İrritabl Bağırsak Sendromu ve Fonksiyonel Dispepsi Tedavisinde Probiyotikler ve Prebiyotikler

Year 2019, Volume: 6 Issue: 2, 178 - 191, 29.08.2019

Gözde Ağca Ece Yalçın Zeynep Göktaş

https://doi.org/10.21020/husbfd.437227

Cited By: 1

Abstract

Bağırsak florasında yaklaşık 500 mikroorganizma türü olduğu bilinmektedir ve bunların %98’inin yararlı olduğu tespit edilmiştir fakat her bireyin bağırsak florasında farklı mikroorganizmalar bulunabilmektedir. Probiyotiklerin ve prebiyotiklerin bireylerdeki etkilerine bakıldığında bağışıklığı arttırdıkları, inflamasyonu engelleyen sitokinleri uyararak inflamasyonu önledikleri, patojenlerin üremesini ve virüslerin tutulumunu engelledikleri bilinmektedir. İrritabl Bağırsak Sendromu (IBS) ve Fonksiyonel Dispepsi (FD) karın ağrısı, diyare ve/veya konstipasyon, şişkinlik, erken doygunluk, mide bulantısı gibi semptomlara ek olarak üst gastrointestinal sistem semptomlarının eşlik ettiği hastalıklardır. İBS ve FD hastalarında karın ağrıları, karındaki gaz ve gurultu şikayetleri, mide bulantıları ve şişkinlik semptomları tedavisi zor semptomlar olmakla birlikte bireyin sosyal hayatını ve yaşam kalitesini oldukça etkilemektedir. Probiyotiklerin ve prebiyotiklerin bireylerin sağlığına olan olumlu etkileri ile bu semptomlarda etkili olabileceği düşünülmektedir. Bu derlemede İBS ve FD hastalarında probiyotiklerin ve prebiyotiklerin tedavi amaçlı kullanılabilirliğini ve semptomları azaltmadaki etkilerini araştıran yayınlar değerlendirilerek özetlenmiştir.

Keywords

İrritabl barsak sendromu, dispepsi, probiyotik, prebiyotik

Probiotics and Prebiotics in the Treatment of Irrıtable Bowel Syndrome and Functional Dyspepsia

Abstract

In the
intestinal flora, there seems to be about 500 microorganism species and 98% of
them are found to be useful. However intestinal flora can contain different
microorganisms in each individual. Probiotics and prebiotics might have
beneficial effects such as increasing immunity, preventing inflammation by
stimulating inflammation-inhibiting cytokines, inhibiting the reproduction of
pathogens and the involvement of viruses. Irritable Bowel Syndrome (IBS) and
Functional Dyspepsia (FD) are disorders associated with upper gastrointestinal
system symptoms in addition to symptoms such as abdominal pain, diarrhea and /
or constipation, bloating, early satiety, and nausea. Abdominal pain, gas,
bloating and nausea complaints are common and very difficult to treat in IBS
and FD patients, and may affect the social life and quality of life of the
individual. Probiotics and prebiotics are claimed to be effective in treating
these symptoms with positive effects on the health of the individual. This
review evaluates and summarizes the literature on the use of probiotics and
prebiotics as a treatment and their efficacy in reducing the symptoms in IBS
and FD patients.

