The Role of Purported Mucoprotectants in Dealing with Irritable Bowel Syndrome, Functional Diarrhea, and Other Chronic Diarrheal Disorders in Adults

Alonso-Cotoner, Carmen; Abril-Gil, Mar; Albert-Bayo, Mercé; Mall, John-P Ganda; Expósito, Elba; González‐Castro, Ana M; Lobo, Beatriz; Santos, Javier

doi:10.1007/s12325-021-01676-z

Cited by 12 publications

(12 citation statements)

References 134 publications

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“…Thus, strengthening the glycocalyx could be critical in conditions characterised by increased gut permeability and low-grade mucosal inflammation. There could be a potential for future nutritional interventions in rescuing glycocalyx integrity or complementing it by using, for example, mucoprotectants, milk oligosaccharides, or non-digestible carbohydrates [77][78][79].…”

Section: Discussionmentioning

confidence: 99%

Mucosal Plasma Cell Activation and Proximity to Nerve Fibres Are Associated with Glycocalyx Reduction in Diarrhoea-Predominant Irritable Bowel Syndrome: Jejunal Barrier Alterations Underlying Clinical Manifestations

Pardo-Camacho

Mall

Martínez

et al. 2022

Cells

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Irritable bowel syndrome (IBS) is a disorder of brain-gut interaction characterised by abdominal pain and changes in bowel habits. In the diarrhoea subtype (IBS-D), altered epithelial barrier and mucosal immune activation are associated with clinical manifestations. We aimed to further evaluate plasma cells and epithelial integrity to gain understanding of IBS-D pathophysiology. One mucosal jejunal biopsy and one stool sample were obtained from healthy controls and IBS-D patients. Gastrointestinal symptoms, stress, and depression scores were recorded. In the jejunal mucosa, RNAseq and gene set enrichment analyses were performed. A morphometric analysis by electron microscopy quantified plasma cell activation and proximity to enteric nerves and glycocalyx thickness. Immunoglobulins concentration was assessed in the stool. IBS-D patients showed differential expression of humoral pathways compared to controls. Activation and proximity of plasma cells to nerves and IgG concentration were also higher in IBS-D. Glycocalyx thickness was lower in IBS-D compared to controls, and this reduction correlated with plasma cell activation, proximity to nerves, and clinical symptoms. These results support humoral activity and loss of epithelial integrity as important contributors to gut dysfunction and clinical manifestations in IBS-D. Additional studies are needed to identify the triggers of these alterations to better define IBS-D pathophysiology.

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Section: Discussionmentioning

confidence: 99%

Mucosal Plasma Cell Activation and Proximity to Nerve Fibres Are Associated with Glycocalyx Reduction in Diarrhoea-Predominant Irritable Bowel Syndrome: Jejunal Barrier Alterations Underlying Clinical Manifestations

Pardo-Camacho

Mall

Martínez

et al. 2022

Cells

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“…The USA and Singapore have recommended not using certain bentonite clays, or restricted the indication of Smecta ® to infants ≥2 years old and adults, while recommending against its use during pregnancy [74,75]. Smectite (also called dioctahedral smectite, diosmectite, bentonite, or montmorillonite) is an over-thecounter medication often recommended in Eastern Europe, France, and China for adults and children with acute diarrhea [76]. Assessing the efficacy of Medilac-S as an adjuvant to non-clay-type intestinal adsorbents could be of interest.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Medilac-S as an Adjuvant to Conventional Irritable Bowel Syndrome Treatments: A Systematic Review with Meta-Analysis

Tremblay,

Xu,

Colee

et al. 2023

Gastroenterology Insights

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Numerous clinical studies published in the Chinese language support the use of Medilac-S (Bacillus subtilis R0179 and Enterococcus faecium R0026; non-commercial name IBacilluS+) as an adjuvant in various indications, including ulcerative colitis, irritable bowel syndrome, acute gastritis, and Helicobacter pylori therapy. This systematic review with a meta-analysis was conducted to summarize clinical studies evaluating the efficacy of this probiotic formulation as an adjuvant to conventional IBS medications. The systematic literature searches in six international and Chinese databases identified 37 eligible studies, of which 33 reported the efficacy of Medilac-S adjunctive therapy using a standardized categorical scale. These 33 studies were included in the meta-analysis using a random-effect model with a stratification by IBS subtype. Overall, Medilac-S significantly improved the efficacy of conventional IBS treatment (RR = 1.21; 95% CI: 1.17–1.25; and p < 0.0001) with an average probability of treatment effectiveness being 21% higher with the probiotic adjuvant, regardless of the subtype. Adverse events, reported in 78% of the trials, were described as mild-to-moderate and self-resolving, with a similar incidence in the probiotic adjuvant (6.2%; n = 1347) and control (5.9%; n = 1331) groups. The results of this meta-analysis strengthen the conclusions that Medilac-S is a safe and effective adjuvant to a variety of conventional treatments in IBS patients.

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“…. ) with the ability of enhancing the intestinal barrier by creating a film-forming barrier over the intestinal mucosa (Figure 3), helping to reduce the effect of pathogens and to improve the function of the intestinal barrier (378). These compounds work intraluminally to modify enteric contents and may represent an alternative or complementary therapy for dealing with acute and chronic diarrheal disorders (379,380).…”

Section: Mucoprotectorsmentioning

confidence: 99%

Present and Future Therapeutic Approaches to Barrier Dysfunction

et al. 2021

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There is converging and increasing evidence, but also uncertainty, for the role of abnormal intestinal epithelial barrier function in the origin and development of a growing number of human gastrointestinal and extraintestinal inflammatory disorders, and their related complaints. Despite a vast literature addressing factors and mechanisms underlying changes in intestinal permeability in humans, and its connection to the appearance and severity of clinical symptoms, the ultimate link remains to be established in many cases. Accordingly, there are no directives or clinical guidelines related to the therapeutic management of intestinal permeability disorders that allow health professionals involved in the management of these patients to carry out a consensus treatment based on clinical evidence. Instead, there are multiple pseudoscientific approaches and commercial propaganda scattered on the internet that confuse those affected and health professionals and that often lack scientific rigor. Therefore, in this review we aim to shed light on the different therapeutic options, which include, among others, dietary management, nutraceuticals and medical devices, microbiota and drugs, and epigenetic and exosomes-manipulation, through an objective evaluation of the scientific publications in this field. Advances in the knowledge and management of intestinal permeability will sure enable better options of dealing with this group of common disorders to enhance quality of life of those affected.

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The Role of Purported Mucoprotectants in Dealing with Irritable Bowel Syndrome, Functional Diarrhea, and Other Chronic Diarrheal Disorders in Adults

Abstract: 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

Cited by 12 publications

References 134 publications

Mucosal Plasma Cell Activation and Proximity to Nerve Fibres Are Associated with Glycocalyx Reduction in Diarrhoea-Predominant Irritable Bowel Syndrome: Jejunal Barrier Alterations Underlying Clinical Manifestations

Mucosal Plasma Cell Activation and Proximity to Nerve Fibres Are Associated with Glycocalyx Reduction in Diarrhoea-Predominant Irritable Bowel Syndrome: Jejunal Barrier Alterations Underlying Clinical Manifestations

Effectiveness of Medilac-S as an Adjuvant to Conventional Irritable Bowel Syndrome Treatments: A Systematic Review with Meta-Analysis

Present and Future Therapeutic Approaches to Barrier Dysfunction

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