Erratum: The Effect of Inactivated <i>Lactobacillus</i> LB Fermented Culture Medium on Symptom Severity: Observational Investigation in 297 Patients with Diarrhea-Predominant Irritable Bowel Syndrome

<i>Introduction:</i> Little is known about the intensity of symptoms of diarrhea-predominant IBS (IBS-D) or the consequences of the disease on patients’ health-related quality of life (HRQOL). This observational investigation assessed the symptoms (abdominal pain, bloating, number of stools per day, and stool consistency), impact on HRQOL, and consequence on anal continence in 297 patients with IBS-D before and after 1 month of probiotic treatment with Lacteol (inactivated <i>Lactobacillus </i>LB plus fermented culture medium). <i>Methods:</i> Functional assessment using a standardized visual analogue scale in order to quantify abdominal pain, bloating, and quality of life before and after 1 month of treatment with 2 capsules/day of Lacteol. The number of symptomatic days per week, number of stools, consistency of stools, secondary fecal incontinence rate, and potential trigger effect of food were quantified. A χ² test was used to compare qualitative data and the variance of quantitative criteria was analyzed. <i>Results:</i> The pain score decreased from 4.46 ± 0.15 on a scale of 0–10 before treatment to 2.8 ± 0.14 after treatment (p &lt; 0.0001). Bloating decreased from 4.49 ± 0.18 to 2.5 ± 0.15 on a scale of 0–10 (p &lt; 0.0001). The HRQOL score, which is inversely correlated with quality of life, decreased from 5.99 ± 0.14 to 3.92 ± 0.16 (p &lt; 0.0001). In this cohort study, the fecal incontinence rate secondary to diarrhea was clearly higher than that of the general population: 18% versus a prevalence of 9–10%, according to different studies. The mean number of stools per week decreased from 17.59 to 12.83 after treatment (p &lt; 0.0001). Before treatment, 54% of patients had watery stools and 46% had smooth stools; at the end of treatment, only 18.5% of patients still had watery stools, and 34% had normal stools. 52% of patients attributed their symptoms to their diet: 34% to vegetables, 29% to fruit, 15% to milk, 15% to fat, 6% to peppers and spices, and 4% to sugar. <i>Conclusion:</i> This observational investigation shed new light on patients with IBS-D, the HRQOL of which is altered by a fecal incontinence rate twice as high as that of the general population. Correlation with diet is confirmed by 1 out of 2 patients reporting poor tolerance of fiber and dairy products. Nutritional management should thus be part of these patients’ treatment. Inactivated <i>Lactobacillus</i> LB plus fermented culture medium is a probiotic drug that has been used by physicians for a long time to treat patients with diarrhea. Strongly concentrated, it has no side effects and seems to help these patients. Due to a strong placebo effect in patients with this pathology, however, a controlled study is necessary to confirm this result.引言：目前学界对腹泻型肠易激综合征（diarrhea-predominant IBS, IBS-D）的症状严重程度，以及该疾病对患者健康相关生活质量（health-related quality of life, HRQOL）的影响尚缺乏深入认知。本项观察性研究纳入297例IBS-D患者，评估了其症状（腹痛、腹胀、每日排便次数及粪便性状）、对HRQOL的影响，以及接受为期1个月的Lacteol（由灭活乳酸杆菌LB（inactivated Lactobacillus LB）与发酵培养基组成的益生菌制剂）治疗前后的肛门控便能力变化。 方法：采用标准化视觉模拟评分法开展功能评估，以量化每日服用2粒Lacteol的患者在治疗前后的腹痛、腹胀程度及生活质量。研究同时量化了每周症状发作天数、排便次数、粪便性状、继发性粪便失禁发生率，以及食物的潜在诱发作用。采用卡方（χ²）检验对定性数据进行比较，并分析定量指标的方差。 结果：疼痛评分在0~10分量表中从治疗前的4.46±0.15降至治疗后的2.8±0.14（p<0.0001）；腹胀评分同样从4.49±0.18降至2.5±0.15（p<0.0001）。与生活质量呈负相关的HRQOL评分从5.99±0.14降至3.92±0.16（p<0.0001）。本项队列研究中，腹泻继发的粪便失禁发生率显著高于普通人群：据不同研究报道，普通人群粪便失禁患病率为9%~10%，而本研究中该比例达18%。治疗后，患者每周平均排便次数从17.59降至12.83（p<0.0001）。治疗前，54%的患者存在水样便，46%为软便；治疗结束后，仅18.5%的患者仍存在水样便，34%的患者粪便性状恢复正常。52%的患者将症状归因于饮食：其中34%归因于蔬菜，29%归因于水果，15%归因于牛奶，15%归因于脂肪类食物，6%归因于辣椒及香料，4%归因于糖类。 结论：本项观察性研究为IBS-D患者群体带来了新的学术见解：该群体的健康相关生活质量因粪便失禁发生率达普通人群2倍而受损。每2名患者中即有1名报告膳食纤维及乳制品耐受性不佳，证实了症状与饮食的相关性。因此，营养管理应纳入此类患者的治疗方案。灭活乳酸杆菌LB加发酵培养基是一种益生菌制剂，临床医师长期以来将其用于治疗腹泻患者。该制剂浓度高且无不良反应，似乎可改善此类患者的症状。但由于该类疾病患者存在较强的安慰剂效应，仍需开展对照研究以验证本研究结果。