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Kısa Barsak Sendromunda Mikrobiyota ve Pre-Probiyotikler

Year 2021, Volume: 6 Issue: 3, 166 - 175, 30.10.2021

Eftal Geçgil Demir Fatma Bengü Kuyulu Bozdoğan Aybala Tazeoğlu

Abstract

İnce bağırsağın normal uzunluğu 320-800 cm arasında değişmektedir. İnce bağırsak uzunluğunun 200 cm'den daha az olması kısa bağırsak sendromu olarak tanımlanmaktadır. Kısa bağırsak sendromu (KBS), özellikle çocuklarda bağırsak yetmezliğinin ana nedenidir. KBS, ince bağırsağın anatomik ve/veya fonksiyonel kaybından sonra ortaya çıkan ve malabsorbsiyon, ishal, osteoporoz, karaciğer ve safra hastalıkları gibi bulgularla kendini gösteren klinik bir tablodur. Oluşan komplikasyonlar sonucunda kişinin yaşam kalitesi düşmektedir. Hastalarda bağırsak uzunluğunun kısalması, besin öğelerinin emilim yüzey alanının ve bağırsaklardan geçiş süresinin azalmasına neden olmaktadır. Emilim yetersizliğini telafi etmek için tedavi protokolünde hastaların tolere edebileceği düzeyde yüksek enerji almaları gerekir. Kolon sağlığı için nişasta, nişasta olmayan polisakkatirler ve çözünebilir posa gibi kompleks karbonhidrat içerikli besinlerle beslenmelidirler. Kompleks karbonhidratlar, ince barsaklar tarafından sindirilmez, kolonda fermente olur bu sayede kısa zincirli yağ asitlerini oluştururlar. Kısa bağırsak sendromunda tedavinin en temel hedefi bağırsak adaptasyonunun sağlanmasıdır. Son zamanlarda bağırsak adaptasyonu için probiyotikler-prebiyotikler gibi besin takviyeleri araştırılmaktadır. Bu makale kısa barsak sendromu ve mikrobiyota üzerine etkileri, pre ve probiyotiklerin tedavideki rolünü incelemek amacıyla derlenmiştir.

