Dietary nutrition,intestinal microbiota dysbiosis and post-weaning diarrhea in piglets

Weaning is a critical transitional point in the life cycle of piglets.Early weaning can lead to post-weaning syndrome,destroy the intestinal barrier function and microbiota homeostasis,cause diarrhea and threaten the health of piglets.The nutritional components of milk and solid foods consumed by newborn animals can affect the diversity and structure of their intestinal microbiota,and regulate post-weaning diarrhea in piglets.Therefore,this paper reviews the effects and mechanisms of different nutrients,including protein,dietary fiber,dietary fatty acids and dietary electrolyte balance,on diarrhea and health of piglets by regulating intestinal function.Protein is an essential nutrient for the growth of piglets;however,excessive intake will cause many harmful effects,such as allergic reactions,intestinal barrier dysfunction and pathogenic growth,eventually aggravating piglet diarrhea.Dietary fiber is a nutrient that alleviates post-weaning diarrhea in piglets,which is related to its promotion of intestinal epithelial integrity,microbial homeostasis and the production of short-chain fatty acids.In addition,dietary fatty acids and dietary electrolyte balance can also facilitate the growth,function and health of piglets by regulating intestinal epithelial function,immune system and microbiota.Thus,a targeted control of dietary components to promote the establishment of a healthy bacterial community is a significant method for preventing nutritional diarrhea in weaned piglets.

First identification of a novel Aichivirus D in goats with diarrhea

Kobuvirus comprises 6 officially recognized species,namely Aichivirus A-F,and can be further divided into 20 genotypes through VP1 gene phylogenetic analysis(https://ictv.global/report/chapter/picornaviridae/picornaviridae/kobuvirus).Aichivirus A in human,Aichivirus B in bovine,Aichivirus C in porcine and caprine,Aichivirus D in yak have been proved to be associated with diarrhea(Chen Y S et al.2013;Yang et al.2015;Zhu et al.2016;Zhai et al.2017;Wang et al.2020;Abi et al.2022;Yan et al.2023).

The protective role of prebiotics and probiotics on diarrhea and gut damage in the rotavirus-infected piglets

Rotavirus is one of the pathogenic causes that induce diarrhea in young animals, especially piglets, worldwide. However, nowadays, there is no specific drug available to treat the disease, and the related vaccines have no obvious efficiency in some countries. Via analyzing the pathogenesis of rotavirus, it inducing diarrhea is mainly due to disturb enteric nervous system, destroy gut mucosal integrity, induce intracellular electrolyte imbalance, and impair gut microbiota and immunity. Many studies have already proved that prebiotics and probiotics can mitigate the damage and diarrhea induced by rotavirus infection in hosts. Based on these, the current review summarizes and discusses the effects and mechanisms of prebiotics and probiotics on rotavirus-induced diarrhea in piglets. This information will highlight the basis for the swine production utilization of prebiotics and probiotics in the prevention or treatment of rotavirus infection in the future.

Maternal or post-weaning dietary fructo-oligosaccharide supplementation reduces stillbirth rate of sows and diarrhea of weaned piglets

Fructo-oligosaccharides(FOS)are well-known prebiotics that have the potential to improve sow reproductive performance and increase piglet growth.However,previous studies were observed in sole FOS-supplemented diets of sows or weaned piglets and did not consider the sow-to-piglet transfer effect on the performance and diarrhea rate of weaned piglets.This study explores the effects of dietary FOS supplementation on the reproductive performance of sows,and the effects of FOS supplementation at different stages on the growth performance and diarrhea rate of weaned piglets.A split-plot experi-mental design was used with sow diet effect in the whole plot and differing piglet diet effect in the subplot.Fifty-two multiparous sows(223.24±14.77 kg)were randomly divided into 2 groups(0 or 0.2%FOS).The experiment lasted from day 85 of gestation to day 21 of lactation.Reproductive performance,glucose tolerance,placental angiogenesis,and intestinal flora of sows were assessed.At weaning,192 weaned piglets were grouped in 2 × 2 factorial designs,with the main effects of FOS supplemental level of sow diet(0 and 0.2%),and FOS supplemental level of weaned piglet diet(0 and 0.2%),respectively.The growth performance and diarrhea rate of the weaned piglets were analyzed during a 28-d experiment.Maternal dietary supplementation of FOS was shown to reduce the stillbirth and invalid piglet rates(P<0.05),improve the insulin sensitivity(P<0.05)and fecal scores(P<0.05)of sows,increase the abundance of Akkermansia muciniphila(P=0.016),decrease the abundance of Escherichia coli(P=0.035),and increase the isovalerate content in feces(P=0.086).Meanwhile,the placental angiogenesis marker CD31 expression was increased in sows fed FOS diet(P<0.05).Moreover,maternal and post-weaning dietary FOS supplementation reduced the diarrhea rate of weaned piglets(P<0.05)and increased the content of short-chain fatty acids in feces(P<0.05).Furthermore,only post-weaning dietary FOS sup-plementation could improve nutrient digestibility of weaned piglets(P<0.05).Collectively,FOS sup-plementation in sows can reduce stillbirth rate,perinatal constipation,and insulin resistance,as well as improve placental vascularization barrier.Additionally,maternal and post-weaning dietary FOS sup-plementation reduced the diarrhea rate of weaned piglets,but only FOS supplementation in piglets alone at weaning stage could improve their nutrient digestibility.

