Diarrhoea is a common and serious complication of enteral tube feeding. Its pathogenesis involves antibiotic prescription, enteropathogenic colonization and abnormal colonic responses, all of which involve an interaction with the colonic microbiota. Alterations in the colonic microbiota have been identified in patients receiving enteral tube feeding and these changes may be associated with the incidence of diarrhoea. Preventing negative alterations in the colonic microbiota has therefore been investigated as a method of reducing the incidence of diarrhoea. Probiotics and prebiotics may be effective because of their suppression of enteropathogenic colonization, stimulation of immune function and modulation of colonic metabolism. Randomized controlled trials of probiotics have produced contrasting results, although Saccharomyces boulardii has been shown to reduce the incidence of diarrhoea in patients in the intensive care unit receiving enteral tube feeding. Prebiotic fructo-oligosaccharides have been shown to increase the concentration of faecal bifidobacteria in healthy subjects consuming enteral formula, although this finding has not yet been confirmed in patients receiving enteral tube feeding. Furthermore, there are no clinical trials investigating the effect of a prebiotic alone on the incidence of diarrhoea. Further trials of the efficacy of probiotics and prebiotics, alone and in combination, in preventing diarrhoea in this patient group are warranted.

译文

腹泻是肠内管喂养的常见且严重的并发症。其发病机制涉及抗生素处方,肠致病性定植和异常结肠反应,所有这些都涉及与结肠微生物群的相互作用。在接受肠管喂养的患者中已经发现了结肠微生物群的变化,这些变化可能与腹泻的发生率有关。因此,已研究了防止结肠微生物群发生负面变化的方法,以减少腹泻的发生率。益生菌和益生元可能是有效的,因为它们抑制肠道致病性定植,刺激免疫功能和调节结肠代谢。益生菌的随机对照试验产生了相反的结果,尽管已证明布拉氏酵母可以减少重症监护病房接受肠内管喂养的患者的腹泻发生率。在食用肠内配方的健康受试者中,益生元低聚果糖已被证明可以增加粪便双歧杆菌的浓度,尽管这一发现尚未在接受肠管喂养的患者中得到证实。此外,尚无临床试验研究单独使用益生元对腹泻发生率的影响。需要进一步试验益生菌和益生元单独或联合使用预防该患者组腹泻的功效。

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