Kim Joo Kyung, Cheon Jae Hee
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
J Yeungnam Med Sci. 2023 Jan;40(1):37-48. doi: 10.12701/jyms.2022.00031. Epub 2022 Apr 18.
Commensal bacteria play an important role in the pathogenesis of inflammatory bowel disease (IBD) and probiotics have been used as treatment options. We aimed to explore the current use of probiotics and factors associated with their prescription in patients with IBD.
This cross-sectional study was conducted on a single hospital-based cohort. Patients were eligible if they were ≥18 years old, visited the IBD clinic as an outpatient more than twice during the study period, and had a confirmed diagnosis of IBD. Patients were divided into two groups based on the prescription of probiotics. Clinical assessments were compared between the two groups.
In total, 217 patients were enrolled in this study. In patients with Crohn disease (CD), moderate or severe abdominal pain; prior use of methotrexate (MTX), iron, thiopurines, or biologics; history of IBD-related surgery; and stool frequency were independently associated with the prescription of probiotics. In patients with ulcerative colitis (UC), moderate or severe abdominal pain, hematochezia, stool frequency, and moderate or severe physician global assessment score were independently associated with the prescription of probiotics.
Increased disease activity may be associated with fewer prescriptions of probiotics in patients with IBD. However, physicians prescribed probiotics to control symptoms, such as abdominal pain and increased stool frequency in patients with UC and CD, and hematochezia in patients with UC. Additionally, the use of MTX and iron, and a history of IBD-related surgeries were associated with more frequent probiotic prescriptions in patients with CD.
共生菌在炎症性肠病(IBD)的发病机制中起重要作用,益生菌已被用作治疗选择。我们旨在探讨IBD患者中益生菌的当前使用情况及其处方相关因素。
本横断面研究在一个基于单一医院的队列中进行。符合条件的患者年龄≥18岁,在研究期间作为门诊患者就诊IBD诊所超过两次,且确诊为IBD。根据益生菌处方将患者分为两组。比较两组的临床评估结果。
本研究共纳入217例患者。在克罗恩病(CD)患者中,中度或重度腹痛、既往使用甲氨蝶呤(MTX)、铁剂、硫唑嘌呤或生物制剂、IBD相关手术史以及大便频率与益生菌处方独立相关。在溃疡性结肠炎(UC)患者中,中度或重度腹痛、便血、大便频率以及中度或重度医生整体评估评分与益生菌处方独立相关。
疾病活动度增加可能与IBD患者较少使用益生菌处方有关。然而,医生开具益生菌处方是为了控制症状,如UC和CD患者的腹痛及大便频率增加,以及UC患者的便血。此外,MTX和铁剂的使用以及IBD相关手术史与CD患者更频繁使用益生菌处方有关。