Servei de Aparell Digestiu, Vall d'Hebron Hospital Universitari, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Grup de Neuro-Inmuno-Gastroenterología, Unitat de Fisiología I Fisiopatología Digestiva, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.
Adv Ther. 2021 May;38(5):2054-2076. doi: 10.1007/s12325-021-01676-z. Epub 2021 Mar 18.
Chronic diarrhea is a frequent presenting symptom, both in primary care medicine and in specialized gastroenterology units. It is estimated that more than 5% of the global population suffers from chronic diarrhea. and that about 40% of these subjects are older than 60 years. The clinician is frequently faced with the need to decide which is the best therapeutic approach for these patients. While the origin of chronic diarrhea is diverse, impairment of intestinal barrier function, dysbiosis. and mucosal micro-inflammation are being increasingly recognized as underlying phenomena characterizing a variety of chronic diarrheal diseases. In addition to current pharmacological therapies, there is growing interest in alternative products such as mucoprotectants, which form a mucoadhesive film over the epithelium to reduce and protect against the development of altered intestinal permeability, dysbiosis, and mucosal micro-inflammation. This manuscript focuses on chronic diarrhea in adults, and we will review recent evidence on the ability of these natural compounds to improve symptoms associated with chronic diarrhea and to exert protective effects for the intestinal barrier.
慢性腹泻是一种常见的症状,无论是在初级保健医学还是在专门的胃肠病学单位都很常见。据估计,全球有超过 5%的人口患有慢性腹泻,其中约 40%的患者年龄大于 60 岁。临床医生经常需要决定哪种治疗方法对这些患者最有效。虽然慢性腹泻的病因多种多样,但越来越多的人认为肠道屏障功能受损、菌群失调和黏膜微炎症是各种慢性腹泻疾病的潜在特征。除了目前的药物治疗外,人们对替代产品(如黏膜保护剂)越来越感兴趣,这些产品在肠上皮形成一层黏附性薄膜,以减少和防止改变的肠道通透性、菌群失调和黏膜微炎症的发展。本文重点讨论成人慢性腹泻,我们将回顾这些天然化合物改善慢性腹泻相关症状和发挥肠道屏障保护作用的最新证据。