Aim of investigation: to assess the effectiveness and tolerance of dietary supplements (BAA) STIM and STIM LaxMaterials and methods: The analysis of the treatment of 73 patients who were divided into 2 groups. Group 1-32 patients with functional constipation (8 men and 24 women; mean age — 45.7 ± 12.4 years), Group 2-41 patients with functional diarrhea (19 men and 22 women; mean age — 41.0 ± 15,8 years). The study of clinical symptoms was carried out according to the data of an individual diary, using specialized questionnaires with a scoring of symptoms before and after the course of treatment, before and after treatment, the result of the carbolene test, the content of short-chain fatty acids in the feces was assessed. Tolerability was assessed by recording side effects and adverse events.Monotherapy was carried out with STIM LAX for patients with functional constipation at a dose of 1 tablet 3 times a day for 30 days. STIM for patients with functional diarrhea was prescribed in a dose of 2 tablets 3 times a day for 30 days.Results of the study: The results of the study showed that FC therapy with StimLax effectively reduces the frequency and intensity of symptoms such as difficulty / pain, discomfort during defecation, feeling of incomplete emptying, abdominal pain, time spent in the toilet and the number of failed bowel movements. We observed the normalization of transit time according to the carbolene test and an increase in stool frequency up to 5 times a week.Treatment of patients with FD with Stim led to a significant decrease in the intensity of abdominal pain, rumbling, flatulence, stool frequency, an increase in the time of the carbolene test and the normalization of its consistency.Adverse events were observed in 8 (10.9%) patients (4 patients with FD and 4 patients with FD). On the 3-5th day of treatment, there was an increase in flatulence, rumbling in the abdomen. A temporary decrease in the dose of the drug to 1-2 tablets per day removed these phenomena and the symptoms that appeared were resolved within 1-3 days. After that, the dose of the drug was gradually increased to the initial (effective), which the patients tolerated normally.Conclusions: The results of this study indicate high clinical efficacy and good tolerability of treatment with drugs StimLax and Stim in patients with FC and FD. In some cases, it is necessary to titrate the dose of the drug (downward), but this is not accompanied by a decrease in the effectiveness of therapy. The use of these drugs with metaprebiotic properties helps to modify the microbiota of patients with functional bowel diseases. With constipation, the number and activity of both lactic acid flora and microorganisms that produce butyric acid are stimulated; in addition, calcium lactate is an additional source of butyric acid due to metabolism. With diarrhea, along with the stimulation of the number and activity of the lactic acid flora, there is an improvement in the utilization of butyrate by intestinal cells.
The frequency of intestinal microbiota disorders in patients with chronic pancreatitis (CP) is extremely high and can reach 97%. The bacterial overgrowth syndrome (SIBO) and the syndrome of increased epithelial permeability (SPEP), developing against the background of excretory insufficiency of the pancreas, affect the severity of the clinical picture of the disease, reduce the effectiveness of enzyme replacement therapy and generally contribute to the further progression of CP.The article presents a modern view on the mechanisms of the formation of SIBO and SPEP in CP. There is their aggravating effect on the course of the disease and the aggravation of disorders of the digestive and absorption processes that accompany them is shown and analyzed in the article.For decontamination of conditionally pathogenic and pathogenic flora, increasing the number and metabolic activity of indigenous microflora in patients with CP, the use of a non-absorbable broad-spectrum antibiotic rifaximin is effective. In order to restore the barrier function of the gastrointestinal mucosa, the drug of choice is rebamipid, a universal cytoprotector that affects all three levels of epithelial tissue protection (preepithelial, epithelial and subepithelial).Conclusion. CP is characterized by the complexity of its etiology and pathogenesis. Bacterial factors, in particular, SIBO and SPEP, play an essential role in the development of inflammatory changes in the pancreas. In the complex therapy of CP, it is advisable to take measures aimed at correcting disorders of the intestinal microbiota.
Aim of investigation: to evaluate the effectiveness and safety of the use of dietary supplement "Tummy ease" in the treatment of patients with functional constipation and IBS with a predominance of constipation. Materials and methods: The treatment of 33 patients was analyzed. 18 patients with FС (2 men and 16 women, mean age 50.6 ± 4.0 g) and 15 patients with IBS-C (2 men, 13 women, mean age 51.8 ± 4.5 years). Patients received Tummy ease 2-3 capsules/day for 28 days. The safety of treatment was assessed by the dynamics of biochemical parameters, the frequency and presence of side effects. To evaluate the effectiveness, we studied: the time of the carbolenic test, the dynamics of constipation symptoms according to the sum of points of the counting scale for assessing the severity of constipation and the PAC-SYM questionnaire, the dynamics of symptoms of the gastrointestinal tract according to the GIS questionnaire, the dynamics of quality of life according to the GSRS questionnaire. Results of the study: in patients with FC and IBS, there was a significant decrease in the symptoms of constipation (difficulty/pain during defecation, feeling of incomplete emptying, abdominal pain, time spent in the toilet, assistance with defecation, unsuccessful attempts to empty) and an increase in the frequency of defecation. According to the PAC-SYM questionnaire, patients with FC and IBS-C showed a significant decrease in abdominal discomfort, bloating, straining, feeling of incomplete emptying, defecation scarcity and difficulty, and the total symptom score. Patients with IBS-C additionally noted a decrease in abdominal pain, painful bowel movements and the number of false urges. The time of the carbolenic test significantly decreased in patients with FC from 49.4 ± 3.8 to 30.0 ± 2.3 hours (p = 0.00003), in patients with IBS-C from 62.7 ± 6.9 to 43.8 ± 6.4 hours (p= 0.002). In patients with FC and IBS-C, there was a significant positive dynamics of the symptoms of the gastrointestinal tract according to the GIS questionnaire and a significant improvement in the quality of life according to the GSRS questionnaire. Conclusion: The drug (BAA) Tummy ease is effective and safe in the treatment of patients with functional constipation and IBS-C and can be used as an alternative therapy.
Among the diseases of the digestive system, a significant place is occupied by acid-dependent diseases caused by excessive secretion of hydrochloric acid secreted by the parietal cells of the gastric mucosa. Due to their high prevalence and risk of complications, these pathologies represent a serious medical and social problem. Gastroprotective agents have a protective effect on the mucous membrane of the stomach and intestines. This group of medicines includes a range of drugs that differ in principle and mechanism of action, such as misoprostol, bismuth salts, as well as some herbal preparations, etc.
The article presents a review of current European and Russian guidelines on diagnostics and treatment of exocrine pancreatic insufficiency in patients with chronic pancreatitis. Results of our own comparative study on treatment of 55 chronic pancreatitis patients with low and adequate doses of pancreatic enzyme replacement therapy (PERT) confirm the need for usage of recommended doses of modern micronized polyenzyme drugs since it improves both clinical manifestation and nutritional status in such patients unlike the lower doses. Our research findings show that the optimal criterium for PERT efficacy assessment is the normalization of antropometric and biochemical nutritional markers.
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