The value and advanced features of pre- and metabiotics in the treatment of symptomatic uncomplicated diverticular colon disease

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Abstract

Background. Symptomatic uncomplicated diverticular colon disease (SNDCD) is a common condition that significantly affects the quality of life of patients. One of the main therapeutic targets in SNDCD is the microbiota.

Aim. To evaluate the efficacy and safety of microbiocenosis-based therapy (prebiotic Mucofalk + metabiotic Zakofalk) in relieving symptoms of SNDCD and maintaining asymptomatic remission.

Materials and methods. The study included 60 patients with clinically apparent SNDCD. For 3 months, they were treated with Mukofalk and Zakofalk and then followed up for another 3 months. Parameters such as treatment efficacy, satisfaction and compliance were evaluated, as well as change of short-chain fatty acids in feces using gas-liquid chromatography was measured.

Results. A statistically significant improvement of all assessed symptoms (abdominal pain, constipation, diarrhea, flatulence, tenesmus) was observed after 3 months of therapy. Relapse of abdominal pain and bowel movement disorders (constipation) after completion of therapy were observed in 7 (11.6%) subjects. The compliance study showed that more than 80% of the required number of sachets/tablets was taken by more than 80% of patients. At the end of follow-up, 49 (81.7%) patients rated their outcomes as "excellent" and 11 (18.3%) as "good". During treatment, there was a significant tendency to increase the absolute content of butyric acid in feces.

Conclusion. Microbiocenosis-based therapy with the prebiotic Mukofalk and the metabiotic Zakofalk is effective and safe for treating SNDCD and preventing the recurrence of symptoms and disease complications. The therapy is associated with excellent and good satisfaction and a high compliance to treatment. Therapy with Mukofalk and Zakofalk resulted in the normalization of the intestinal microbiota.

About the authors

Mikhail B. Patsenko

Kirov Military Medical Academy – the branch in Moscow

Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0001-8391-1691

д-р мед. наук, доц., нач. каф. терапии неотложных состояний

Russian Federation, Moscow

Maria D. Ardatskaya

Central State Medical Academy of the President of the Russian Federation

Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0001-8150-307X

д-р мед. наук, проф. каф. гастроэнтерологии 

Russian Federation, Moscow

Aleksandr A. Anuchkin

Kirov Military Medical Academy – the branch in Moscow

Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0002-8469-7196

канд. мед. наук, доц., зам. нач. каф. терапии неотложных состояний 

Russian Federation, Moscow

Ludmila I. Butorova

Kirov Military Medical Academy – the branch in Moscow

Author for correspondence.
Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0003-4689-2844

канд. мед. наук, преп. каф. терапии неотложных состояний

Russian Federation, Moscow

Ivan N. Gaivoronsky

Kirov Military Medical Academy – the branch in Moscow

Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0002-7232-6419

канд. мед. наук, доц. каф. терапии неотложных состояний

Russian Federation, Moscow

Larisa A. Konkova

Kirov Military Medical Academy – the branch in Moscow

Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0002-0301-8180

канд. мед. наук, доц., доц. каф. терапии неотложных состояний

Russian Federation, Moscow

Vladimir I. Levin

Kirov Military Medical Academy – the branch in Moscow

Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0002-2089-2961

преп. каф. терапии неотложных состояний 

Russian Federation, Moscow

Nelli R. Nugaeva

Kirov Military Medical Academy – the branch in Moscow

Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0002-1938-7829

канд. мед. наук, преп. каф. терапии неотложных состояний

Russian Federation, Moscow

Alexandr I. Pavlov

National Medical Research Center of High Medical Technologies – Vishnevsky Central Military Clinical Hospital; Russian Biotechnological University

Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0003-1836-7946

д-р мед. наук, проф., зам. нач. ФГБУ «НМИЦ ВМТ ЦВКГ им. А.А. Вишневского» по медицинской части, проф. каф. терапии с курсом фармакологии и фармации ФГБОУ ВО «РОСБИОТЕХ»

Russian Federation, Moscow; Moscow

Tatiana B. Topchiy

Central State Medical Academy of the President of the Russian Federation

Email: ludmilabutorova@mail.ru
ORCID iD: 0000-0003-4491-881X

канд. мед. наук, доц., доц. каф. гастроэнтерологии

Russian Federation, Moscow

Oksana Yu. Patsenko

Branch No. 1 of National Medical Research Center of High Medical Technologies – Vishnevsky Central Military Clinical Hospital

Email: ludmilabutorova@mail.ru

подполковник медицинской службы, начальник 19-го гастроэнтерологического отд-ния 

Russian Federation, Moscow

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2. Fig. 1. Physiological effects of Mucofalk in diverticular disease [4].

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