Efikasi Prebiotik dan Probiotik untuk Dyspepsia Fungsional

Oleh :

dr.Eduward Thendiono, SpPD,FINASIM

Prebiotik dan probiotik telah banyak digunakan dalam tata laksana dyspepsia fungsional.[1] Hal ini karena patofisiologi dyspepsia fungsional diduga berhubungan dengan berbagai faktor, termasuk ketidakseimbangan flora intestinal, perubahan motilitas gastrointestinal, hipersensitivitas viseral, disregulasi aksis gut-brain, gangguan psikologis, inflamasi ringan, dan disfungsi imun.[2-5]

Hingga kini, belum ada tata laksana definitif yang disarankan untuk dyspepsia fungsional. Penggunaan prebiotik dan probiotik untuk tujuan ini pun masih menjadi kontroversi.[1]

Sekilas Mengenai Prebiotik dan Probiotik

Menurut International Scientific Association of Probiotics and Prebiotics (ISAPP), dietary prebiotik didefinisikan sebagai bahan selektif yang akan mengalami fermentasi sehingga menghasilkan perubahan pada komposisi dan atau aktivitas dari mikrobiota gastrointestinal yang memberi manfaat pada kesehatan host.[1,6]

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Referensi

1. Zhang J, Wu HM, Wang X, Xie J, Li X, Ma J, Wang F, Tang X. Efficacy of prebiotics and probiotics for functional dyspepsia: A systematic review and meta-analysis. Medicine 2020;99:7(e19107).
2. Tziatzios G, Giamarellosbourboulis EJ, Papanikolaou IS, et al. Is small intestinal bacterial overgrowth involved in the pathogenesis of functional dyspepsia? Med Hypotheses 2017;106:26–32
3. Shimura S, Ishimura N, Mikami H, et al. Small intestinal bacterial overgrowth in patients with refractory functional gastrointestinal disorders. J Neurogastroenterol Motil 2016;22:60–8.
4. Hadizadeh F, Bonfiglio F, Belheouane M, et al. Faecal microbiota composition associates with abdominal pain in the general population. Gut 2017;Epub 2017 Aug 1. PubMed PMID: 28765473.
5. Vanheel H, Farré R. Changes in gastrointestinal tract function and structure in functional dyspepsia. Nat Rev Gastroenterol Hepatol 2013;10:142–9.
6. Davani-Davari D, Negahdaripour M, Karimzadeh I, Seifan M, Mohkam M, Masoumi SJ, Berenjian A, Ghasemi Y. Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods. 2019;8(3):92. doi: 10.3390/foods8030092.
7. Hill, C. et al. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol 11, 506–514 (2014); published online 10 June 2014; doi:10.1038/nrgastro.2014.66
8. Patel RM, Myers LS, Kurundkar AR, et al. Probiotic bacteria induce maturation of intestinal claudin 3 expression and barrier function. Am J Pathol 2012;180:626–35.
9. Igarashi M, Nakae H, Matsuoka T, et al. Alteration in the gastric microbiota and its restoration by probiotics in patients with functional dyspepsia. BMJ Open Gastroenterology 2017;4 :e000144.doi: 10.1136/bmjgast-2017-000144
10. Sarowska J et al. The therapeutic effect of probiotic bacteria on gastrointestinal disease. Adv Clin Exp Med.2013;22(5):759-66.
11. Chey WD, Lacy BE, Cash BD, Epstein M, Shah SM. Randomized Controlled Trial to Assess the Efficacy & Safety of Caraway Oil/L-Menthol Plus Usual Care Polypharmacy vs. Placebo Plus Usual Care Polypharmacy for Functional Dyspepsia. Gastroenterology, 152(5), S306. doi:10.1016/s0016-5085(17)31313-6