Probiotics for Gastrointestinal and Liver Diseases: An Updated Review of the Published Literature.

BACKGROUND: Probiotics can be viewed as biological agents that modify the intestinal microbiota and certain cytokine profiles, which can lead to an improvement in certain gastrointestinal diseases, including diarrhea, inflammatory bowel disease, and liver disease. DISCUSSION: Consumption of probiotics in their various forms, including yogurt, functional foods, and dietary supplements, is frequently encountered worldwide. Often, however, the correct prescription of these agents is dampened due to a lack of knowledge of the scientific evidence and the different presentations and microbial compositions of the currently available probiotic options. Here, we provide an up-to-date review of the evidence of probiotics in the prevention and treatment of various gastrointestinal diseases. OBJECTIVE: Consumption of probiotics in their various forms, including yogurt, functional foods, and dietary supplements, is frequently encountered worldwide. Often, however, the correct prescription of these agents is dampened due to a lack of knowledge of the scientific evidence and the different presentations and microbial compositions of the currently available probiotic options. METHODS/RESULTS: Here, we provide an up-to-date review of the evidence of probiotics in the prevention and treatment of various gastrointestinal diseases. CONCLUSION: While not efficacious in every disease process studied, probiotics have demonstrated some benefit in several specific gastrointestinal and liver diseases.

Small Bowel Obstruction Caused by Carcinoid Tumor and Incidental Capsule Retention.

Capsule endoscopy (CE) is a sensitive modality for examining the small bowel and is commonly employed to identify a variety of small bowel pathologies. We report a case of capsule retention leading to diagnosis of a chronic condition. A 60-year-old female presented with abdominal pain, nausea, and weight loss for 3 years. Physical exam revealed a mildly tender abdomen with hypoactive bowel sounds. Laboratory was normal. Abdominal radiographs showed a partial small bowel obstruction with retained capsule. Abdominal computed tomography (CT) demonstrated a retained capsule in the mid-portion of the jejunum, dilated small bowel, and terminal ileal mass. She underwent exploratory laparotomy showing an ileal mass with hepatic metastasis. A right hemicolectomy, reanastomosis, and removal of the retained capsule were performed. Pathology showed well-differentiated carcinoid tumor. She was discharged home for further treatment with oncology. Carcinoid tumors of the small bowel usually present with abdominal pain or small bowel obstruction. Our patient had intermittent small bowel obstruction due to a carcinoid tumor and retained capsule causing her symptoms. CE is a valuable tool but requires extensive consideration and possible patency capsule prior to use in patients presenting with symptoms consistent with Crohn's disease or small bowel tumor.