Wirksamkeit eines Lactobazillen-Lyophilisats bei funktioneller Diarrhoe: eine Pilotstudie

Zusammenfassung

Hintergrund und Fragestellung: Die Rolle des intestinalen Milieus bei der Symptomentstehung bei funktionellen Darmkrankheiten (reine Stuhlgangsveränderungen wie z. B. bei der funktionellen Diarrhoe oder begleitende Schmerzen/Blähungen beim Reizdarmtyp) begründet probiotische Therapieansätze. Ziel dieser Pilotstudie war es, Effekte eines Lyophilisats aus abgetöteten Lactobazillen bei Patienten mit chronischer FD zu prüfen.

Methodik: 22 Patienten mit funktionellen Diarrhoe (davon 12 mit Reizdarmsyndrom) wurden nach einwöchiger Basisphase für 4 Wochen mit 2 Kapseln Lacteol pro Tag behandelt. In einem Tagebuch wurden Stuhlfrequenz und Stuhlkonsistenz anhand der „Bristol Stool Form Scale“ (BSFS), imperativer Stuhldrang, Schmerzen und Blähungen täglich, allgemeines Therapieansprechen am Ende jeder Woche dokumentiert.

Ergebnisse: Stuhlfrequenz/Tag und Anzahl der Tage mit imperativem Stuhldrang/Woche waren bereits in Woche 1 (–0,6 ± 0,2/Tag; p = 0,005; bzw. –1,3 ± 0,3 Tage; p = 0,001) sowie anhaltend bis Woche 4 (–0,6 ± 0,2/Tag; p = 0,02; bzw. –1,4 ± 0,5 Tage; p = 0,025) signifikant gesenkt. Nach 4 Wochen berichteten 50 % der Patienten über eine befriedigende Linderung ihrer Beschwerden, die maximale Stuhlkonsistenz war signifikant verbessert (mittlere Differenz der BSFS-Einheit –0,3 ± 0,2; p = 0,04), und 43 % der Patienten hatten eine Stuhlfrequenzabnahme um ≥ 25 %.

Folgerungen: Die Ergebnisse lassen eine klinisch relevante Wirksamkeit des Lactobazillen-Lyophilisats bei einer Untergruppe der Patienten mit funktioneller Diarrhoe vermuten, insbesondere hinsichtlich einer Verbesserung von Stuhlfrequenz, Stuhldrang und Stuhlkonsistenz. Eine Placebo-Komponente konnte nicht ausgeschlossen werden; die Ergebnisse sollten daher in einer größeren, placebokontrollierten Studie geprüft werden.

Abstract

Background and objective: The pathogenic role of the intestinal milieu for symptoms in functional bowel disorders such as functional diarrhea (FD) or associated pain and bloating in the irritable bowel syndrome (IBS) is the rationale for probiotic treatment approaches. It was the aim of this pilot study to test the effects of a lyophilisate from devitalized lactobacilli and their culture medium in patients with chronic FD.

Methods: Following a one-week basal period, 22 patients mit FD (12 with IBS) were treated with Lacteol (2 capsules/day) for 4 weeks. Stool frequency, consistency (assessed by BSFS), urge, pain and bloating were recorded daily using a standardized symptom diary, and global relief was recorded weekly.

Results: Daily stool frequency and number of days with urge were significantly decreased starting in week 1 (-0.6 ± 0.2/day; p = 0.005; and -1.3 ± 0.3 days, respectively; p = 0.001). This effect persisted throughout week 4 (-0.6 ± 0.2/day; p< 0.02; and -1.4 ± 0.5 days, respectively; p = 0.025). After 4 weeks, 50% of patients reported satisfactory symptom relief, including improvement in maximal stool consistency (BSFS: -0.3 ± 0.2; p = 0.04), and 43% of patients recorded a decrease in stool frequency of ≥ 25%.

Conclusion: These findings suggest a clinically relevant efficacy of Lacteol in a subgroup of patients with FD, particularly with regard to stool frequency, urge and stool consistency. As the study design does not allow to exclude that a placebo component might have contributed to these effects, the results should be corroborated in an larger, placebo-controlled trial.

Schlüsselwörter

funktionelle Diarrhoe - lyophilisierte Lactobazillen - Diarrhoe-prädominantes Reizdarmsyndrom - Probiotika

Keywords

functional diarrhoea - freeze-dried lactobacilli - diarrhoea-predominant irritable bowel syndrome - probiotics

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