Keywords

Irritable Bowel Syndrome, dyspepsia, probiotics, prebiotics

References

• Agrawal, A., Houghton, L. A., Morris, J., Reilly, B., Guyonnet, D., Goupil Feuillerat, N. ve diğerleri. (2009). Clinical trial: the effects of a fermented milk product containing Bifidobacterium lactis DN‐173 010 on abdominal distension and gastrointestinal transit in irritable bowel syndrome with constipation. Alimentary pharmacology & therapeutics, 29(1), 104-114.
• Al-Sheraji, S. H., Ismail, A., Manap, M. Y., Mustafa, S., Yusof, R. M., & Hassan, F. A. (2013). Prebiotics as functional foods: A review. Journal of Functional Foods, 5(4), 1542-1553.
• Aro, P., Talley, N. J., Ronkainen, J., Storskrubb, T., Vieth, M., Johansson, S. E. ve diğerleri. (2009). Anxiety is associated with uninvestigated and functional dyspepsia (Rome III criteria) in a Swedish population-based study. Gastroenterology, 137(1), 94-100.
• Blaut, M. (2002). Relationship of prebiotics and food to intestinal microflora. European Journal of Nutrition, 41(1), i11-i16.
• Brun, R., & Kuo, B. (2010). Functional dyspepsia. Therap Adv Gastroenterol, 3(3), 145-164. doi:10.1177/1756283x10362639.
• Butel, M. J. (2014). Probiotics, gut microbiota and health. Médecine et Maladies Infectieuses, 44(1), 1-8. doi:https://doi.org/10.1016/j.medmal.2013.10.002
• Canavan, C., West, J., & Card, T. (2014). The epidemiology of irritable bowel syndrome. Clinical Epidemiology, 6, 71-80. doi:10.2147/CLEP.S40245
• Carvalho, R. V. B., Lorena, S. L. S., de Souza Almeida, J. R., & Mesquita, M. A. (2009). Food Intolerance, Diet Composition, and Eating Patterns in Functional Dyspepsia Patients. Digestive Diseases and Sciences, 55(1), 60. doi:10.1007/s10620-008-0698-8
• Chen, S. L. (2013). A review of drug therapy for functional dyspepsia. Journal of digestive diseases, 14(12), 623-625.
• Chey, W. D., Kurlander, J., & Eswaran, S. (2015). Irritable bowel syndrome: A clinical review. JAMA, 313(9), 949-958. doi:10.1001/jama.2015.0954
• Coşkun, T. (2007). Pro-, Pre-ve sinbiyotikler. Turkiye Klinikleri Journal of Pediatrical Sciences, 3(6), 82-98.
• De Ponti, F., & Tonini, M. (2001). Irritable Bowel Syndrome. Drugs, 61(3), 317-332. doi:10.2165/00003495-200161030-00001
• Dibaise, J. K., Islam, R. S., Dueck, A. C., Roarke, M. C., & Crowell, M. D. (2016). Psychological distress in Rome III functional dyspepsia patients presenting for testing of gastric emptying. Neurogastroenterol Motil, 28(2), 196-205. doi:10.1111/nmo.12709
• Duncanson, K. R., Talley, N. J., Walker, M. M., & Burrows, T. L. Food and functional dyspepsia: a systematic review. Journal of Human Nutrition and Dietetics, n/a-n/a. doi:10.1111/jhn.12506
• Ford, A. C., Luthra, P., Tack, J., Boeckxstaens, G. E., Moayyedi, P., & Talley, N. J. (2015). Efficacy of psychotropic drugs in functional dyspepsia: systematic review and meta-analysis. Gut, gutjnl-2015-310721.
• Gallego, C. G., & Salminen, S. (2016). Novel probiotics and prebiotics: How can they help in human gut microbiota dysbiosis? Applied Food Biotechnology, 3(2), 72-81.
• Gareau, M. G., Sherman, P. M., & Walker, W. A. (2010). Probiotics and the gut microbiota in intestinal health and disease. Nature Reviews Gastroenterology and Hepatology, 7(9), 503.
• Geboes, K. (2001). Biological therapies in IBD: an international course. IDrugs, 4(3), 265-267.
• Gerritsen, J., Smidt, H., Rijkers, G. T., & Vos, W. M. (2011). Intestinal microbiota in human health and disease: the impact of probiotics. Genes & nutrition, 6(3), 209.
