临床指导和实践建议 益生菌在患有刺激性肠综合征,功能性便秘和困难菌感染的患者使用,考虑到基于性别的差异
Yong Sung Kim1,2, Seon-Young Park3, Seung Joo Kang4
1Digestive Disease Research Institute, School of Medicine, Wonkwang University, Iksan, Korea.
Journal of neurogastroenterology and motility
|March 10, 2026
概括
益生菌可能有助于刺激性肠综合征 (IBS) 和功能性便秘 (FC) 症状,但疗效是菌株特异性的. 对这些和C. difficile感染 (CDI) 的益生菌反应的性别相关差异的研究正在进行中.
科学领域:
- 胃肠病学 胃肠病学
- 微生物学 微生物学
- 免疫学 免疫学 免疫学
背景情况:
- 益生菌越来越多地被认为是治疗下部胃肠道疾病.
- 证据证明它们的有效性,特别是关于与性别相关的差异,是有限的.
- 本综述重点介绍了治疗刺激性肠综合征 (IBS),功能性便秘 (FC) 和Clostridioides difficile感染 (CDI) 的益生菌.
研究的目的:
- 为IBS,FC和CDI提供基于证据的见解和实践建议,用于益生菌的使用.
- 考虑潜在的益生菌疗效的性别相关差异.
- 引导临床医生选择适当的益生菌干预措施.
主要方法:
- 对随机对照试验和元分析的证据的审查.
- 对IBS进行临床研究和实验动物模型的分析.
- 考虑与性别和年龄相关的免疫学差异,用于CDI.
主要成果:
- 益生菌对IBS症状 (全球性,疼痛,胀气) 和FC (肠道频率,便一致性) 显示出适度的,菌株特异性的益处.
- 临床研究表明IBS中没有显著的性别差异,但动物模型表明潜在的性别依赖反应.
- 益生菌对预防CDI的有效性不一致;通常不建议常规使用.
结论:
- 益生菌可以作为IBS和FC的辅助疗法,反应受到微生物,宿主和潜在的性别相关因素的影响.
- 目前的证据不支持常规使用益生菌来预防CDI.
- 考虑到菌株特异性和患者特征 (包括性别) 的个性化益生菌策略需要进一步研究.
相关概念视频
Drugs for Treatment of Constipation-Predominant IBS
1.0K
Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
1.0K
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
994
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
994
Drugs for Treatment of Diarrhea-Predominant IBS
824
Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
824
Irritable Bowel Syndrome III: Medical and Nursing Management
957
Managing Irritable Bowel Syndrome (IBS) involves a multifaceted approach, including lifestyle modifications, dietary changes, and medication.
957
Irritable Bowel Syndrome I: Introduction
1.3K
Irritable Bowel Syndrome (IBS) is characterized by functional disturbances in the gastrointestinal system, presenting a cluster of symptoms without evident structural or biochemical abnormalities. It primarily affects the large intestine and may cause abdominal pain, bloating, excessive gas, diarrhea, constipation, or both.
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
1.3K
Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
1.0K
Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
1.0K


