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DOI: 10.1055/a-2223-3963
PMA – Zeolite (Clinoptilolite) in the Management of Irritable Bowel Syndrome – a Non-Interventional Study
Zum Einsatz von PMA – Zeolith (Klinoptilolith) bei Patienten mit Reizdarmsyndrom – eine nicht-interventionelle Studie Gefördert durch: Panaceo International GmbHAbstract
In clinical practice, the treatment of patients with irritable bowel syndrome (IBS) can be very challenging. The aims of the present non-interventional study (NIS) were to investigate the tolerability and efficacy of PMA-zeolite under everyday conditions in patients with diarrheic IBS type (IBS-D) or constipated type (IBS-C) or mixed type (IBS-M).
Methods To document prospective data on tolerability and symptom frequency in the frame of a nationwide NIS, we recruited 204 IBS patients. The study focused on the IBS-related quality of life (measured by the SF-36 questionnaire) and improvements of IBS-related symptoms according to specific ROM-III criteria and stool consistency (Bristol stool scale). The participants documented their abdominal pain, bloating, number of bowel movements, and stool consistency through a web-based internet platform (initial and exit questionnaires) and daily diary entries over the period of intake (8 weeks).
Results A total of 82.2% of the recruited patients had filled in the questionnaires before and after the 8-week treatment with PMA-zeolite. Seven of the eight subscales of the SF-36 improved significantly (p<0,001); the reduction in abdominal pain was especially significant (p<0,001). The diary entries confirmed the reduction in abdominal pain and revealed a significant reduction in days with bloating (p<0,001). The Bristol-stool-scale analysis showed improvements; particularly, patients with IBS-D benefited from the treatment (p<0,001).
Conclusion The treatment duration of 8 weeks was well tolerated by most patients. Under everyday life conditions, PMA-zeolite alleviated the global IBS-related symptoms and raised the quality of life (QOL). The PMA-zeolite, thus, may represent a good adjuvant therapeutic option for patients with irritable bowel syndrome.
Zusammenfassung
Die medizinische Betreuung von Patienten mit Reizdarmsyndrom (RDS) kann sehr herausfordernd sein. Die Ziele der vorliegenden Nicht-Interventionellen-Studie (NIS) waren die Dokumentation der Verträglichkeit und Wirksamkeit des PMA-Zeoliths unter Alltagsbedingungen bei Patienten mit durchfallartigem RDS-Typ (RDS-D) oder Obstipationstyp (RDS-C) oder Mischtyp (RDS-M).
Methoden Im Rahmen einer bundesweiten NIS wurden 204 Patienten mit RDS rekrutiert, um Daten zu Verträglichkeit, Lebensqualität, und Symptomfrequenz zu gewinnen. Die Studie konzentrierte sich auf die RDS-bezogene Lebensqualität (gemessen mit dem SF-36-Fragebogen) und Verbesserungen der RDS-bezogenen Symptome gemäß der RDS-spezifischen ROM-III-Kriterien, sowie der Stuhlkonsistenz (gemessen per Bristol-Stuhlformen-Skala). Die Teilnehmer dokumentierten ihre Symptome wie Bauchschmerzen und Blähungen, sowie die Anzahl der Stuhlgänge und die Stuhlkonsistenz über eine webbasierte Internetplattform (Anfangs- und Ausstiegsfragebögen) und führten ein Tagebuch über den Einnahmezeitraum von 8 Wochen.
Ergebnisse 82,2% der rekrutierten Patienten hatten die Fragebögen vor und nach der 8-wöchigen Behandlung mit PMA-Zeolith ausgefüllt. Sieben der acht Subskalen des SF-36 verbesserten sich signifikant (p<0,001), die Reduktion der Bauchschmerzen war ebenfalls signifikant (p<0,001). Die Analysen der Tagebucheinträge bestätigten die Verringerung der Bauchschmerzen und zeigten eine deutliche Abnahme der Tage mit Blähungen. Die Bristol-Stuhlformen Analyse zeigte Verbesserungen. Besonders Patienten mit RDS-D profitierten von der Behandlung (p<0,001).
Schlussfolgerung Unter Alltagsbedingungen linderte PMA-Zeolith die globalen RDS-bedingten Symptome und verbesserte die Stuhlkonsistenz und krankheitsassoziierte Lebensqualität.