Keywords

kısa barsak sendromu mikrobiyota besin takviyesi prebiyotik probiyotik

References

  • Referans1 Uko V, Radhakrishnan K, Alkhouri N. Short Bowel Syndrome in Children. Paediatr Drugs. 2012; 14(3):179-188.
  • Referans2 Özdemir M, Sarıtaş AE. Kısa Barsak Sendromu ve Nutrisyon. Güncel Gastroenteroloji. 2016;20(3):289-295.
  • Referans3 Boccia S, Torre I, Santarpia L, Iervolino C, Del Piano C, Puggina A et al. Intestinal microbiota in adult patients with short bowel syndrome: preliminary results from a pilot study. Clin Nutr. 2017;36(6):1707-1709.
  • Referans4 Çelik A. Bağırsak Yetmezliği/Kısa Bağırsak Sendromunda Transplant Dışı Cerrahi Yaklaşımlar. Çoc. Cer. Derg. 2017;31:56-76.
  • Referans5 Kelly DG, Tappenden KA, Winkler MF. Short bowel syndrome: highlights of patient management, quality of life, and survival. JPEN J Parenter Enteral Nutr. 2014;38(4):427–437.
  • Referans6 Lloyd DA, Vega R, Bassett P, Forbes A, Gabe SM. Survival and dependence on home parenteral nutrition: experience over a 25- year period in a UK referral centre. Aliment Pharmacol Ther. 2006;24(8):1231–1240.
  • Referans7 Carroll R, Benedetti E. Management and Complications of Short Bowel Syndrome: an Updated Review. Curr Gastroenterol Rep. 2016;18: 40.
  • Referans8 Vanderhoof JA. Enteral And Parenteral Nutrition İn The Care Of Patients With Short-Bowel Syndrome. Best Pract Res Clin Gastroenterol BEST PRACT RES CL GA. 2003;17(6):997–1015.
  • Referans9 Jeppesen PB, Gabe SM, Seidner DL, Lee H, Olivier C. Factors associated with response to teduglutide in patients with short-bowel syndrome and intestinal failure. Gastroenterology. 2018;154:874–885.
  • Referans10 Hvistendahl M, Brandt CF, Tribler S, Naimi RM, Hartmann B, Holst JJ. Effect of liraglutide treatment on jejunostomy output in patients with short bowel syndrome: an open-label pilot study. JPEN J Parenter Enteral Nutr. 2016;42(1):112-121.
  • Referans11 Pape UF, Maasberg S, Pascher A. Pharmacological strategies to enhance adaptation in intestinal failure. Curr Opin Organ Transplant. 2016;21:147–152
  • Referans12 Thompson JS. The role of prophylactic cholecystectomy in the short-bowel syndrome.Arch Surg. 1996;131(5):556–559.
  • Referans13 Braga CB, Bizari L, Suen VM, Marchini JS, Paula FJ, Cunha SF. Bone mineral density in short bowel syndrome: correlation with BMI and serum vitamins C, E and K. Arch Endocrinol Metab. 2015;59(3):252–258.
  • Referans14 Finkielstein VA, Goldfarb DS. Strategies for preventing calcium oxalate stones. CMAJ. 2006;174(10):1407–1409.
  • Referans15 Fitzgibbons SC, Jones BA, Hull MA, Zurakowski D, Duro D, Duggan C, et al. Relationship between biopsy-proven parenteralnutrition-associated liver fibrosis and biochemical cholestasis in children with short bowel syndrome. J Pediatr Surg. 2010;45(1):95–99.
  • Referans16 Kowlgi NG, Chhabra L. D-lactic acidosis: an underrecognized complication of short bowel syndrome. Gastroenterol Res Pract. 2015.
  • Referans17 Winkler MF, Smith CE. Clinical, social, and economic impacts of home parenteral nutrition dependence in short bowel syndrome. JPEN J Parenter Enteral Nutr. 2014;38(1):32–37.
  • Referans18 Seetharam, P, Rodrigues, G. Short bowel syndrome: a review of management options. Saudi J Gastroenterol. 2011; 17(4): 229.
  • Referans19 Şener M, Canda E, Gürel D. Enteral beta glukanın ratlarda oluşturulan deneysel kısa barsak modelinde intestinal adaptasyon üzerindeki etkisi. Genel Tip Dergisi. 2011; 21(3).
  • Referans20 Liu S. The Development of Our Organ of Other Kinds—The Gut Microbiota. Front Microbiol. 2016;7:1-5.
  • Referans21 Pelzer E, Gomez-Arango LF, Barrett HL, Nitert ML. Maternal health and the placental microbiome. Placenta. 2017; 54:30-37.
  • Referans22 Sommer F, Bäckhed F. Know your neighbor: Microbiota and host epithelial cells interact locally to control intestinal function and physiology. Bioessays. 2016;38(5):455- 464.
  • Referans23 İpek Derya K, Yılmaz Ongun H. Diyetin ve karbonhidrat içeriğinin mikrobiyotaya etkisi. Cumhuriyet Üniv. Sağ. Bil. Enst. Derg. 2018;3(2): 29-39.
  • Referans24 Varım P, Vatan MB, Varım C. Kardiyovasküler Hastalıklar ve Mikrobiyota. J Biotechnoland Strategic Health Res. 2017;1:141-147.
  • Referans25 Özdemir A, Büyüktuncer Demirel Z. Beslenme ve Mikrobiyota İlişkisi. J Biotechnol and Strategic Health Res. 2017; 1: 25-33.
  • Referans26 OchoaReferans-Repáraz J, Kasper LH. The Second Brain: Is the Gut Microbiota a Link Between Obesity and Central Nervous System Disorders? Curr Obes Rep. 2016;5(1):51-64.
  • Referans27 Madan JC, Hoen AG, Lundgren SN, Farzan SF, Cottingham KL, Morrison HG, et al. Association of Cesarean Delivery and Formula Supplementation With the Intestinal Microbiome of 6-Week-Old Infants. JAMA pediatrics. 2016;170(3):212-219.
  • Referans28 Karatay E. Mikrobiyota, prebiyotik ve probiyotikler. Anatolian Curr Med J. 2019; 1(3): 68-71.
  • Referans29 Guarner F, Khan AG, Garisch J, Eliakim R, Gangl A, Thomson A, et al. World Gastroenterology Organisation Global Guidelines: probiotics and prebiotics October. J Clin Gastroenterol. 2012;46(6):468-481.
  • Referans30 Joint FAO/WHO Working Group: Guidelines for the evaluation of probiotics in food: report of a joint FAO/WHO working group on drafting guidelines for the evaluation of probiotics in food. London, ON, Canada. 2002.
  • Referans31 Tolga-Müftüoğlu MA, Civak T, Çetin S, Civak L, Güngör O, Sağlam A. Effects of probiotics on experimental short-bowel syndrome. The American Journal of Surgery. 2011;202(4): 461-468.
  • Referans32 Kanamori Y, Sugiyama M, Hashizume K, Yuki N, Morotomi M, Tanaka R. Experience of longterm synbiotic therapy in seven short bowel patients with refractory enterocolitis. J Pediatr Surg. 2004;39(11):1686-1692.
  • Referans33 Kanamori Y, Hashizume K, Sugiyama M, Morotomi M, Yuki N. Combination therapy with Bifidobacterium breve, Lactobacillus casei, and galactooligosaccharides dramatically improved the intestinal function in a girl with short bowel syndrome: a novel synbiotics therapy for intestinal failure. Dig Dis Sci. 2001;46(9):2010-2016.
  • Referans34 Uchida K, Takahashi T, Inoue M, Morotomi M, Otake K, Nakazawa M, et al. Immunonutritional effects during synbiotics therapy in pediatric patients with short bowel syndrome’’. Pediatr Surg Int. 2007;23(3):243-248.
  • Referans35 Goulet O, Joly F. Intestinal microbiota in short bowel syndrome. Gastroenterol Clin Biol. 2010;34:37-43.

