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lüll A stand-alone synbiotic treatment for the prevention of D-lactic acidosis in short bowel syndrome Takahashi K; Terashima H; Kohno K; Ohkohchi NInt Surg 2013[Apr]; 98 (2): 110-3Synbiotics 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.|*Bifidobacterium[MESH]|*Lacticaseibacillus casei[MESH]|*Synbiotics[MESH]|Acidosis, Lactic/etiology/*therapy[MESH]|Adult[MESH]|Humans[MESH]|Male[MESH]|Short Bowel Syndrome/*complications[MESH] |