Keywords
IBS - irritable bowel syndrome - PMA-zeolite as adjuvant remedy - observational (non-interventional) studySchlüsselwörter
RDS – Reizdarm-Syndrom - PMA-Zeolith als adjuvante Therapieoption - Anwenderbeobachtung - Nicht-interventionelle-Studie (NIS)Publikationsverlauf
Eingereicht: 20. Oktober 2022
Angenommen nach Revision: 27. November 2023
Artikel online veröffentlicht:
15. Januar 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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References
- 1 Enck P, Aziz Q, Barbara G. et al. Irritable bowel syndrome. Nature reviews Disease primers 2016; 2: 16014 DOI: 10.1038/nrdp.2016.14. (PMID: 27159638)
- 2 Holtmann GJ, Ford AC, Talley NJ. Pathophysiology of irritable bowel syndrome. The lancet Gastroenterology & hepatology 2016; 1: 133-146 DOI: 10.1016/s2468-1253(16)30023-1. (PMID: 28404070)
- 3 Gecse K, Róka R, Séra T. et al. Leaky gut in patients with diarrhea-predominant irritable bowel syndrome and inactive ulcerative colitis. Digestion 2012; 85: 40-46 DOI: 10.1159/000333083.
- 4 Soares RLS. Irritable bowel syndrome, food intolerance and non celiac gluten sensistivity. A new clinical challenge. Arquivos de gastroenterologia 2018; 55: 417-422 DOI: 10.1590/s0004-2803.201800000-88.
- 5 Layer P, Andresen V, Allescher H. et al. Update S3-Leitlinie Reizdarmsyndrom: Definition, Pathophysiologie, Diagnostik und Therapie. Gemeinsame Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Neurogastroenterologie und Motilität (DGNM) – Juni 2021 – AWMF-Registriernummer: 021/016. Z Gastroenterol 2021; 59: 1323-1415 DOI: 10.1055/a-1591-4794.
- 6 Ford AC, Lacy BE, Talley NJ. Irritable bowel syndrome. The New England journal of medicine 2017; 376: 2566-2578 DOI: 10.1056/NEJMra1607547. (PMID: 28657875)
- 7 Raskov H, Burcharth J, Pommergaard HC. et al. Irritable bowel syndrome, the microbiota and the gut-brain axis. Gut microbes 2016; 7: 365-383 DOI: 10.1080/19490976.2016.1218585. (PMID: 27472486)
- 8 Spiller R. Review article: probiotics and prebiotics in irritable bowel syndrome. Alimentary pharmacology & therapeutics 2008; 28: 385-396 DOI: 10.1111/j.1365-2036.2008.03750.x. (PMID: 18532993)
- 9 Petkov V, Schütz B, Eisenwagen S. et al. PMA-zeolite can modulate inflammation associated markers in irritable bowel disease – an explorative randomized, double blinded, controlled pilot trial. Neuro Endocrinol Lett 2021; 42: 1-12 (PMID: 33930939)
- 10 Mastinu A, Kumar A, Maccarinelli G. et al. Zeolite clinoptilolite: therapeutic virtues of an ancient mineral. Molecules 2019; 24: 1517 DOI: 10.3390/molecules24081517. (PMID: 30999685)
- 11 Pabalan RT, Bertetti FP. Cation-exchange properties of natural zeolites. Reviews in Mineralogy and Geochemistry 2001; 45: 453-518 DOI: 10.2138/rmg.2001.45.14.
- 12 Millini R, Bellussi G. Chapter 1, Zeolite science and perspectives. In: Čejka J, Morris RE, Nachtigall P. Zeolites in catalysis: properties and applications. The Royal Society of Chemistry. 2017: 1-36 DOI: 10.1039/9781788010610-00001
- 13 Thompson LA, Darwish WS. Environmental chemical contaminants in food: review of a global problem. Journal of Toxicology 2019; 2019: 2345283 DOI: 10.1155/2019/2345283. (PMID: 30693025)
- 14 Jurkic LM, Cepanec I, Pavelic SK. et al. Biological and therapeutic effects of ortho-silicic acid and some ortho-silicic acid-releasing compounds: New perspectives for therapy. Nutrition & metabolism 2013; 10: 2 DOI: 10.1186/1743-7075-10-2.
- 15 Danilczuk M, Dlugopolska K, Ruman T. et al. Molecular sieves in medicine. Mini reviews in medicinal chemistry 2008; 8: 1407-1417 DOI: 10.2174/138955708786369537. (PMID: 18991756)
- 16 Bacakova L, Vandrovcova M, Kopova I. et al. Applications of zeolites in biotechnology and medicine – a review. Biomaterials Science 2018; 6: 974-989 DOI: 10.1039/C8BM00028J. (PMID: 29630078)
- 17 Kraljević Pavelić S, Simović Medica J, Gumbarević D. et al. Critical review on zeolite clinoptilolite safety and medical applications in vivo. Frontiers in pharmacology 2018; 9: 1350 DOI: 10.3389/fphar.2018.01350.
