Olveira Gabriel, González-Molero Inmaculada
UGC Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, España; CIBERDEM, Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CB07/08/0019), Instituto de Salud Carlos III, Madrid, España.
UGC Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, España; CIBERDEM, Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CB07/08/0019), Instituto de Salud Carlos III, Madrid, España.
Endocrinol Nutr. 2016 Nov;63(9):482-494. doi: 10.1016/j.endonu.2016.07.006. Epub 2016 Sep 12.
The concept of prebiotics, probiotics, and symbiotics and their use in different situations of daily clinical practice related to clinical nutrition is reviewed, as well as their role in the treatment/prevention of diarrhea (acute, induced by antibiotics, secondary to radiotherapy), inflammatory bowel disease (ulcerative colitis and pouchitis), in colonic health (constipation, irritable bowel), in liver disease (steatosis and minimum encephalopathy), and in intensive care, surgical, and liver transplantation. While their effectiveness for preventing antibiotic-induced diarrhea and pouchitis in ulcerative colitis appears to be shown, additional studies are needed to establish recommendations in most clinical settings. The risk of infection associated to use of probiotics is relatively low; however, there are selected groups of patients in whom they should be used with caution (as jejunum infusion).
本文综述了益生元、益生菌和合生元的概念，以及它们在与临床营养相关的日常临床实践不同情况下的应用，及其在治疗/预防腹泻（急性腹泻、抗生素诱发的腹泻、放疗继发的腹泻）、炎症性肠病（溃疡性结肠炎和袋炎）、结肠健康（便秘、肠易激综合征）、肝病（脂肪变性和轻微肝性脑病）以及重症监护、外科手术和肝移植中的作用。虽然益生菌预防抗生素诱发的腹泻和溃疡性结肠炎袋炎的有效性似乎已得到证实，但在大多数临床环境中仍需要更多研究来制定相关建议。使用益生菌相关的感染风险相对较低；然而，有特定患者群体应谨慎使用益生菌（如空肠输注）。