Lactose-free milk powder can effectively relieve diarrhea symptoms in weaning SD rats and children

Diarrhea has become the leading cause of illness and death among infants and young children in developing countries.Clinically,patients with diarrhea showed damaged intestinal epithelial villi,usually accompanied by lactase deficiency.In this study,we evaluated the therapeutic effects of lactose-free milk powder on rats and children with diarrhea.Antibiotic-associated diarrhea(AAD)model was established by gavage with antibiotic mixture in SD rats,followed by administration of milk powder containing lactose or not.The results showed that lactose-free milk powder ameliorated A AD-related diarrhea symptoms,and accelerated the recovery from diarrhea.And 16S sequencing results indicated lactose-free milk powder contributed to increase theα-andβ-diversity of intestinal flora,and restore the intestinal microbiota disorder.In conclusion,our data demonstrate that lactose-free milk powder could alleviate diarrhea by restoring gut microbiota and intestinal barrier function.

A CRISPR/Cas12a-based platform for rapid on-site bovine viral diarrhea virus diagnostics

Bovine viral diarrhea virus(BVDV)is a positive-sense single-stranded RNA virus,belonging to the genus Pestivirus in the Flaviviridae family(Riitho et al.2020).Currently,BVDV is divided into 3 main genotypes,BVDV-1,BVDV-2,and BVDV-3,based on the genetic differences in the 5′untranslated region(5′UTR)(Muasya et al.2022).

Transcriptome analysis suggests broad jejunal alterations in Linghu’s obesity-diarrhea syndrome:A pilot study

BACKGROUND Obesity is associated with a significantly increased risk for chronic diarrhea,which has been proposed as Linghu’s obesity-diarrhea syndrome(ODS);however,its molecular mechanisms are largely unknown.AIM To reveal the transcriptomic changes in the jejunum involved in ODS.METHODS In a cohort of 6 ODS patients(JOD group),6 obese people without diarrhea(JO group),and 6 healthy controls(JC group),high-throughput sequencing and bioinformatics analyses were performed to identify jejunal mucosal mRNA expression alterations and dysfunctional biological processes.In another cohort of 16 ODS patients(SOD group),16 obese people without diarrhea(SO group),and 16 healthy controls(SC group),serum diamine oxidase(DAO)and D-lactate(DLA)concentrations were detected to assess changes in intestinal barrier function.RESULTS The gene expression profiles of jejunal mucosa in the JO and JC groups were similar,with only 1 differentially expressed gene(DEG).The gene expression profile of the JOD group was significantly changed,with 411 DEGs compared with the JO group and 211 DEGs compared with the JC group,129 of which overlapped.The enrichment analysis of these DEGs showed that the biological processes such as digestion,absorption,and transport of nutrients(especially lipids)tended to be up-regulated in the JOD group,while the biological processes such as rRNA processing,mitochondrial translation,antimicrobial humoral response,DNA replication,and DNA repair tended to be down-regulated in the JOD group.Eight DEGs(CDT1,NHP2,EXOSC5,EPN3,NME1,REG3A,PLA2G2A,and PRSS2)may play a key regulatory role in the pathological process of ODS,and their expression levels were significantly decreased in ODS patients(P<0.001).In the second cohort,compared with healthy controls,the levels of serum intestinal barrier function markers(DAO and D-LA)were significantly increased in all obese individuals(P<0.01),but were higher in the SOD group than in the SO group(P<0.001).CONCLUSION Compared with healthy controls and obese individuals without diarrhea,patients with Linghu’s ODS had extensive transcriptomic changes in the jejunal mucosa,likely affecting intestinal barrier function and thus contributing to the obesity and chronic diarrhea phenotypes.