• Göktaş, Z., Köklü, S., Dikmen, D., Öztürk, Ö., Yılmaz, B., Asıl, M. ve diğerleri.(2016). Nutritional habits in functional dyspepsia and its subgroups: a comparative study. Scandinavian journal of gastroenterology, 51(8), 903-907.
• Guarner, F., & Malagelada, J.-R. (2003). Gut flora in health and disease. The Lancet, 361(9356), 512-519. doi:https://doi.org/10.1016/S0140-6736(03)12489-0
• Gupta, V., & Garg, R. (2009). Probiotics. Indian journal of medical microbiology, 27(3), 202.
• Gutiérrez, R. L., Riddle, M. S., & Porter, C. K. (2015). Increased Risk of Functional Gastrointestinal Sequelae After Clostridium difficile Infection Among Active Duty United States Military Personnel (1998–2010). Gastroenterology, 149(6), 1408-1414.
• Hassanzadeh, S., Saneei, P., Keshteli, A. H., Daghaghzadeh, H., Esmaillzadeh, A., & Adibi, P. (2016). Meal frequency in relation to prevalence of functional dyspepsia among Iranian adults. Nutrition, 32(2), 242-248.
• Horvath, A., & Szajewska, H. (2013). Probiotics, prebiotics, and dietary fiber in the management of functional gastrointestinal disorders. World Rev Nutr Diet, 108, 40-48. doi:10.1159/000351483
• Ianiro, G., Pizzoferrato, M., Franceschi, F., Tarullo, A., Luisi, T., & Gasbarrini, G. (2013). Effect of an extra-virgin olive oil enriched with probiotics or antioxidants on functional dyspepsia: a pilot study. Eur Rev Med Pharmacol Sci, 17(15), 2085-2090.
• Joint, F. (2007). WHO Working Group on Drafting Guidelines for the Evaluation of Probiotics in Food. Guidelines for the evaluation of probiotics in food: report of a Joint FAO/WHO Working Group on Drafting Guidelines for the Evaluation of Probiotics in Food, London, Ontario, Canada, April 30 and May 1, 2002. ftp. fao. org/es/esn/food/wgreport2. pdf. Accessed, 16.
• Jones, M. P., Talley, N. J., Eslick, G. D., Dubois, D., & Tack, J. (2008). Community subgroups in dyspepsia and their association with weight loss. The American journal of gastroenterology, 103(8), 2051-2060.
• Kajander, K., Hatakka, K., Poussa, T., Farkkila, M., & Korpela, R. (2005). A probiotic mixture alleviates symptoms in irritable bowel syndrome patients: a controlled 6-month intervention. Aliment Pharmacol Ther, 22(5), 387-394. doi:10.1111/j.1365-2036.2005.02579.x
• Karabulut, S., Karabulut, M., Akarsu, C., Bozkurt, M. A., Bademler, S., Kocataş, A., ve diğerleri.(2015). Araştırmalar. Türk Toplumunda Organik ve Fonksiyonel Dispepsili Hastalarda Etyolojiye Yönelik Analiz. Researches. To investigate possible etiologic factors of organic and functional dyspepsia in Turkey., 11(1), 17-23. doi:10.5350/BTDMJB201511105
• Katz, J. A. (2002). Advances in the medical therapy of inflammatory bowel disease. Curr Opin Gastroenterol, 18(4), 435-440.
• Kaya, M., & Kaçmaz, H. (2016). Roma IV Kriterlerine Göre Fonksiyonel Barsak Hastalıklarının Yeniden Değerlendirilmesi.
• Keohane, J., & Quigley, E. M. (2007). Functional dyspepsia and nonerosive reflux disease: clinical interactions and their implications. Medscape General Medicine, 9(3), 31.
• Kulich, K. R., Madisch, A., Pacini, F., Piqué, J. M., Regula, J., Van Rensburg, C. J., . . . ve diğerleri.(2008). Reliability and validity of the Gastrointestinal Symptom Rating Scale (GSRS) and Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire in dyspepsia: a six-country study. Health and quality of life outcomes, 6(1), 12.
