Modern possibilities of colonoprotection in patients with irritable bowel syndrome

Authors

  • D.T. Janelidze Gastro Center “Olymed”, Kyiv, Ukraine

DOI:

https://doi.org/10.22141/2308-2097.54.3.2020.211737

Keywords:

irritable bowel syndrome, butyrate, butyric acid, probiotics, coloprotectors, review

Abstract

The literature search was carried out using the Scopus and MedLine databases. Functional bowel disorders are now viewed as a spectrum of intestinal symptoms that form 6 variants: irritable bowel syndrome, functional constipation, functional diarrhea, functional bloating/distension, non-specific functional bowel disorder and opioid-induced constipation. The etiology of irritable bowel syndrome symptoms has not been fully established. The lack of a clear understanding of the pathogenesis of one or another functional intestinal disease, including irritable bowel syndrome, taking into account the presence of various structural and morphological disorders in the intestinal wall, dictates the need to search for new drugs, the action of which will be directed to different links of the pathogenesis of intestinal diseases. The composition of the new original coloprotector Colonzak includes the following ingredients: calcium butyrate — equivalent to 250 mg of butyric acid, fructooligosaccharides (inulin) — 100 mg and a 2.7 billion strains of bifidobacteria (B.bifidum & B.lactis). Taking into account the effects of inulin, butyric acid and bifidobacteria, Colonzak is a coloprotector that restores the energy potential of colonocytes, normalizes mucus formation and goblet cell function, reduces the permeability of the mucous membrane, has a cancer prevention effect on normal colonocytes and inhibits the growth and replication of intestinal tumor cells. Also, being a pre- and probiotic, it creates conditions for the growth and normalization of intestinal microflora, changes in which in varying degrees of severity are found in both inflammatory and functional intestinal diseases. The use of preparations contai­ning butyric acid and non-fermentable dietary fibers is a promising direction in the prevention of colon cancer. It is necessary to carry out further studies in the mentioned direction, which will allow optimizing the dose and duration of treatment with the drug Colonzak, as well as to determine the groups of patients most sensitive to treatment with multicomponent coloprotectors.

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References

Aziz I, Törnblom H, Palsson OS, Whitehead WE, Simrén M. How the Change in IBS Criteria From Rome III to Rome IV Impacts on Clinical Characteristics and Key Pathophysiological Factors. Am J Gastroenterol. 2018;113(7):1017-1025. doi:10.1038/s41395-018-0074-z.

Gwee KA, Ghoshal UC, Chen M. Irritable bowel syndrome in Asia: Pathogenesis, natural history, epidemiology, and management. J Gastroenterol Hepatol. 2018;33(1):99-110. doi:10.1111/jgh.13987.

Cañón M, Ruiz AJ, Rondón M, Alvarado J. Prevalence of irritable bowel syndrome and health-related quality of life in adults aged 18 to 30 years in a Colombian University: an electronic survey. Ann Gastroenterol. 2017;30(1):67-75. doi:10.20524/aog.2016.0093.

Sperber AD, Dumitrascu D, Fukudo S, et al. The global prevalence of IBS in adults remains elusive due to the heterogeneity of studies: a Rome Foundation working team literature review. Gut. 2017;66(6):1075-1082. doi:10.1136/gutjnl-2015-311240.

Palsson OS, Whitehead WE, van Tilburg MA, et al. Rome IV Diagnostic Questionnaires and Tables for Investigators and Clinicians. Gastroenterology. 2016;S0016-5085(16)00180-3. doi:10.1053/j.gastro.2016.02.014.

Palsson O, vanTilburg M, Simren M, et al. Population Prevalence of Rome IV and Rome III Irritable Bowel Syndrome (IBS) in the United States (US), Canada and the United Kingdom (UK). Gastroenterology. 2016;150(4 Suppl 1):S739-S740. doi:10.1016/S0016-5085(16)32513-6.