Tryptophan metabolism and piglet diarrhea:Where we stand and the challenges ahead

The intestinal architecture of piglets is vulnerable to disruption during weaning transition and leads to diarrhea,frequently accompanied by inflammation and metabolic disturbances(including amino acid metabolism).Tryptophan(Trp)plays an essential role in orchestrating intestinal immune tolerance through its metabolism via the kynurenine,5-hydroxytryptamine,or indole pathways,which could be dictated by the gut microbiota either directly or indirectly.Emerging evidence suggests a strong asso-ciation between piglet diarrhea and Trp metabolism.Here we aim to summarize the intricate balance of microbiota-host crosstalk by analyzing alterations in both the host and microbial pathways of Trp and discuss how Trp metabolism may affect piglet diarrhea.Overall,this review could provide valuable in-sights to explore effective strategies for managing piglet diarrhea and the related challenges.

Frequency of Rotavirus among under 5 Children Admitted to Wad Madani Pediatric Teaching Hospital with Diarrhea, Gezira State, Sudan (2021-2022)

Rotavirus is the leading cause of acute gastroenteritis and responsible for 20% of death in children under 5 years of age approximately 111 million episodes of gastroenteritis due to Rotavirus in under 5 children, which result in 25 million visits to clinic, 2 million hospitalization and 352,000 - 592,000 deaths. Children in the poorest countries account 82% of rotaviruses death. Diarrhea disease are major cause of death and disease among children under five years, a child on average suffers 2 to 3 attacks of diarrhea every year. Stools samples were collected from 196 children suffering from diarrhea and were tested for rotaviruses by immune chromatography test antigen (ICT-Ag), ELISA and RT PCR The data were analyzed using statistical package for the Social Sciences (SPSS). The results showed that prevalence of rotavirus was 26/196 (13.3%) by ICT Ag and ELISA and confirmed by RT-PC R. 87.8% of the children were vaccinated by Rota vaccine, 70% of their mothers not using soap for cleaning the children and thought diarrhea not infectious disease and believed it was caused by teething. In conclusion there was a decrease in prevalence of diarrhea by Rotavirus due to insertion of Rota vaccine in routine vaccination, rotavirus infection mostly occurs in poor family that not able to provide safe water and due to poor sanitation and low education of mother beside that some children suffered from malnutrition, so it recommended to incorporate ELISA as a diagnostic tool in routine diagnosis of rotavirus among children suffered from gastroenteritis.

Calcium/calcimimetic via calcium-sensing receptor ameliorates cholera toxin-induced secretory diarrhea in mice

BACKGROUND Enterotoxins produce diarrhea through direct epithelial action and indirectly by activating the enteric nervous system.Calcium-sensing receptor(CaSR)inhibits both actions.The latter has been well documented in vitro but not in vivo.The hypothesis to be tested was that activating CaSR inhibits diarrhea in vivo.AIM To determine whether CaSR agonists ameliorate secretory diarrhea evoked by cholera toxin(CTX)in mice.METHODS CTX was given orally to C57BL/6 mice to induce diarrhea.Calcium and calci-mimetic R568 were used to activate CaSR.To maximize their local intestinal actions,calcium was administered luminally via oral rehydration solution(ORS),whereas R568 was applied serosally using an intraperitoneal route.To verify that their actions resulted from the intestine,effects were also examined on Cre-lox intestine-specific CaSR knockouts.Diarrhea outcome was measured biochemically by monitoring changes in fecal Cl-or clinically by assessing stool consistency and weight loss.RESULTS CTX induced secretory diarrhea,as evidenced by increases in fecal Cl-,stool consistency,and weight loss following CTX exposure,but did not alter CaSR,neither in content nor in function.Accordingly,calcium and R568 were each able to ameliorate diarrhea when applied to diseased intestines.Intestinal CaSR involvement is suggested by gene knockout experiments where the anti-diarrheal actions of R568 were lost in intestinal epithelial CaSR knockouts(villinCre/Casrflox/flox)and neuronal CaSR knockouts(nestinCre/Casrflox/flox).CONCLUSION Treatment of acute secretory diarrheas remains a global challenge.Despite advances in diarrhea research,few have been made in the realm of diarrhea therapeutics.ORS therapy has remained the standard of care,although it does not halt the losses of intestinal fluid and ions caused by pathogens.There is no cost-effective therapeutic for diarrhea.This and other studies suggest that adding calcium to ORS or using calcimimetics to activate intestinal CaSR might represent a novel approach for treating secretory diarrheal diseases.

