Treatment of diarrhea-predominant irritable bowel syndrome with mesalazine and/or Saccharomyces boulardii
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Data
2013-12
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Resumo
Irritable bowel syndrome (IBS) is a functional bowel disease characterized by abdominal pain and altered in-
testinal habits. The pathophysiology of IBS remains unclear. Recent studies have demonstrated that some IBS patients, especially in
diarrhea-predominant IBS (IBS-D), display persistent signs of minor mucosal inflammation and a modified intestinal microflora.
The mesalazine has known intestinal anti-inflammatory properties. Saccharomyces boulardii is a probiotic used for a long time in
treatment of diarrhea, including infectious diarrhea. Objective - Evaluate the effects of mesalazine alone, combined therapy of me-
salazine with liophylised Saccharomyces boulardii or alone on symptoms of IBS-D patients. Methods - Based on Rome III criteria,
53 IBS-D patients (18 year or more) were included. To exclude organic diseases all patients underwent colonoscopy, stool culture,
serum anti-endomisium antibody, lactose tolerance test and ova and parasite exam. Patients were divided in three groups: mesalazine
group (MG) - 20 patients received mesalazine 800 mg t.i.d. for 30 days; mesalazine and Saccharomyces boulardii group (MSbG) - 21
patients received mesalazine 800 mg t.i.d. and Saccharomyces boulardii 200 mg t.i.d. for 30 days and; Saccharomyces boulardii group
(SbG) – 12 patients received Sb 200 mg t.i.d. for 30 days. Drugs that might have any effect on intestinal motility or secretion were
not allowed. Symptom evaluations at baseline and after treatment were performed by means of a 4-point likert scale including: stool
frequency, stool form and consistency (Bristol scale), abdominal pain and distension. Paired t test and Kruskal-Wallis test were used
for statistical analyses. Results - Compared to baseline, there were statistically significant reduction of symptom score after 30 th day
therapy in all three groups: MG (P<0.0001); MSbG (P<0.0001) and in SbG (P = 0.003). There were statistically significant differ-
ences in the symptom score at 30 th day therapy of the MG, MSbG and SbG groups (P = 0.03). There were no statistical differences
between MSbG and MG symptom score at 30th day therapy (P = 0.9). Conclusions - The use of mesalazine alone, Saccharomyces
boulardii alone or combined treatment with mesalasine and Saccaromyces boulardii improved IBS-D symptoms. The improvement of
the symptom score was greater with mesalazine alone or combined with Sb as compared with Sb treatment alone. These preliminary
results suggest that mezalazine may be useful in treatment of IBS-d patients, and warrant further larger studies.
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Irritable bowel syndrome, Saccharomyces boulardii, Diarrhea. Mesalamine, Síndrome do intestino irritável, Diarreia, Saccharomyces boulardii, Mesalamina
Citação
BAFUTTO, Mauro et al. Treatment of diarrhea-predominant irritable bowel syndrome with mesalazine and/or saccharomyces boulardii. Arquivos de Gastroenterologia, São Paulo, v. 50, n. 4, p. 304-309, Oct./Dec. 2013.