Vork L, Weerts ZZRM, Mujagic Z, et al. Rome III vs Rome IV criteria for irritable bowel syndrome: A comparison of clinical characteristics in a large cohort study. Neurogastroenterol Motil. 2018;30(2):10.1111/nmo.13189. doi:10.1111/nmo.13189.

Waehrens R, Zöller B, Sundquist J, Sundquist K, Pirouzifard M. A Swedish national adoption study of risk of irritable bowel syndrome (IBS). BMJ Open Gastroenterol. 2017;4(1):e000156. doi:10.1136/bmjgast-2017-000156.

Gazouli M, Wouters MM, Kapur-Pojskić L, et al. Lessons learned--resolving the enigma of genetic factors in IBS. Nat Rev Gastroenterol Hepatol. 2016;13(2):77-87. doi:10.1038/nrgastro.2015.206.

Wouters MM, Van Wanrooy S, Nguyen A, et al. Psychological comorbidity increases the risk for postinfectious IBS partly by enhanced susceptibility to develop infectious gastroenteritis. Gut. 2016;65(8):1279-1288. doi:10.1136/gutjnl-2015-309460.

Klem F, Wadhwa A, Prokop LJ, et al. Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis. Gastroenterology. 2017;152(5):1042-1054.e1. doi:10.1053/j.gastro.2016.12.039.

Wadhwa A, Al Nahhas MF, Dierkhising RA, et al. High risk of post-infectious irritable bowel syndrome in patients with Clostridium difficile infection. Aliment Pharmacol Ther. 2016;44(6):576-582. doi:10.1111/apt.13737.

Drossman DA. Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV. Gastroenterology. 2016;S0016-5085(16)00223-7. doi:10.1053/j.gastro.2016.02.032.

Houghton LA, Heitkemper M, Crowell M, et al. Age, Gender and Women's Health and the Patient. Gastroenterology. 2016;S0016-5085(16)00183-9. doi:10.1053/j.gastro.2016.02.017.

Chen B, Kim JJ, Zhang Y, Du L, Dai N. Prevalence and predictors of small intestinal bacterial overgrowth in irritable bowel syndrome: a systematic review and meta-analysis. J Gastroenterol. 2018;53(7):807-818. doi:10.1007/s00535-018-1476-9.

Barbara G, Feinle-Bisset C, Ghoshal UC, et al. The Intestinal Microenvironment and Functional Gastrointestinal Disorders. Gastroenterology. 2016;S0016-5085(16)00219-5. doi:10.1053/j.gastro.2016.02.028.

Boeckxstaens G, Camilleri M, Sifrim D, et al. Fundamentals of Neurogastroenterology: Physiology/Motility - Sensation. Gastroenterology. 2016;S0016-5085(16)00221-3. doi:10.1053/j.gastro.2016.02.030.

Slattery SA, Niaz O, Aziz Q, Ford AC, Farmer AD. Systematic review with meta-analysis: the prevalence of bile acid malabsorption in the irritable bowel syndrome with diarrhoea. Aliment Pharmacol Ther. 2015;42(1):3-11. doi:10.1111/apt.13227.

Weaver KR, Sherwin LB, Walitt B, Melkus GD, Henderson WA. Neuroimaging the brain-gut axis in patients with irritable bowel syndrome. World J Gastrointest Pharmacol Ther. 2016;7(2):320-333. doi:10.4292/wjgpt.v7.i2.320.

Van Oudenhove L, Crowell MD, Drossman DA, et al. Biopsychosocial Aspects of Functional Gastrointestinal Disorders. Gastroenterology. 2016;S0016-5085(16)00218-3. doi:10.1053/j.gastro.2016.02.027.

Mulak A, Paradowski L. Enterocerebral interactions - new pathogenetic aspects. Terapia/ 2017;1:8-12. (in Polish).

Lee C, Doo E, Choi JM, et al. The Increased Level of Depression and Anxiety in Irritable Bowel Syndrome Patients Compared with Healthy Controls: Systematic Review and Meta-analysis. J Neurogastroenterol Motil. 2017;23(3):349-362. doi:10.5056/jnm16220.