Relationship between dietary fiber intake and chronic diarrhea in adults

BACKGROUND Dietary fiber is essential for human health and can help reduce the symptoms of constipation.However,the relationship between dietary fiber and diarrhea is,poorly understood.AIM To evaluate the relationship between dietary fiber and chronic diarrhea.METHODS This retrospective study was conducted using data from the United States National Health and Nutrition Examination Survey,conducted between 2005 and 2010.Participants over the age of 20 were included.To measure dietary fiber consumption,two 24-hour meal recall interviews were conducted.The independent relationship between the total amount of dietary fiber and chronic diarrhea was evaluated with multiple logistic regression and interaction analysis.RESULTS Data from 12829 participants were analyzed.Participants without chronic diarrhea consumed more dietary fiber than participants with chronic diarrhea(29.7 vs 28.5,P=0.004).Additionally,in participants with chronic diarrhea,a correlation between sex and dietary fiber intake was present:Women who consume more than 25 g of dietary fiber daily can reduce the occurrence of chronic diarrhea.CONCLUSION Dietary fiber can reduce the occurrence of chronic diarrhea.

Assessment of the triglyceride glucose index in adult patients with chronic diarrhea and constipation

BACKGROUND Accumulating evidence suggests that the gut microbiome is involved in the pathogenesis of insulin resistance(IR).However,the link between two of the most prevalent bowel disorders,chronic diarrhea and constipation,and the triglyceride glucose(TyG)index,a marker of IR,has not yet been investigated.AIM To investigate the potential association between TyG and the incidence of chronic diarrhea and constipation.METHODS This cross-sectional study enrolled 2400 participants from the National Health and Nutrition Examination Survey database from 2009-2010.TyG was used as an exposure variable,with chronic diarrhea and constipation as determined by the Bristol Stool Form Scale used as the outcome variables.A demographic investigation based on TyG quartile subgroups was performed.The application of multivariate logistic regression models and weighted generalized additive models revealed potential correlations between TyG,chronic diarrhea,and constipation.Subgroup analyses were performed to examine the stability of any potential associations.RESULTS In the chosen sample,chronic diarrhea had a prevalence of 8.00%,while chronic constipation had a prevalence of 8.04%.In multiple logistic regression,a more prominent positive association was found between TyG and chronic diarrhea,particularly in model 1(OR=1.45;95%CI:1.17-1.79,P=0.0007)and model 2(OR=1.40;95%CI:1.12-1.76,P=0.0033).No definite association was observed between the TyG levels and chronic constipation.The weighted generalized additive model findings suggested a more substantial positive association with chronic diarrhea when TyG was less than 9.63(OR=1.89;95%CI:1.05-3.41,P=0.0344),and another positive association with chronic constipation when it was greater than 8.2(OR=1.74;95%CI:1.02-2.95,P=0.0415).The results of the subgroup analyses further strengthen the extrapolation of these results to a wide range of populations.CONCLUSION Higher TyG levels were positively associated with abnormal bowel health.

New paradigm of oral rehydration in patients affected by irritable bowel syndrome with chronic diarrhea

Irritable bowel syndrome with diarrhea is a very frequent clinical condition characterized by disabling intestinal symptoms.This disease presents with daily abdominal pain for at least 3 months related to defecation and associated with a change in the frequency of bowel movements and the shape of the stool.International surveys about this disease report a global prevalence of about 1.5%.A new amino acid based electrolyte solution has recently been commercialized for oral rehydration in diarrhea.It is composed of water,electrolytes,and five selected amino acids that function as sodium co-transporters without containing glucose.In recent years,some studies explored the effectiveness of the amino acid based electrolyte beverage in oncologic patients with gastrointestinal mucositis,reporting good results.Recently,a prospective study to evaluate the clinical impact of the amino acid based medical beverage was conducted in patients with diarrhea predominant irritable bowel syndrome.The research was based on a real-life methodology minimizing the disruption of the routine care.One hundred patients suffering from irritable bowel syndrome with diarrhea drank a solution based on selected amino acids twice a day for 2 wk.Each enrolled patient completed the study and showed a significant response rate with regard to stool consistency and pain reduction.Based on this data,we can hypothesize that the amino acid based oral rehydration solution could be a valid tool in the treatment of patients affected by irritable bowel syndrome with diarrhea.It is certainly necessary to plan highquality clinical trials comparing glucose based oral solutions and amino acid based solutions in patients with persisting diarrhea.Probably in the near future all oral rehydration solutions will contain amino acids.