• Kutlu, T. (2011). Pre ve probiyotikler. Türk Pediatri Arşivi, 46(11).
• Lesbros-Pantoflickova, D., Corthesy-Theulaz, I., & Blum, A. L. (2007). Helicobacter pylori and probiotics. J Nutr, 137(3 Suppl 2), 812s-818s.
• Maggi, C. A. (1992). Therapeutic potential of capsaicin-like molecules: studies in animals and humans. Life sciences, 51(23), 1777-1781.
• Marteau, P., Seksik, P., & Jian, R. (2002). Probiotics and intestinal health effects: a clinical perspective. British Journal of Nutrition, 88(S1), s51-s57. Merenstein, D., & Salminen, S. (2017). Probiotics and prebiotics.
• Mullin, G. E., Shepherd, S. J., Chander Roland, B., Ireton‐Jones, C., & Matarese, L. E. (2014). Irritable Bowel Syndrome. Journal of Parenteral and Enteral Nutrition, 38(7), 781-799.
• Navarro-Rodriguez, T., Silva, F. M., Barbuti, R. C., Mattar, R., Moraes-Filho, J. P., de Oliveira, M. N. ve diğerleri.(2013). Association of a probiotic to a Helicobacter pylori eradication regimen does not increase efficacy or decreases the adverse effects of the treatment: a prospective, randomized, double-blind, placebo-controlled study. BMC Gastroenterol, 13, 56-56. doi:10.1186/1471-230X-13-56
• National Institute for Health and Care Excellence (NICE) (2008).https://www.nice.org.uk/guidance/qs114 adresinden elde edilmiştir.
• Noddin, L., Callahan, M., & Lacy, B. E. (2005). Irritable Bowel Syndrome and Functional Dyspepsia: Different Diseases or a Single Disorder With Different Manifestations? Medscape GeneralMedicine, 7(3), 17-17.
• O’Mahony, L., McCarthy, J., Kelly, P., Hurley, G., Luo, F., Chen, K. ve diğerleri.(2005). Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles. Gastroenterology, 128(3), 541-551.
• Orel, R., & Kamhi Trop, T. (2014). Intestinal microbiota, probiotics and prebiotics in inflammatory bowel disease. World Journal of Gastroenterology : WJG, 20(33), 11505-11524. doi:10.3748/wjg.v20.i33.11505
• Ozdemir, O. (2012). Any Benefit of Probiotics for Autoimmune Gastrointestinal Diseases? Journal of Pediatric Sciences, 4(4), 1-17.
• Özden, A., Köksal, A. Ş., Dilek, O., Çiçek, B., Yılmaz, U., Dağlı, Ü. ve diğerleri. (2006). Türkiye'de birinci basamak sağlık kurumlarında irritabl barsak sendromu görülme sıklığı. Akademik Gastroenteroloji Dergisi, 5(1).
• Özyurt, V. H., & Ötleş, S. (2014). Prebiyotikler: metabolizma için önemli bir gıda bileşeni. Academic Food Journal, 12(1), 115-123.
• Patcharatrakul, T., & Gonlachanvit, S. (2016). Chili Peppers, Curcumins, and Prebiotics in Gastrointestinal Health and Disease. Current Gastroenterology Reports, 18(4), 19. doi:10.1007/s11894-016-0494-0
• Piessevaux, H., De Winter, B., Louis, E., Muls, V., De Looze, D., Pelckmans, P. ve diğerleri. (2009). Dyspeptic symptoms in the general population: a factor and cluster analysis of symptom groupings. Neurogastroenterol Motil, 21(4), 378-388. doi:10.1111/j.1365-2982.2009.01262.x
• Ring, E., Olsen, R. E., Gifstad, T., Dalmo, R. A., Amlund, H., Hemre, G. I., & Bakke, A. M. (2010). Prebiotics in aquaculture: a review. Aquaculture Nutrition, 16(2), 117-136. doi:10.1111/j.1365-2095.2009.00731.x
• Roberfroid, M. (2007). Prebiotics: the concept revisited. The Journal of nutrition, 137(3), 830S-837S.
• Round, J. L., & Mazmanian, S. K. (2009). The gut microbiota shapes intestinal immune responses during health and disease. Nature Reviews Immunology, 9, 313. doi:10.1038/nri2515
• Sakin, Y. S., & Tanoglu, A. (2016). Prebiotics and Their Effects on Human Health [Prebiyotikler ve İnsan Sağlığı Üzerindeki Etkileri]. Medicine Science| International Medical Journal, 5(3), 210-223.