Microbiota and Pre-Probiotics in Short Bowel Syndrome

Year 2021, Volume: 6 Issue: 3, 166 - 175, 30.10.2021

Eftal Geçgil Demir Fatma Bengü Kuyulu Bozdoğan Aybala Tazeoğlu

Abstract

The normal length of the small intestine ranges from 320 to 800 cm. Short bowel syndrome is defined as the small bowel length less than 200 cm. Short bowel syndrome (SBS) is the main cause of intestinal failure especially in children. Short bowel syndrome is a clinical manifestation that occurs mainly after anatomical and / or functional loss of small intestine and presents with malabsorption, diarrhea, osteoporosis, liver and biliary diseases. As a result of the complications, the quality of life of the person decreases. The shortening of the intestinal length in patients causes a decrease in the absorption surface area and transit time of the nutrients. In order to compensate for the malabsorption, patients should receive high energy levels that can be tolerated in the treatment protocol. For colon health, they need to be fed complex carbohydrate foods such as starch, non-starch polysaccharides and soluble fiber. Complex carbohydrates are not digested by the small intestine, but are fermented in the colon to form short-chain fatty acids. The main goal of treatment in short bowel syndrome is to provide bowel adaptation. Recently, nutritional supplements such as probiotics and prebiotics have been investigated for intestinal adaptation. This article was compiled to examine short bowel syndrome and its effects on microbiota and the role of pre- and probiotics in treatment.