Wu JC, Chan AO, Chan YW, et al. The current treatment landscape of irritable bowel syndrome in adults in Hong Kong: consensus statements. Hong Kong Med J. 2017;23(6):641-647. doi:10.12809/hkmj177060.

Moayyedi P, Mearin F, Azpiroz F, et al. Irritable bowel syndrome diagnosis and management: A simplified algorithm for clinical practice. United European Gastroenterol J. 2017;5(6):773-788. doi:10.1177/2050640617731968.

Song KH, Jung HK, Kim HJ, et al. Clinical Practice Guidelines for Irritable Bowel Syndrome in Korea, 2017 Revised Edition. J Neurogastroenterol Motil. 2018;24(2):197-215. doi:10.5056/jnm17145.

US Department of Health and Human Services; US Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. 2015. Available from: http://health.gov/dietaryguidelines/2015/guidelines/.

Johannesson E, Ringström G, Abrahamsson H, Sadik R. Intervention to increase physical activity in irritable bowel syndrome shows long-term positive effects. World J Gastroenterol. 2015;21(2):600-608. doi:10.3748/wjg.v21.i2.600.

Schneck AS, Anty R, Tran A, et al. Increased Prevalence of Irritable Bowel Syndrome in a Cohort of French Morbidly Obese Patients Candidate for Bariatric Surgery. Obes Surg. 2016;26(7):1525-1530. doi:10.1007/s11695-015-1907-0.

Aasbrenn M, Lydersen S, Farup PG. A Conservative Weight Loss Intervention Relieves Bowel Symptoms in Morbidly Obese Subjects with Irritable Bowel Syndrome: A Prospective Cohort Study. J Obes. 2018;2018:3732753. doi:10.1155/2018/3732753.

Hajizadeh Maleki B, Tartibian B, Mooren FC, et al. Low-to-moderate intensity aerobic exercise training modulates irritable bowel syndrome through antioxidative and inflammatory mechanisms in women: Results of a randomized controlled trial. Cytokine. 2018;102:18-25. doi:10.1016/j.cyto.2017.12.016.

Laird KT, Tanner-Smith EE, Russell AC, Hollon SD, Walker LS. Short-term and Long-term Efficacy of Psychological Therapies for Irritable Bowel Syndrome: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2016;14(7):937-947.e4. doi:10.1016/j.cgh.2015.11.020.

Laird KT, Tanner-Smith EE, Russell AC, Hollon SD, Walker LS. Comparative efficacy of psychological therapies for improving mental health and daily functioning in irritable bowel syndrome: A systematic review and meta-analysis. Clin Psychol Rev. 2017;51:142-152. doi:10.1016/j.cpr.2016.11.001.

Schnabel L, Buscail C, Sabate JM, et al. Association Between Ultra-Processed Food Consumption and Functional Gastrointestinal Disorders: Results From the French NutriNet-Santé Cohort. Am J Gastroenterol. 2018;113(8):1217-1228. doi:10.1038/s41395-018-0137-1.

Ali A, Weiss TR, McKee D, et al. Efficacy of individualised diets in patients with irritable bowel syndrome: a randomised controlled trial. BMJ Open Gastroenterol. 2017;4(1):e000164. doi:10.1136/bmjgast-2017-000164.

Buscail C, Sabate JM, Bouchoucha M, et al. Association between self-reported vegetarian diet and the irritable bowel syndrome in the French NutriNet cohort. PLoS One. 2017;12(8):e0183039. doi:10.1371/journal.pone.0183039.

Eswaran SL, Chey WD, Han-Markey T, Ball S, Jackson K. A Randomized Controlled Trial Comparing the Low FODMAP Diet vs. Modified NICE Guidelines in US Adults with IBS-D. Am J Gastroenterol. 2016;111(12):1824-1832. doi:10.1038/ajg.2016.434.