Anti-Cancer Agents Associated Diarrhea:Current Status and Prospects

Cancer stands as one of the major threats to human life.Ensuring the safety of drugs is paramount,and the impact of adverse reactions on patients’quality of life and prognosis should not be underestimated.Diarrhea is a common clinical adverse event,and despite the absence of specific anti-diarrhea drugs,there is a pressing need for improvement.This article aims to provide a valuable reference for researchers in clinical drug use and scientific tumor treatment.It summarizes recent advancements in drug mechanisms and adverse reactions,whether in preclinical research or clinical diagnosis and therapy.

Clinical Thoughts and Cases of Jianpi Yishen Sechang Decoction Combined with Acupuncture in the Treatment of Functional Diarrhea

Functional diarrhea(FDr)accounts for a relatively high proportion of digestive diseases.It is an infection that is not accompanied by abdominal pain and shows negative results in laboratory tests for bacteria and viruses.The main symptoms are persistent or recurrent discharge of watery and soft stools.The course of the disease is prolonged and recurring,and the treatment cost is higher and greatly affects the patient’s daily life.The incidence rate has a gradual increase in the trend.Its pathogenesis is complex where Western medicine is mostly used in symptomatic drug treatment.The treatment can be fast-acting and effective in relieving diarrhea.However,the long-term use of Western medicine poses a high risk in terms of side effects and a high chance of recurring upon stopping medication.At the same time,some diarrhea patients show the existence of drug-resistant strains of bacteria,and the overall efficacy of the drug is limited.Chinese medicine is mild and able to provide excellent treatment of diarrhea.With its lower price and cost,most families can afford it.Fengliang Tian,director of traditional Chinese medicine,implemented the“needle and medicine”method,which combines medicine and acupuncture,involving the usage of Jianpi Yishen Sechang Decoction and acupuncture in the treatment of functional diarrhea.The method has a low price,fewer side effects,is easy to accept,and can significantly reduce the recurrence rate with high efficacy.The study would like to share the clinical thinking and cases as follows to provide ideas and methods for the treatment of functional diarrhea by traditional Chinese medicine.

Current Research Status of Traditional Chinese Medicine External Treatment for Diarrhea Type Irritable Bowel Syndrome

Irritable bowel syndrome(IBS-D)with diarrhea is a common gastrointestinal functional disease in clinical practice,which seriously affects the quality of life of patients.Cur‐rently,Western medicine has poor therapeutic effects,while traditional Chinese medi‐cine has unique advantages in relieving IBS-D symptoms and preventing recurrence.In recent years,especially with external treatment of traditional Chinese medicine,it has become a new treatment direction in clinical practice and has achieved good therapeutic effects.This article will provide a review of recent research on the treatment of IBS-D using traditional Chinese medicine external treatment methods.

乌梅丸治疗脓毒症合并腹泻及胃肠功能障碍的临床疗效观察

目的观察乌梅丸汤剂治疗脓毒症合并腹泻及胃肠功能障碍的临床疗效。方法选取2016年4月—2022年3月就诊于首都医科大学附属北京中医医院急诊科的64例脓毒症合并腹泻及胃肠功能障碍患者为研究对象,通过随机数字表法将患者分为观察组和对照组,各32例。2组均给予常规治疗,观察组在常规治疗基础上加乌梅丸汤剂口服、鼻饲或直肠滴注。2组疗程均为7 d。观察2组病死率、腹泻疗效、安全性,及治疗前后胃肠功能障碍评分、序贯器官衰竭(SOFA)、急性生理与慢性健康评分系统Ⅱ(APACHEⅡ)评分。结果观察组死亡5例(16.13%),对照组死亡9例(29.03%),2组病死率差异无统计学意义(P>0.05)。死亡RR为0.85(95%CI 0.644~1.112)。观察组总有效率高于对照组(P<0.05)。与治疗前比较,2组治疗后胃肠功能障碍评分、SOFA评分、APACHEⅡ评分均降低(P<0.05),且观察组治疗后胃肠功能障碍评分、SOFA评分、APACHEⅡ评分均低于对照组(P<0.05)。2组患者均未出现药物相关的不良反应,2组血常规及肝、肾功能均无异常改变。结论乌梅丸汤剂对脓毒症合并腹泻及胃肠功能障碍,有明显的胃肠保护作用,同时也能减轻患者整体病情严重程度。

