title: A stand-alone synbiotic treatment for the prevention of D-lactic acidosis in short bowel syndrome.
abstract: Synbiotics are combinations of probiotics and prebiotics that have recently been used in the context of various gastrointestinal diseases, including infectious enteritis, inflammatory bowel disease, and bowel obstruction. We encountered a patient with recurrent D-lactic acidosis who was treated successfully for long periods using synbiotics. The patient was diagnosed as having short bowel syndrome and had recurrent episodes of neurologic dysfunction due to D-lactic acidosis. In addition to fasting, the patient had been treated with antibiotics to eliminate D-lactate-producing bacteria. After the failure of antibiotic treatment, a stand-alone synbiotic treatment was started, specifically Bifidobacterium breve Yakult and Lactobacillus casei Shirota as probiotics, and galacto-oligosaccharide as a prebiotic. Serum D-lactate levels declined, and the patient has been recurrence-free for 3 years without dietary restriction. Synbiotics allowed the reduction in colonic absorption of D-lactate by both prevention of D-lactate-producing bacterial overgrowth and stimulation of intestinal motility, leading to remission of D-lactate acidosis.
authors.affiliation: Organ Transplantation Gastroenterological and Hepatobiliary Surgery, Faculty of Medicine, Division of Clinical Medicine, Graduate School of the University of Tsukuba, Tsukuba, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Takahashi
authors.forename: Hideo
authors.initials: H
authors.lastname: Terashima
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kohno
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Ohkohchi
mesh_terms: D000140:Acidosis, Lactic / Q000209:etiology / Q000628:therapy*; D000328:Adult; D001644:Bifidobacterium; D006801:Humans; D007780:Lacticaseibacillus casei; D008297:Male; D012778:Short Bowel Syndrome / Q000150:complications*; D058616:Synbiotics