Keywords

short bowel syndrome microbiota nutritional supplement prebiotic probiotic

References

  • Referans1 Uko V, Radhakrishnan K, Alkhouri N. Short Bowel Syndrome in Children. Paediatr Drugs. 2012; 14(3):179-188.
  • Referans2 Özdemir M, Sarıtaş AE. Kısa Barsak Sendromu ve Nutrisyon. Güncel Gastroenteroloji. 2016;20(3):289-295.
  • Referans3 Boccia S, Torre I, Santarpia L, Iervolino C, Del Piano C, Puggina A et al. Intestinal microbiota in adult patients with short bowel syndrome: preliminary results from a pilot study. Clin Nutr. 2017;36(6):1707-1709.
  • Referans4 Çelik A. Bağırsak Yetmezliği/Kısa Bağırsak Sendromunda Transplant Dışı Cerrahi Yaklaşımlar. Çoc. Cer. Derg. 2017;31:56-76.
  • Referans5 Kelly DG, Tappenden KA, Winkler MF. Short bowel syndrome: highlights of patient management, quality of life, and survival. JPEN J Parenter Enteral Nutr. 2014;38(4):427–437.
  • Referans6 Lloyd DA, Vega R, Bassett P, Forbes A, Gabe SM. Survival and dependence on home parenteral nutrition: experience over a 25- year period in a UK referral centre. Aliment Pharmacol Ther. 2006;24(8):1231–1240.
  • Referans7 Carroll R, Benedetti E. Management and Complications of Short Bowel Syndrome: an Updated Review. Curr Gastroenterol Rep. 2016;18: 40.
  • Referans8 Vanderhoof JA. Enteral And Parenteral Nutrition İn The Care Of Patients With Short-Bowel Syndrome. Best Pract Res Clin Gastroenterol BEST PRACT RES CL GA. 2003;17(6):997–1015.
  • Referans9 Jeppesen PB, Gabe SM, Seidner DL, Lee H, Olivier C. Factors associated with response to teduglutide in patients with short-bowel syndrome and intestinal failure. Gastroenterology. 2018;154:874–885.
  • Referans10 Hvistendahl M, Brandt CF, Tribler S, Naimi RM, Hartmann B, Holst JJ. Effect of liraglutide treatment on jejunostomy output in patients with short bowel syndrome: an open-label pilot study. JPEN J Parenter Enteral Nutr. 2016;42(1):112-121.
  • Referans11 Pape UF, Maasberg S, Pascher A. Pharmacological strategies to enhance adaptation in intestinal failure. Curr Opin Organ Transplant. 2016;21:147–152
  • Referans12 Thompson JS. The role of prophylactic cholecystectomy in the short-bowel syndrome.Arch Surg. 1996;131(5):556–559.
  • Referans13 Braga CB, Bizari L, Suen VM, Marchini JS, Paula FJ, Cunha SF. Bone mineral density in short bowel syndrome: correlation with BMI and serum vitamins C, E and K. Arch Endocrinol Metab. 2015;59(3):252–258.
  • Referans14 Finkielstein VA, Goldfarb DS. Strategies for preventing calcium oxalate stones. CMAJ. 2006;174(10):1407–1409.
  • Referans15 Fitzgibbons SC, Jones BA, Hull MA, Zurakowski D, Duro D, Duggan C, et al. Relationship between biopsy-proven parenteralnutrition-associated liver fibrosis and biochemical cholestasis in children with short bowel syndrome. J Pediatr Surg. 2010;45(1):95–99.
  • Referans16 Kowlgi NG, Chhabra L. D-lactic acidosis: an underrecognized complication of short bowel syndrome. Gastroenterol Res Pract. 2015.
  • Referans17 Winkler MF, Smith CE. Clinical, social, and economic impacts of home parenteral nutrition dependence in short bowel syndrome. JPEN J Parenter Enteral Nutr. 2014;38(1):32–37.
  • Referans18 Seetharam, P, Rodrigues, G. Short bowel syndrome: a review of management options. Saudi J Gastroenterol. 2011; 17(4): 229.
  • Referans19 Şener M, Canda E, Gürel D. Enteral beta glukanın ratlarda oluşturulan deneysel kısa barsak modelinde intestinal adaptasyon üzerindeki etkisi. Genel Tip Dergisi. 2011; 21(3).
  • Referans20 Liu S. The Development of Our Organ of Other Kinds—The Gut Microbiota. Front Microbiol. 2016;7:1-5.
  • Referans21 Pelzer E, Gomez-Arango LF, Barrett HL, Nitert ML. Maternal health and the placental microbiome. Placenta. 2017; 54:30-37.
  • Referans22 Sommer F, Bäckhed F. Know your neighbor: Microbiota and host epithelial cells interact locally to control intestinal function and physiology. Bioessays. 2016;38(5):455- 464.
  • Referans23 İpek Derya K, Yılmaz Ongun H. Diyetin ve karbonhidrat içeriğinin mikrobiyotaya etkisi. Cumhuriyet Üniv. Sağ. Bil. Enst. Derg. 2018;3(2): 29-39.
  • Referans24 Varım P, Vatan MB, Varım C. Kardiyovasküler Hastalıklar ve Mikrobiyota. J Biotechnoland Strategic Health Res. 2017;1:141-147.
  • Referans25 Özdemir A, Büyüktuncer Demirel Z. Beslenme ve Mikrobiyota İlişkisi. J Biotechnol and Strategic Health Res. 2017; 1: 25-33.
  • Referans26 OchoaReferans-Repáraz J, Kasper LH. The Second Brain: Is the Gut Microbiota a Link Between Obesity and Central Nervous System Disorders? Curr Obes Rep. 2016;5(1):51-64.
  • Referans27 Madan JC, Hoen AG, Lundgren SN, Farzan SF, Cottingham KL, Morrison HG, et al. Association of Cesarean Delivery and Formula Supplementation With the Intestinal Microbiome of 6-Week-Old Infants. JAMA pediatrics. 2016;170(3):212-219.
  • Referans28 Karatay E. Mikrobiyota, prebiyotik ve probiyotikler. Anatolian Curr Med J. 2019; 1(3): 68-71.
  • Referans29 Guarner F, Khan AG, Garisch J, Eliakim R, Gangl A, Thomson A, et al. World Gastroenterology Organisation Global Guidelines: probiotics and prebiotics October. J Clin Gastroenterol. 2012;46(6):468-481.
  • Referans30 Joint FAO/WHO Working Group: Guidelines for the evaluation of probiotics in food: report of a joint FAO/WHO working group on drafting guidelines for the evaluation of probiotics in food. London, ON, Canada. 2002.
  • Referans31 Tolga-Müftüoğlu MA, Civak T, Çetin S, Civak L, Güngör O, Sağlam A. Effects of probiotics on experimental short-bowel syndrome. The American Journal of Surgery. 2011;202(4): 461-468.
  • Referans32 Kanamori Y, Sugiyama M, Hashizume K, Yuki N, Morotomi M, Tanaka R. Experience of longterm synbiotic therapy in seven short bowel patients with refractory enterocolitis. J Pediatr Surg. 2004;39(11):1686-1692.
  • Referans33 Kanamori Y, Hashizume K, Sugiyama M, Morotomi M, Yuki N. Combination therapy with Bifidobacterium breve, Lactobacillus casei, and galactooligosaccharides dramatically improved the intestinal function in a girl with short bowel syndrome: a novel synbiotics therapy for intestinal failure. Dig Dis Sci. 2001;46(9):2010-2016.
  • Referans34 Uchida K, Takahashi T, Inoue M, Morotomi M, Otake K, Nakazawa M, et al. Immunonutritional effects during synbiotics therapy in pediatric patients with short bowel syndrome’’. Pediatr Surg Int. 2007;23(3):243-248.
  • Referans35 Goulet O, Joly F. Intestinal microbiota in short bowel syndrome. Gastroenterol Clin Biol. 2010;34:37-43.
There are 35 citations in total.