- 18 Weiss S, Tauber M, Somitsch W. et al. Enhancement of biogas production by addition of hemicellulolytic bacteria immobilised on activated zeolite. Water research 2010; 44: 1970-1980 DOI: 10.1016/j.watres.2009.11.048. (PMID: 20022352)
- 19 Prasai TP, Walsh KB, Bhattarai SP. et al. Biochar, bentonite and zeolite supplemented feeding of layer chickens alters intestinal microbiota and reduces campylobacter load. PloS one 2016; 11: e0154061 DOI: 10.1371/journal.pone.0154061. (PMID: 27116607)
- 20 Prasai TP, Walsh KB, Bhattarai SP. et al. Zeolite food supplementation reduces abundance of enterobacteria. Microbiological research 2017; 195: 24-30 DOI: 10.1016/j.micres.2016.11.006. (PMID: 28024523)
- 21 Sabbioni A, Ferrario C, Milani C. et al. Modulation of the bifidobacterial ommunities of the dog microbiota by zeolite. Frontiers in microbiology 2016; 7: 1491 DOI: 10.3389/fmicb.2016.01491.
- 22 Wu QJ, Wang LC, Zhou YM. et al. Effects of clinoptilolite and modified clinoptilolite on the growth performance, intestinal microflora, and gut parameters of broilers. Poultry science 2013; 92: 684-692 DOI: 10.3382/ps.2012-02308. (PMID: 23436519)
- 23 Almeida JA, Ponnuraj NP, Lee JJ. et al. Effects of dietary clays on performance and intestinal mucus barrier of broiler chicks challenged with Salmonella enterica serovar Typhimurium and on goblet cell function in vitro. Poultry science 2014; 93: 839-847 DOI: 10.3382/ps.2013-03587.
- 24 Vitale MG, Barbato C, Crispo A. et al. ZeOxaN multi trial: a randomized, double-blinded, placebo-controlled trial of oral PMA-zeolite to prevent chemotherapy-induced side efects, in particular, peripheral neuropathy. Molecules 2020; 25: 2297 DOI: 10.3390/molecules25102297.
- 25 Eisenwagen S, Pavelić K. Potential role of zeolites in rehabilitation of cancer patients. Archives of Physiotherapy and Rehabilitation 2020; 3: 29-40 DOI: 10.26502/fapr0011.
- 26 Payra P, Dutta PK. Zeolites: a primer. In: Auerbach S, Carrado K, Dutta P. Handbook of zeolite science and technology. New York, Basel: Marcel Dekker, Inc; 2003: 1-19
- 27 Morfeld M, Bullinger M, Nantke J. et al. The version 2.0 of the SF-36 health survey: results of a population-representative study. Sozial- und Praventivmedizin 2005; 50: 292-300 DOI: 10.1007/s00038-005-4090-6. (PMID: 16300173)
- 28 Deeks JJ, Dinnes J, D'Amico R. et al. Evaluating non-randomised intervention studies. Health technology assessment (Winchester, England) 2003; 7: iii-x, 1–173 DOI: 10.3310/hta7270.
- 29 Drossman DA, Hasler WL. Rome IV-functional GI disorders: disorders of gut-brain interaction. Gastroenterology 2016; 150: 1257-1261 DOI: 10.1053/j.gastro.2016.03.035. (PMID: 27147121)
- 30 Youssef NN, Murphy TG, Langseder AL. et al. Quality of life for children with functional abdominal pain: a comparison study of patients' and parents' perceptions. Pediatrics 2006; 117: 54-59 DOI: 10.1542/peds.2005-0114.
- 31 Varni JW, Bendo CB, Nurko S. et al. Health-related quality of life in pediatric patients with functional and organic gastrointestinal diseases. The Journal of pediatrics 2015; 166: 85-90 DOI: 10.1016/j.jpeds.2014.08.022.
- 32 Muss C, Mulder L. Pathogenesis and Diagnostics in Irritable Bowel Syndrome and the Potential Treatment with Probiotics. Ernährung & Medizin 2005; 20: 73-76 DOI: 10.1055/s-2005-871661.
- 33 Saltiel AR, Olefsky JM. Inflammatory mechanisms linking obesity and metabolic disease. The Journal of clinical investigation 2017; 127: 1-4 DOI: 10.1172/jci92035. (PMID: 28045402)
- 34 Saad MJ, Santos A, Prada PO. Linking gut microbiota and inflammation to obesity and insulin resistance. Physiology (Bethesda, Md) 2016; 31: 283-293 DOI: 10.1152/physiol.00041.2015.