İnsanlarda ve pet hayvanlarında intestinal İnflamasyona yönelik klinik beslenme stratejileri: İyileştirebilen Gıda Takviyeleri

Öz

Bağırsak iltihabı, tüm ulusal/uluslararası nomenklatürde bilindiği hali ile inflamatuvar bağırsak hastalığı (İbH), ‘beyin-bağırsak-deri ekseni’ kapsamında değer çeşitli kronik hastalıklara yol açar. İbH esas olarak kalın bağırsağı etkiler, ancak gastrointestinal sistemi bir bütün olarak da etkileyebilir. İnsanlarda da, pet hayvanlarında da benzer nomenklatür kullanılabilmeketdir. İnsanlarda başlıca semptomlar ağrı, ishal ve kilo kaybıdır; genellikle makro ve mikro besin kayıplarıyla ilişkilidir. Pet hayvanlarında kusma ve/veya ishal hastalık tanımlandırmasını ve histopatolojik lokasyonun değişimi ile doğru orantılı olduğundan klinik bulgu şiddeti, hastalık aktivitesine göre (endoskopi, ultrasonografi, sitoloji, skorlandırmalar ile biyopsi eşliğinde) değişebilmektedir. Klasik sağaltıma ilişkin olarak ya da baskılayıcı ilaç seçenekleri ile ne yazık ki, bir süre sonra vücutta direnç gelişmektet; bu nedenle, hastaların çoğu remisyonu sürdüremez ve remisyon vakaların %50'sinden azında sağlanır. Pet hayvanlarında yıllardır süregelen immunosupresif sağaltım girşimlerinin yarar sağlamadığı gün gibi aşikardır. Diyet (inflamatuvar/anti-inflamatuvar, glisemik indeks, yüksek karbohidratla beslenme, glifosfat, gluten içeriği vb.) bağırsak iltihabının en önemli belirleyicilerindendir. Dengesiz bir diyet, hem insan hem de pet hayvanlarında bağırsak mikrobiyotasını etkileyebilir ve düzensiz bir bağışıklık tepkisiyle ilişkili olan disbiyozise yol açabilir. Akdeniz diyeti (insanlarda), ev tipi ketojenik diyet (kedi ve köpekler için Felin Dermatoloji Grubu tarafından olgu özelinde hazırlanmakta) anti-enflamatuar etkileri ve disbiyozisi önleme yeteneği ile tanınır. İbH yönetimini ve tedavisini iyileştirmek için, bağırsak mikrobiyal dengesini koruyan ve mukozal bariyeri güçlendirerek İbH semptomlarını azaltan, anti-enflamatuar etkiye sahip (probiyotikler, bütirat, laktoferrin, fosfatidilkolin, silimarin ve omega-3) takviyeler ya da trofik aminoasitler hastaların diyetlerine ilave edilmelidir. Besin takviyeleri, ilaç kullanımının yüksek maliyetlerini, yan etkilerini ve tekrarlayan nükslerini azaltmaya yardımcı olabilir.

Anahtar Kelimeler

• inflamatuar bağırsak hastalığı
• diyet
• besin takviyesi

Clinical nutrition strategies for intestinal inflammation in humans and pets: Ameliorative dietary supplements

Öz

Inflammation of the intestine, known in all national/international nomenclature as inflammatory bowel disease (IBD), leads to various chronic diseases within the scope of the ‘brain-gut-skin axis’. IBD mainly affects the large intestine, but can also affect the gastrointestinal system as a whole. Similar nomenclature can be used in humans and pets. The main symptoms in humans are pain, diarrhea and weight loss; usually associated with macro and micronutrient losses. Since vomiting and/or diarrhea in pets are directly proportional to the disease definition and the change in histopathological location, the severity of clinical findings can vary according to the disease activity (with endoscopy, ultrasonography, cytology, scoring and biopsy). Unfortunately, after a while, resistance develops in the body with classical treatment or suppressive drug options; therefore, most patients cannot maintain remission and remission is achieved in less than 50% of cases. It is clear that immunosuppressive treatment attempts that have been going on for years in pets have not been effective. Diet (inflammatory/anti-inflammatory, glycemic index, high carbohydrate diet, glyphosphate, gluten content, etc.) is one of the most important determinants of intestinal inflammation. An unbalanced diet can affect the intestinal microbiota in both humans and pets and lead to dysbiosis, which is associated with an irregular immune response. The Mediterranean diet (in humans), the home ketogenic diet (prepared by the Feline Dermatology Group for cats and dogs on a case-by-case basis) are known for their anti-inflammatory effects and ability to prevent dysbiosis. To improve IBD management and treatment, supplements or trophic amino acids with anti-inflammatory effects (probiotics, butyrate, lactoferrin, phosphatidylcholine, silymarin, and omega-3) that maintain intestinal microbial balance and reduce IBD symptoms by strengthening the mucosal barrier should be added to the patients' diets. Dietary supplements can help reduce the high costs, side effects, and relapses of medication use.

Anahtar Kelimeler

• inflammatory bowel disease
• diet
• dietary supplements

Kaynakça

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