[The use of bismuth tripotassium dicitrate (De-Nol), a promising line of pathogenetic therapy for irritated bowel syndrome with diarrhea].Klin Med (Mosk). 2008; 86(10):47-52.KM
The aim of the study was to assess the expediency of prescription and efficiency of bismuth tri-potassium di-citrate in different therapeutic schemes for the management of irritable bowel syndrome (IBS) dominated by diarrhea. The open prospective study of de-nol efficacy and safety included 30 patients with this disorder allocated to 2 groups. Patients of the main group (n=20) were given 120 mg of de-nol thrice daily in combination with meteospasmyl (a spasmolytic and antifoaming agent). Control patients (n=10) received aluminium phosphate with meteospasmyl (1 capsule thrice daily). Duration of the treatment was 3 weeks. Therapeutic efficiency was assessed from the dynamics of abdominal pain syndrome, stool frequency, properties of faeces, results of their microscopic and microbiological studies, lactulose breath hydrogen test, rectoromanoscopy with rectal mucosal biopsy, and hepatic biochemical test. Before the study, all patients had abdominal pain, diarrhea, meteorism, altered composition of fecal bacteria, their excessive growth in the intestines, and morphological signs of chronic inflammation. Bacterial activity was recorded in 80 and 40% of the patients of the respective groups. By the end of therapy, abdominal pain was eliminated in 90 and 60%, meteorism was absent in 80 and 40%, diarrhea in 75 and 50%, excessive bacterial growth in small intestine in 75 and 30%, changes of fecal microflora persisted in 20 and 70%, histological signs of active mucosal inflammation remained in 40 and 85.7% of the patients of the main and control groups respectively. It is concluded that all patients with irritable bowel syndrome and diarrhea show altered composition of intestinal microflora, morphological signs of moderate chronic inflammation of intestinal mucosa. Most of them have apparent bacterial activity. Treatment with de-nol and spasmolytics for 3 weeks effectively eliminated clinical manifestations of the disease, restored normal composition of intestinal microflora, normalized faeces properties, and resolved active inflammation.