Böhn L, Störsrud S, Liljebo T, et al. Diet low in FODMAPs reduces symptoms of irritable bowel syndrome as well as traditional dietary advice: a randomized controlled trial. Gastroenterology. 2015;149(6):1399-1407.e2. doi:10.1053/j.gastro.2015.07.054.

Hustoft TN, Hausken T, Ystad SO, et al. Effects of varying dietary content of fermentable short-chain carbohydrates on symptoms, fecal microenvironment, and cytokine profiles in patients with irritable bowel syndrome. Neurogastroenterol Motil. 2017;29(4):10.1111/nmo.12969. doi:10.1111/nmo.12969.

Krogsgaard LR, Lyngesen M, Bytzer P. Systematic review: quality of trials on the symptomatic effects of the low FODMAP diet for irritable bowel syndrome. Aliment Pharmacol Ther. 2017;45(12):1506-1513. doi:10.1111/apt.14065.

Bennet SMP, Böhn L, Störsrud S, et al. Multivariate modelling of faecal bacterial profiles of patients with IBS predicts responsiveness to a diet low in FODMAPs. Gut. 2018;67(5):872-881. doi:10.1136/gutjnl-2016-313128.

Laatikainen R, Koskenpato J, Hongisto SM, et al. Randomised clinical trial: low-FODMAP rye bread vs. regular rye bread to relieve the symptoms of irritable bowel syndrome. Aliment Pharmacol Ther. 2016;44(5):460-470. doi:10.1111/apt.13726.

Shahbazkhani B, Sadeghi A, Malekzadeh R, et al. Non-Celiac Gluten Sensitivity Has Narrowed the Spectrum of Irritable Bowel Syndrome: A Double-Blind Randomized Placebo-Controlled Trial. Nutrients. 2015;7(6):4542-4554. doi:10.3390/nu7064542.

Mosaffa-Jahromi M, Lankarani KB, Pasalar M, Afsharypuor S, Tamaddon AM. Efficacy and safety of enteric coated capsules of anise oil to treat irritable bowel syndrome. J Ethnopharmacol. 2016;194:937-946. doi:10.1016/j.jep.2016.10.083.

Wong RK, Yang C, Song GH, Wong J, Ho KY. Melatonin regulation as a possible mechanism for probiotic (VSL#3) in irritable bowel syndrome: a randomized double-blinded placebo study. Dig Dis Sci. 2015;60(1):186-194. doi:10.1007/s10620-014-3299-8.

Yoon H, Park YS, Lee DH, Seo JG, Shin CM, Kim N. Effect of administering a multi-species probiotic mixture on the changes in fecal microbiota and symptoms of irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial. J Clin Biochem Nutr. 2015;57(2):129-134. doi:10.3164/jcbn.15-14.

Spiller R, Pélerin F, Cayzeele Decherf A, et al. Randomized double blind placebo-controlled trial of Saccharomyces cerevisiae CNCM I-3856 in irritable bowel syndrome: improvement in abdominal pain and bloating in those with predominant constipation. United European Gastroenterol J. 2016;4(3):353-362. doi:10.1177/2050640615602571.

Hod K, Sperber AD, Ron Y, et al. A double-blind, placebo-controlled study to assess the effect of a probiotic mixture on symptoms and inflammatory markers in women with diarrhea-predominant IBS. Neurogastroenterol Motil. 2017;29(7):10.1111/nmo.13037. doi:10.1111/nmo.13037.

Pinto-Sanchez MI, Hall GB, Ghajar K, et al. Probiotic Bifidobacterium longum NCC3001 Reduces Depression Scores and Alters Brain Activity: A Pilot Study in Patients With Irritable Bowel Syndrome. Gastroenterology. 2017;153(2):448-459.e8. doi:10.1053/j.gastro.2017.05.003.

