Background. In the treatment of post-infectious irritable bowel syndrome (PI-IBS), the leading role belongs to the normalization of the composition of the intestinal microbiome, the disturbances of which are associated with previous intestinal infections. Aim. To study the effectiveness of the drug Bifiform in the treatment of PI-IBS. Materials and methods. An open, prospective, comparative, randomized study included 62 patients with PI-IBS. The diagnosis was confirmed by the results of clinical, laboratory and endoscopic examination of the intestine and met the diagnostic criteria for IBS of the Rome Consensus IV. The patients were randomized into 2 groups depending on the therapy. The patients of the main group received an antispasmodic drug (mebeverin 200 mg 2 times a day or trimebutin 200 mg 3 times a day for 4 weeks), an antibiotic (rifaximin 400 mg 3 times a day or nifuroxazide 400 mg 2 once a day for 1 week), a drug that normalizes the consistency of feces (dioctahedral smectite or macrogol 4000) and Bifiform 2 capsules 2 times a day for 2 weeks. For patients of control group similar therapy was performed without the Bifiform. Evaluation of the effectiveness of treatment was carried out at the end of the course of therapy and 6 months after its termination. Results. All included patients with PI-IBS had abdominal pain, flatulence and tenderness to palpation along the bowel, most of them had diarrhea. Disorders of the intestinal microbiota were detected in 77.4% of patients, while excessive bacterial growth in the small intestine occurred in 72.6%, disorders of the colon microbiocenosis with the presence of opportunistic bacteria in 62.9% of patients. A significant part of the patients had a combination of small and large intestinal dysbiosis. Histological examination of the colon mucosa showed signs of low degree of inflammation activity in all patients. The moderate increase in the level of fecal calprotectin was found in 62.2% of patients with colonic dysbiosis. The majority of patients in the main group showed a pronounced positive dynamics of clinical manifestations of the disease, restoration of the normal composition of the intestinal microbiota and normalization of the content of fecal calprotectin at the end of the course therapy. The good result was observed much more often in the main group at the end of the course of treatment and 6 months after its termination. Conclusion. The inclusion of Bifiform in the complex therapy of PI-IBS significantly increases its effectiveness both in arresting the clinical manifestations of the disease, and in restoring the normal composition of the intestinal microbiome and reducing the inflammatory process in the intestinal mucosa. In the majority of patients receiving Bifiform, the remission of the disease achieved at the end of the course of treatment and persisted even 6 months after its termination.
Яковенко Эмилия Прохоровна, профессор кафедры гастроэнтерологии и диетологии ФДПО, д. м. н.Яковенко Андрей Владиславович, доцент кафедры гастроэнтерологии и диетологии ФДПО, к. м. н.Иванов Александр Николаевич, доцент кафедры гастроэнтерологии и диетологии ФДПО, к. м. н.Агафонова Наталья Анатольевна, доцент кафедры гастроэнтерологии и диетологии ФДПО, к. м. н. Emilia P. Yakovenko, professor Department of Gastroenterology and nutrition, doctor of medical sciences Andrey V. Iakovenko, associate professor department of gastroenterology and nutrition, candidate of medical sciences Natalia A. Agafonova, associate professor department of gastroenterology and nutrition, candidate of medical sciences Alexander N. Ivanov, associate professor department of gastroenterology and nutrition, candidate of medical sciences РезюмеПоражение желудочно-кишечного тракта и печени выявляется у более половины пациентов с COVID-19. При этом заболевание может начинаться с гастроэнтерологических проявлений, к которым впоследствии присоединяются респираторные симптомы. Наличие поражений желудочно-кишечного тракта и печени у больных COVID-19 ухудшает прогноз заболевания и повышает риск смертности. Механизмы повреждения пищеварительной системы многообразны: прямой цитолитический эффект вируса на клетки-мишени, на поверхности которых имеются рецепторы для SARS-CoV-2, действие компонентов системного воспаления, иммунологические и лекарственные повреждения. В терапии больных COVID-19 с гастроэнтерологическими расстройствами и нарушением функции печени перспективным направлением является исследование ребамипида и урсодеоксихолевой кислоты.
Қазақстан Республикасы Ұлттық ғылым академиясы "ҚР ҰҒА Хабаршысы" ғылыми журналының Web of Science-тің жаңаланған нұсқасы Emerging Sources Citation Index-те индекстелуге қабылданғанын хабарлайды. Бұл индекстелу барысында Clarivate Analytics компаниясы журналды одан əрі the Science Citation Index Expanded, the Social Sciences Citation Index жəне the Arts & Humanities Citation Index-ке қабылдау мəселесін қарастыруда. Web of Science зерттеушілер, авторлар, баспашылар мен мекемелерге контент тереңдігі мен сапасын ұсынады. ҚР ҰҒА Хабаршысының Emerging Sources Citation Index-ке енуі біздің қоғамдастық үшін ең өзекті жəне беделді мультидисциплинарлы контентке адалдығымызды білдіреді. НАН РК сообщает, что научный журнал «Вестник НАН РК» был принят для индексирования в Emerging Sources Citation Index, обновленной версии Web of Science. Содержание в этом индексировании находится в стадии рассмотрения компанией Clarivate Analytics для дальнейшего принятия журнала в the Science Citation Index Expanded, the Social Sciences Citation Index и the Arts & Humanities Citation Index. Web of Science предлагает качество и глубину контента для исследователей, авторов, издателей и учреждений. Включение Вестника НАН РК в Emerging Sources Citation Index демонстрирует нашу приверженность к наиболее актуальному и влиятельному мультидисциплинарному контенту для нашего сообщества.
В клинической практике могут быть рекомендованы следующие схемы ведения пациентов с СРК и СРК-подобными расстройствами с включением препарата Спарекс:Схема терапии больных СРК с запором:
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