On the features of the correction of intestinal dysbiosis in chronic pancreatitis (literature review)

Abstract

The aim of the literature review was to analyze the modern approach to the correction of intestinal dysbiosis in patients with chronic pancreatitis, including the one combined with metabolic syndrome, coronary heart disease, and especially bacterial overgrowth syndrome.
 Particular attention is paid to the peculiarities of drug therapy and the pharmacotherapeutic mechanisms of influence of various groups of pro-, pre- and synbiotics on the condition of the intestine, immunity, and inflammatory processes. The requirements for an adequate selection of drugs are considered. They must be useful for the human body; should not cause side effects during long-term use, but should have a minimal ability to translocate from the lumen of the intestine to internal organs; must be resistant to low pH values, the influence of bile acids, and antimicrobial substances produced by endogenous microflora; adhere well to the epithelium of mucous membranes; have a high rate of growth and reproduction in the intestines; and must have a clear physiological, biochemical, and genetic marking. Efficacy criteria are the probiotic effect proven in double-blind placebo-controlled studies. These requirements are met by B. bifidum, Lactobacillus acidophilus, Lactobacillus GG, Lactobacillus fermentum, Strepto(Entero)coccus faecium, Saccharomyces boulardii, which are components of many probiotics.
 Interesting information is provided about the probiotic with level A evidence, called Enterol by the WHO experts: it is a self-eliminating probiotic, each capsule of which contains 250 mg of lyophilized cells of a selective strain of medicinal yeast, Saccharomyces boulardii. It is crucial that the drug prevents the growth of a wide range of pathogenic microorganisms and fungi and promotes their elimination (Clostridium difficile, Clostridium pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, Candida crusei, Candida pseudotropical, Candida albicans, Salmonella typhi, Salmonella enteriditis, Escherichia coli, Shigella dysenteriae, Shigella flexneri, Klebsiella, Proteus, Vibrio cholera, Enthamoeba hystolitica, Enterovirus, Rotavirus).