重症病人肠内营养相关性腹泻风险预测模型的系统评价

目的:对肠内营养相关性腹泻的风险预测模型进行系统检索和评价,以期为构建更高质量的肠内营养相关性腹泻风险预测模型提供参考。方法:检索中国生物医学文献数据库、万方数据库、中国知网、EMbase、PubMed、CINAHL、Web of Science、the Cochrane Library中的相关文献,检索时限为建库至2024年3月1日,限定语种为英文和中文。由2名研究者独立筛选文献和提取数据,并应用预测模型研究的偏倚风险和适用性评估工具(PROBAST)对纳入研究的偏倚风险和适用性进行评价。结果:共纳入6项肠内营养相关性腹泻的风险预测模型构建研究,6个模型的受试者工作特征曲线下面积为0.732~0.940,涉及最多的预测因子是禁食时间、肠内营养日剂量、口服钾制剂时间和应用抗生素情况。整体适应性较好,偏倚风险较高,偏倚主要来自未选择合适的数据来源、样本量不足、对缺失数据关注不足和缺乏模型性能评估等。结论:现有证据表明,肠内营养相关性腹泻风险预测模型研究偏倚风险较高,正处于发展阶段;未来研究应关注对不同风险评估方法有效性的研究,构建偏倚风险低、预测性能优良、符合我国临床实践实施的风险预测模型。

博落回口服液对仔猪大肠杆菌病腹泻的疗效研究

以丰富的植物博落回为原料,提取其活性成分博落回生物碱后,通过改进生产工艺与添加助溶剂和稳定剂等制成博落回口服液,用以治疗仔猪大肠杆菌性腹泻。选择22~30日龄的梅山仔猪140头,随机分为5组,除健康对照组10头仔猪外,其他仔猪人工接种致病性大肠杆菌O_(149)∶K_(88ac),20h后用药物博落回口服液实施治疗。药物试验组分为低、中、高剂量组各30头仔猪,分别按每头仔猪2.5、5.0、10.0mL的剂量灌服博落回口服液,药物对照组30头仔猪,用硫酸安普霉素可溶性粉溶于水中灌服,剂量为12.5mg/kg。感染对照组与健康对照组各10头仔猪,不用药。各组均1d给药2次,连用3d,于停药3d后统计疗效。结果表明:博落回口服液中剂量组和药物对照组的治愈率在90.0%以上,博落回口服液中、高剂量组的总有效率均为96.7%,高于药物对照组(93.3%),但差异不显著(P>0.05)。急性毒性试验结果表明:博落回口服液对大鼠经口染毒LD50大于5g/kg,是非常安全的。试验结果表明:中、高剂量的博落回口服液对仔猪腹泻有较好疗效,通过改进生产工艺和添加助溶剂和稳定剂等在2年期内保持博落回口服液有效成分不变。

维生素D联合粪菌移植治疗腹泻型肠易激综合征的疗效与疾病转归研究

目的:探讨维生素D联合粪菌移植治疗腹泻型肠易激综合征(IBS-D)的疗效及对疾病转归的影响。方法:选取2022年5月至2023年10月该院收治的IBS-D患者122例,采用随机数字表法分为对照组和研究组,每组61例。在常规治疗基础上,对照组患者给予粪菌移植治疗,研究组患者给予维生素D联合粪菌移植治疗。比较两组患者的临床疗效、肠道菌群、内脏敏感性指标及3个月复发率。结果:对照组58例、研究组59例患者完成研究。研究组患者的治疗总有效率高于对照组[94.9%(56/59)vs.81.0%(47/58)],差异有统计学意义(P<0.05)。治疗后,研究组患者IBS症状严重程度量表各维度评分及总分低于对照组,粪便双歧杆菌、乳杆菌含量高于对照组,肠球菌含量低于对照组,直肠初始感觉阈值、初始排便冲动阈值和最大耐受容量增加,血清5-羟色胺、P物质水平低于对照组,差异均有统计学意义(P<0.05)。两组治疗有效的患者中,研究组患者的复发率低于对照组[5.4%(3/56)vs.19.1%(9/47)],差异有统计学意义(P<0.05)。结论:维生素D联合粪菌移植能够提高IBS-D患者的临床疗效,减少疾病复发,而且能够调节肠道菌群和降低内脏高敏性。