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

:腹泻是肠管喂养的常见和严重并发症。其发病机理涉及抗生素处方,肠道致病菌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。在接受肠管饲喂的患者中,结肠菌群发生了变化,这些变化可能与腹泻的发生有关。因此,作为减少腹泻发生率的方法,已经研究了预防结肠微生物群中的负面变化。益生菌和益生元可能是有效的,因为它们抑制了肠道致病菌定植,刺激了免疫功能并调节了结肠代谢。益生菌的随机对照试验产生了相反的结果,尽管已显示布拉氏酵母能减少接受肠管饲喂的重症监护病房患者腹泻的发生率。益生元低聚果糖已显示可在食用肠溶配方食品的健康受试者中增加粪便双歧杆菌的浓度,尽管尚未在接受肠管饲喂的患者中证实这一发现。此外,还没有临床试验研究仅益生元对腹泻发生率的影响。益生菌和益生元单独或组合使用以预防该患者腹泻的功效值得进一步研究。

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