Probiotics Can Alleviate GI Problems Of Down’s Syndrome Patients


gastro-intestinalHuman beings have 23 pairs of chromosomes. However, in case of chromosomal aberrations, there is an alteration in the number of these chromosomes. In Down’s syndrome (DS), there is a 21 trisomy, which means the total number of chromosomes is 47. DS is detected by a method called chromosomal karyotype. There is an increase in the chances of DS with increased maternal age. This is probably because with advanced age, the likelihood of one of her chromosome having a copy of chromosome 21 is high. Patients with DS are often presented with severe mental retardation and have flat facial profile. Moreover there is an increased chance of developing congenital heart diseases, leukemia upper respiratory tract infection and kidney failures. Of special significance are the gastro-intestinal (GI) disorders that accompany DS. Deudenal atresia, pancreatic insufficiency, imperforated anus and enlarged colon are some of the complications that are associated with DS.

Treatment of DS- Is it possible?

Though there is no medical cure for DS, we can battle the many manifestations of this disease. Early diagnosis of this disease can help the patient fight the different medical problem that may accompany the condition including congenitalheart disease and leukemia. Moreover parental support and patience is crucial for such patients. Scope of probiotics in the management of DS has now been defined. Though the many GI disorders that are often seen in such patients are not exclusive to DS, it is severe because all these symptoms occur together.

Probiotics in DS- A Promise To Keep

Our GIT is a long hollow tube that begins with mouth and ends in anus. It is interesting to note that different probiotics are present in different locations throughout this organ system. These good bacteria assist in the digestion, which is one of its many functions. When these probiotics malfunction, disease sets in the body. In DS, the cells of the GIT are damaged due to improper processing of the food, get inflamed and lead to the triggering of the immunological reactions. This paves way to the immune cells which then enter into the GIT. In the process lot of gas is also produced that causes extreme distress in the patients. Due to the immune reaction, there is the clamping of the cells providing huge gaps for the percolation of the bad bacteria into the GIT. As the sites of adherence are reduced, the probiotics also get wiped out affecting digestion. Good bacteria also assist in the bowel movement, and the lack of it expands the colon. High dose of probiotics therefore is needed to ensure that the GIT is repaired.

  • Pancreatic Insufficiency: One of the hallmark symptoms of DS is pancreatic insufficiency, which needs immediate action. If huge amounts of probiotics are administered in such patients, there is a restoration of the enzymes in pancreas (where glucose metabolism takes place). As the probiotics grow, they produce many products and enzymes that restore health of the gut. It is beneficial to give a mixture of probiotics to patients with pancreatic insufficiency. According toa study published in World J Gastroenterol.(2009), the authors argue that the use of probiotics may also attenuate the inflammation seen in patients with pancreatic insufficiency.
  • Colon: Colon cells assist in the absorption of water and salts in the body, thereby assisting in the movement of the bowel from anus. In patients with DS, there is also a troubled colon, hence high doses of strains of Bifidobacterium helps to prevent the complications related to colon. These probiotics produce butyrate that is an important food for the colonocytes (colon cells).
  • Duodenal Atresia: In patients with DS, duodenum is either closed or absent, which is technically called duodenal atresia. High doses of Lactobacillus acidophilus and Lactobacillus rhamnosus can be used as a treatment modality
  • Celiac Disease: This is a common manifestation of DS and needs to be managed. In patients with DS, administration of Glucosamine HCl(GHCl) has shown very good efficacy. GHCl is a prebiotic, which promotes the growth of bifidobacteria, which is the resident of colon. According to a 2013 study published in J Clin Gastroenterol., Bifidobacterium infantis has shown to alleviate the symptoms of the disease, bringing relief to the patient. Further this study stated that though probiotic appear to show some immunological changes, it did not modify the abnormal intestinal permeability.

Summing up, though Down Syndrome cannot be cured, the gastro-intestinal manifestations can be managed well by the use of probiotics.

References


1. Pezzilli R. Chronic pancreatitis: maldigestion, intestinal ecology and intestinal inflammation. World J Gastroenterol. 2009 Apr 14;15(14):1673-6.
2. Smecuol E, Hwang HJ, Sugai E, Corso L, Cherñavsky AC, Bellavite FP. Exploratory, randomized, double-blind, placebo-controlled study on the effects of Bifidobacterium infantis natren life start strain super strain in active celiac disease. J Clin Gastroenterol. 2013 Feb;47(2):139-47.
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