• Sanders, M. E. (2008). Probiotics: Definition, Sources, Selection, and Uses. Clinical Infectious Diseases, 46(Supplement_2), S58-S61. doi:10.1086/523341
• Sezen, A. G. (2013). Prebiyotik, probiyotik ve sinbiyotiklerin insan ve hayvan sağlığı üzerine etkileri. Atatürk Üniversitesi Veteriner Bilimleri Dergisi, 8(3), 248-258.
• Shanahan, F., & Quigley, E. M. M. Manipulation of the Microbiota for Treatment of IBS and IBD—Challenges and Controversies. Gastroenterology, 146(6), 1554-1563. doi:10.1053/j.gastro.2014.01.050
• Silk, D. B. A., Davis, A., Vulevic, J., Tzortzis, G., & Gibson, G. R. (2009). Clinical trial: the effects of a trans-galactooligosaccharide prebiotic on faecal microbiota and symptoms in irritable bowel syndrome. Aliment Pharmacol Ther, 29(5), 508-518. doi:10.1111/j.1365-2036.2008.03911.x
• Sinn, D. H., Song, J. H., Kim, H. J., Lee, J. H., Son, H. J., Chang, D. K, ve diğerleri. (2008). Therapeutic effect of Lactobacillus acidophilus-SDC 2012, 2013 in patients with irritable bowel syndrome. Digestive diseases and sciences, 53(10), 2714-2718.
• Soccol, C. R., Vandenberghe, L. P. d. S., Spier, M. R., Medeiros, A. B. P., Yamaguishi, C. T., Lindner, J. D. D. ve diğerleri. (2010). The potential of probiotics: a review. Food Technology and Biotechnology, 48(4), 413-434.
• Stanghellini, V., Talley, N. J., Chan, F., Hasler, W. L., Malagelada, J., Suzuki, H., & Tack, J. (2016). Rome IV - Gastroduodenal Disorders. Gastroenterology. doi:10.1053/j.gastro.2016.02.011
• Tack, J., & Lee, K. (2005). Pathophysiology and treatment of functional dyspepsia. Journal of clinical gastroenterology, 39(5), S211-S216.
• Talley, N. J., & Ford, A. C. (2015). Functional dyspepsia. New England Journal of Medicine, 373(19), 1853-1863.
• Talley, N. J., Holtmann, G., & Walker, M. M. (2015). Therapeutic strategies for functional dyspepsia and irritable bowel syndrome based on pathophysiology. Journal of Gastroenterology, 50(6), 601-613. doi:10.1007/s00535-015-1076-x
• Talley, N. J., Walker, M. M., & Holtmann, G. (2016). Functional dyspepsia. Curr Opin Gastroenterol, 32(6), 467-473. doi:10.1097/mog.0000000000000306
• Ünal, S., & Doğan, İ. (2011). İrritabl barsak sendromu. Turkiye Klinikleri Journal of Gastroenterohepatology Special Topics, 4(1), 1.
• Welén, K., Faresjö, Å., & Faresjö, T. (2008). Functional dyspepsia affects women more than men in daily life: a case-control study in primary care. Gender medicine, 5(1), 62-73.
• Whelan, K. (2011). Probiotics and prebiotics in the management of irritable bowel syndrome: a review of recent clinical trials and systematic reviews. Current Opinion in Clinical Nutrition & Metabolic Care, 14(6), 581-587.
• Whorwell, P. J. (2009). Review: Do probiotics improve symptoms in patients with irritable bowel syndrome? Therapeutic advances in gastroenterology, 2(4 suppl), s37-s44.
• Whorwell, P. J., Altringer, L., Morel, J., Bond, Y., Charbonneau, D., O'mahony, L., ve diğerleri. (2006). Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome. The American journal of gastroenterology, 101(7), 1581-1590.
• Zhao, B., Zhao, J., Cheng, W.-F., Shi, W.-J., Liu, W., Pan, X.-L., & Zhang, G.-X. (2014). Efficacy of Helicobacter pylori eradication therapy on functional dyspepsia: a meta-analysis of randomized controlled studies with 12-month follow-up. Journal of clinical gastroenterology, 48(3), 241-247.