Details

Primary Language Turkish
Subjects ​Internal Diseases
Journal Section Review Article
Authors

Eftal Geçgil Demir 0000-0001-7154-7714

Fatma Bengü Kuyulu Bozdoğan

Aybala Tazeoğlu

Publication Date October 30, 2021
Published in Issue Year 2021 Volume: 6 Issue: 3

Cite

APA Geçgil Demir, E., Kuyulu Bozdoğan, F. B., & Tazeoğlu, A. (2021). Kısa Barsak Sendromunda Mikrobiyota ve Pre-Probiyotikler. Journal of Immunology and Clinical Microbiology, 6(3), 166-175.
AMA Geçgil Demir E, Kuyulu Bozdoğan FB, Tazeoğlu A. Kısa Barsak Sendromunda Mikrobiyota ve Pre-Probiyotikler. J Immunol Clin Microbiol. October 2021;6(3):166-175.
Chicago Geçgil Demir, Eftal, Fatma Bengü Kuyulu Bozdoğan, and Aybala Tazeoğlu. “Kısa Barsak Sendromunda Mikrobiyota Ve Pre-Probiyotikler”. Journal of Immunology and Clinical Microbiology 6, no. 3 (October 2021): 166-75.
EndNote Geçgil Demir E, Kuyulu Bozdoğan FB, Tazeoğlu A (October 1, 2021) Kısa Barsak Sendromunda Mikrobiyota ve Pre-Probiyotikler. Journal of Immunology and Clinical Microbiology 6 3 166–175.
IEEE E. Geçgil Demir, F. B. Kuyulu Bozdoğan, and A. Tazeoğlu, “Kısa Barsak Sendromunda Mikrobiyota ve Pre-Probiyotikler”, J Immunol Clin Microbiol, vol. 6, no. 3, pp. 166–175, 2021.
ISNAD Geçgil Demir, Eftal et al. “Kısa Barsak Sendromunda Mikrobiyota Ve Pre-Probiyotikler”. Journal of Immunology and Clinical Microbiology 6/3 (October 2021), 166-175.
JAMA Geçgil Demir E, Kuyulu Bozdoğan FB, Tazeoğlu A. Kısa Barsak Sendromunda Mikrobiyota ve Pre-Probiyotikler. J Immunol Clin Microbiol. 2021;6:166–175.
MLA Geçgil Demir, Eftal et al. “Kısa Barsak Sendromunda Mikrobiyota Ve Pre-Probiyotikler”. Journal of Immunology and Clinical Microbiology, vol. 6, no. 3, 2021, pp. 166-75.
Vancouver Geçgil Demir E, Kuyulu Bozdoğan FB, Tazeoğlu A. Kısa Barsak Sendromunda Mikrobiyota ve Pre-Probiyotikler. J Immunol Clin Microbiol. 2021;6(3):166-75.

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