disease and ulcerative colitis,are chronic conditions associated with high morbidity and healthcare costs.The natural history of IBD is variable and marked by alternating periods of flare and remission.Even though the use of newer therapeutic targets has been associated with higher rates of mucosal healing,a great proportion of IBD patients remain symptomatic despite effective control of inflammation.These symptoms may include but not limited to abdominal pain,dyspepsia,diarrhea,urgency,fecal incontinence,constipation or bloating.In this setting,commonly there is an overlap with gastrointestinal(GI)motility and absorptive disorders.Early recognition of these conditions greatly improves patient care and may decrease the risk of mistreatment.Therefore,in this review we describe the prevalence,diagnosis and treatment of GI motility and absorptive disorders that commonly affect patients with IBD.展开更多
文摘目的研究益生菌对肠易激综合征(irritable bowel syndrome,IBS)合并小肠细菌过度生长(small intestinal bacterial overgrowth,SIBO)的治疗效果。方法选择2012年1月-2013年8月我院诊断的IBS患者100例为研究对象,男性38例,女性62例,年龄(44.7±8.1)岁。所有患者均完成甲烷-氢呼气试验,将64例阳性者随机分为抗生素组(22例,利福昔明治疗)、微生态组(21例,双岐杆菌三联活菌胶囊治疗)及安慰剂组(21例,安慰剂治疗),比较3组患者治疗前后临床症状积分、小肠细菌过度生长转阴率、治疗有效率之间的差异。结果抗生素组(11.39±3.67 vs 4.96±1.19)与微生态组(11.38±3.46 vs 4.89±1.17)治疗前后的临床症状积分均明显改善(P<0.001);微生态组治疗后临床症状积分(4.89±1.17)、总有效率(85.71%)及SIBO转阴率(71.43%)与抗生素组(4.96±1.19,86.36%,72.73%)差异无统计学意义(P>0.05);抗生素组、微生态组治疗后临床症状积分、总有效率及转阴率与安慰剂组治疗后(10.23±3.43,28.57%,9.50%)差异均有统计学意义(P<0.05)。结论双歧杆菌三联活菌胶囊与利福昔明疗效同样确切,微生态制剂可以广泛用于IBS合并SIBO的治疗。
基金Supported by Shandong Provincial Medical and Health Technology Development Project,No.2014ws0020
文摘BACKGROUND Reflux esophagitis(RE) is a common digestive disorder, and its frequent recurrences cause significant physical pain and are financially burdensome to patients. However, studies on the natural history of treated RE are few. Although proton pump inhibitors(PPIs) as the first-line treatment provide notable symptomatic relief, disordered gut microbiota has been observed among PPI users. Probiotics are commonly administered to patients to regulate the disordered intestinal flora.AIM To evaluate the therapeutic effects in RE patients treated with a combination of esomeprazole and probiotics [Bacillus subtilis(B. subtilis) and Enterococcus faecium(E. faecium)].METHODS One hundred and thirty-four RE patients were randomized into two groups of 67 subjects each. The probiotics group was administered with esomeprazole 20 mg b.i.d. and live combined B. subtilis and E. faecium enteric-coated capsules 500 mg t.i.d. for eight weeks; the placebo group was administered with esomeprazole 20 mg b.i.d. and placebo for eight weeks. Subsequently, 12-wk follow-up was carried out on patients who achieved both endoscopic and clinical cure. Endoscopy,reflux diagnostic questionnaire(RDQ), gastrointestinal symptom rating scale(GSRS), and lactulose hydrogen breath test were performed to evaluate the therapeutic effects. A difference of P < 0.05 was considered statistically significant.RESULTSSixty-six patients in the probiotics group and 64 patients in the placebo group completed the 8-wk treatment. The healing rate and RDQ score had no significant difference between the two groups(P > 0.05). However, the GSRS diarrhea syndrome score was decreased significantly in the probiotics group(P = 0.002),and the small intestinal bacterial overgrowth negative rate in the probiotics group was significantly higher than that in the placebo group(P = 0.002). Of 114 endoscopically and clinically cured patients, 96 completed the follow-up. The logrank test showed that the time to relapse was shorter in the placebo group than in the probiotics gro
文摘Inflammatory bowel diseases(IBD),Crohns disease and ulcerative colitis,are chronic conditions associated with high morbidity and healthcare costs.The natural history of IBD is variable and marked by alternating periods of flare and remission.Even though the use of newer therapeutic targets has been associated with higher rates of mucosal healing,a great proportion of IBD patients remain symptomatic despite effective control of inflammation.These symptoms may include but not limited to abdominal pain,dyspepsia,diarrhea,urgency,fecal incontinence,constipation or bloating.In this setting,commonly there is an overlap with gastrointestinal(GI)motility and absorptive disorders.Early recognition of these conditions greatly improves patient care and may decrease the risk of mistreatment.Therefore,in this review we describe the prevalence,diagnosis and treatment of GI motility and absorptive disorders that commonly affect patients with IBD.
