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肠胃道易激综合症 (IBS) 对食物的过敏 及 饮食控制. 黄光明医生 副顾问 国大医院. Gut Bacteria and the Irritable Bowel Syndrome. What is Irritable Bowel Syndrome?. Abdominal pain Bloating Constipation Diarrhoea Eructation Flatulence ‘Gastric’. The Role of Microbes in IBS. Post-infectious IBS - PowerPoint PPT Presentation
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肠胃道易激综合症 肠胃道易激综合症 (IBS)(IBS)对食物的过敏对食物的过敏
及及饮食控制饮食控制黄光明医生副顾问国大医院
黄光明医生副顾问国大医院
Gut Bacteria and the Irritable Bowel Syndrome
What is Irritable Bowel Syndrome?• Abdominal pain• Bloating• Constipation • Diarrhoea
• Eructation • Flatulence • ‘Gastric’
The Role of Microbes in IBS
• Post-infectious IBS
• Small intestinal bacterial overgrowth
• Effect of antibiotics on IBS symptoms
• Probiotic treatment for IBS
IBS can develop after Infection
• Salmonella
• Campylobacter
• Shigella
The risk is as high as 12x more than people without infection
Small Intestinal Bacterial Small Intestinal Bacterial OvergrowthOvergrowth
Colonic Fermentation
Antibiotics, good or bad?
• Antibiotic treatment may improve IBS symptoms if bacterial overgrowth is present
• But, IBS may also develop in some patients after receiving antibiotics for other infections
Protective effect of gut bacteria
How to achieve a balance between good and bad bacteria?
What are probiotics?
• Greek: ‘for life’
• Live organisms that, when ingested in adequate amounts, exert a health benefit on the host
• Eg Lactobacilli, Bifidobacteria, Saccharomyces boulardii
Effect of probiotics on the intestine
• Reduce amount of harmful bacteria
• Control inflammation
• Alter the intestinal movements
• Reduce gas production
Which probiotics to use?
Probiotics (Lactobacillus) in IBS
Organism Study n Outcome
L plantarum Noback 2000 60 ↓flatus, pain
L plantarum Niedzielin 2001 20 ↓pain
L plantarum Sen 2002 12 ↓bloating
L GG O’Sullivan 2000 25 Negative
L GG Bausserman 2005 50 ↓distension
L reuterii Niv 2005 54 Negative
Probiotics (others) in IBS
Organism Study n Outcome
VSL#3 Kim 2003 25 ↓bloating
VSL#3 Kim 2005 48 ↓flatus
B infantis O’Mahony 2005 77 ↓all symptoms
B infantis Whorwell 2006 362 ↓all symptoms
VSL#3 = Streptococcus thermophilus, Lactobacillus spp, Bifidobacteria spp
Bifidobacterium infantis
Conclusions• IBS is a common condition that can severely affect a
person’s quality of life.
• Probiotic organisms may be useful in the treatment of IBS.
• However, the benefits in IBS are brought about by some but not all probiotic organisms.
• Different probiotic organisms have different effects; Some may have opposite effects on the intestines.