Effects of fiber and probiotics on diarrhea associated with enteral nutrition in gastric cancer patients

Abstract

Background and objectives:Diarrhea is a common complication of enteral nutrition (EN), which affects recovery and prolongs the length of hospital stay (LOHS). To investigate the effect of fiber and probiotics in reducing diarrhea associated with EN in postoperative patients with gastric cancer (GC), the authors designed this prospective randomized-controlled trial.Methods and study design:This study included 120 patients with GC, and the patients were classified into 3 groups via random picking of envelopes: fiber-free nutrition formula (FF group, n = 40), fiber-enriched nutrition formula (FE group, n = 40), and fiber- and probiotic-enriched nutrition formula (FEP group, n = 40). All patients were given EN formulas for 7 consecutive days after surgery.Results:The number of diarrhea cases was higher in the FF group than in the FE group (P = .007). The FEP group had a lower number of diarrhea cases compared with the FE group (P = .003). Patients in the FE group had a significantly shorter first flatus time than the FF group (P = .002). However, no significant difference was observed between the FE group and FEP group (P = .30). Intestinal disorders were similar between the FE group and FF group (P = .38). The FEP group had a lower number of intestinal disorder cases than the FF group (P = .03). LOHS in the FE and FEP groups was shorter than that in the FF group (P = .004; P < .001). However, no significant difference was observed between the FE and FEP groups (P = .28). In addition, no significant difference was observed between the 3 groups in terms of total lymphocyte count, albumin, prealbumin, and transferrin levels on day 7 of enteral feeding.Conclusions:The combination of fiber and probiotics was significantly effective in treating diarrhea that is associated with EN in postoperative patients with GC.

A novel highly concentrated enteral nutrition formula, EN-P05, shows nutritional effectiveness comparable to the approved OSN-001 in gastrostomized rats

“…Fermentation of dietary fibers by gut microbiota yields short-chain fatty acids, which provide an energy source for colonic epithelial cells, enhance water absorption from colonic epithelium, and control mucosal immunity (30). Moreover, high concentration of short-chain fatty acids helps to maintain low pH in the colon for colonic microbiota and prevents infection by enteropathogenic organisms that can cause diarrhea (31). These findings suggest that inulin, a dietary fiber included in EN-P05, also promoted good fecal condition in the gastrostomized rats, via promotion of colonic water absorption and prevention of pathogen overgrowth resulting from production of short-chain fatty acids.…”

Effects of 4 weeks of Lactobacillus plantarum 299v supplementation on nutritional status, enteral nutrition tolerance, and quality of life in cancer patients receiving home enteral nutrition – a double-blind, randomized, and placebo-controlled trial

“…as many as 75% of patients quali ed for HEN are malnourished [2]. Furthermore, several trials con rmed that HEN positively affects the patients' nutritional status presenting multiple bene ts; however, enteral nutrition (EN) may also be associated with some complications, such as nausea, vomiting, atulence as well as abdominal pain [3]. Notwithstanding, diarrhoea is the most prevalent side effect during HEN.…”

“…Notwithstanding, diarrhoea is the most prevalent side effect during HEN. It has an impact on overall recovery in the postoperative period, causes uid and electrolyte loss, prolongs the length of hospital stay as well as increases mortality and morbidity [3]. The incidence of diarrhoea in patients receiving EN varies between 12 and 68% patients [4,5].…”

“…chemotherapy-or radiotherapy-related diarrhoea). Another hypothesis is that diarrhoea might be caused by changes in the gut microbiota [3,6]. Overall, the inadequate composition of gut microbiota has been linked to poor eating habits (high-fat diet, low ber intake), administration of antibiotics, side effects of anti-cancer therapy, and surgical procedures [7][8][9].…”

“…These bacteria have been described as colorectal cancer-associated pathogens [6,10]. Moreover, the low level of Bi dobacteria and high level of Clostridia in patients who experienced diarrhoea during EN were noted [3,11]. It should be emphasized that Clostridia is known as pathogenic bacteria causing diarrhoea [3].…”