Almanac of Clinical Medicine, Journal Year: 2024, Volume and Issue: 52(5), P. 280 - 296

Published: Nov. 4, 2024

Chronic constipation is a global medical, social, and economic problem due to its negative impact on patients’ quality of life increased risk colorectal cancer, cardiovascular cerebrovascular disorders. The gut microbiota plays an important role in the pathophysiology through interplay with immune system, enteral central nervous representing promising therapeutic target. Gut dysbiosis patients characterized by reduced relative numbers bacteria producing lactate (Lactobacillaceae, Bifidobacteriaceae) butyrate (Lachnospiraceae, Oscillospiraceae), as well those hydrogen sulfide (Desulfovibrionaceae) methanogenic archaea (Methanobacteriaceae). leading pathogenetic mechanism related intestinal chronic constipation, can be microbial metabolic abnormalities (metabolic dysbiosis) altered production short-chain fatty acid, methane, sulfide, tryptophan metabolites abnormal bile acid biotransformation. It has been proven that dysbiotic microbiome play which allows for use prebiotics, probiotics, synbiotics effective microbiome-modulating therapy constipation. determines effectiveness (prebiotics, synbiotics) this syndrome. Inulin most studied preboitic; it soluble food fiber markedly contributes regulation microbiota, stimulates growth beneficial bacteria, anti-inflammatory metabolites. normalized function increasing stool frequency, softening stool, reducing transit time. In addition, inulin modulates response impacts absorption minerals, appetite, satiety. Treatment probiotics also associated time, compared controls. According systematic review meta-analysis 30 randomized controlled trials, only Bifidobacterium lactis strains (but not other probiotics) significantly increase frequencies adults. Clinical studies have shown targeted probiotic HN019 low (≤ 3 per week) frequency up 4.7–5.0 week, reduce time rate functional gastroenterological symptoms adults Beyond clinical effects, leads changes bifidobacteria decreasing enterobacteria numbers. results trials confirm importance synbiotic correction all improve fecal consistency, prevent disorders Synbiotics, such combination inulin, properties both complementary synergic synbiotic, may greatest potential outcomes or prebiotics used alone.

Language: Английский