Zheng L, Lai Y, Lu W, et al. Pinaverium Reduces Symptoms of Irritable Bowel Syndrome in a Multicenter, Randomized, Controlled Trial. Clin Gastroenterol Hepatol. 2015;13(7):1285-1292.e1. doi:10.1016/j.cgh.2015.01.015.

Agger JL, Schröder A, Gormsen LK, Jensen JS, Jensen TS, Fink PK. Imipramine versus placebo for multiple functional somatic syndromes (STreSS-3): a double-blind, randomised study. Lancet Psychiatry. 2017;4(5):378-388. doi:10.1016/S2215-0366(17)30126-8.

Chen B, Kim JJ, Zhang Y, Du L, Dai N. Prevalence and predictors of small intestinal bacterial overgrowth in irritable bowel syndrome: a systematic review and meta-analysis. J Gastroenterol. 2018;53(7):807-818. doi:10.1007/s00535-018-1476-9.

Acosta A, Camilleri M, Shin A, et al. Effects of Rifaximin on Transit, Permeability, Fecal Microbiome, and Organic Acid Excretion in Irritable Bowel Syndrome. Clin Transl Gastroenterol. 2016;7(5):e173. doi:10.1038/ctg.2016.32.

Bruzzese E, Pesce M, Sarnelli G, Guarino A. Pharmacokinetic drug evaluation of rifaximin for treatment of diarrhea-predominant irritable bowel syndrome. Expert Opin Drug Metab Toxicol. 2018;14(7):753-760. doi:10.1080/17425255.2018.1488964.

Yang Y, Fang JY, Guo X, et al. Efficacy and Safety of Linaclotide in Patients With IBS-C: Results From a Phase 3, Randomized, Double-Blind, Placebo-Controlled Trial in China and Other Regions. Gastroenterology 2016;150(4 Suppl 1):S741. doi:10.1016/S0016-5085(16)32517-3.

Brenner DM, Fogel R, Dorn SD, et al. Efficacy, safety, and tolerability of plecanatide in patients with irritable bowel syndrome with constipation: results of two phase 3 randomized clinical trials. Am J Gastroenterol. 2018;113(5):735-745. doi:10.1038/s41395-018-0026-7.

Cryer B, Drossman DA, Chey WD, Webster L, Habibi S, Wang M. Analysis of Nausea in Clinical Studies of Lubiprostone for the Treatment of Constipation Disorders. Dig Dis Sci. 2017;62(12):3568-3578. doi:10.1007/s10620-017-4680-1.

Chang L, Chey WD, Drossman D, et al. Effects of baseline abdominal pain and bloating on response to lubiprostone in patients with irritable bowel syndrome with constipation. Aliment Pharmacol Ther. 2016;44(10):1114-1122. doi:10.1111/apt.13807.

Lam C, Tan W, Leighton M, et al. A mechanistic multicentre, parallel group, randomised placebo-controlled trial of mesalazine for the treatment of IBS with diarrhoea (IBS-D). Gut. 2016;65(1):91-99. doi:10.1136/gutjnl-2015-309122.

Halkjær SI, Christensen AH, Lo BZS, et al. Faecal microbiota transplantation alters gut microbiota in patients with irritable bowel syndrome: results from a randomised, double-blind placebo-controlled study. Gut. 2018;67(12):2107-2115. doi:10.1136/gutjnl-2018-316434.

Johnsen PH, Hilpüsch F, Cavanagh JP, et al. Faecal microbiota transplantation versus placebo for moderate-to-severe irritable bowel syndrome: a double-blind, randomised, placebo-controlled, parallel-group, single-centre trial. Lancet Gastroenterol Hepatol. 2018;3(1):17-24. doi:10.1016/S2468-1253(17)30338-2.

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Published

2021-09-06

How to Cite

Janelidze, D. (2021). Modern possibilities of colonoprotection in patients with irritable bowel syndrome. GASTROENTEROLOGY, 54(3), 172–178. https://doi.org/10.22141/2308-2097.54.3.2020.211737

Issue

Vol. 54 No. 3 (2020)

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Reviews and Lections

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