Enteral feeding: the effect on faecal output, the faecal microflora and SCFA concentrations

Whelan, Kevin; Judd, Patricia A.; Preedy, Victor R.; Taylor, Moira A.

doi:10.1079/pns2003317

Cited by 53 publications

(32 citation statements)

References 72 publications

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“…In view of their potential role in the pathogenesis of diarrhoea during ETF a number of studies have investigated the impact of enteral formula on the colonic microbiota of healthy subjects and of patients receiving ETF (Whelan et al 2004a). However, many of these early studies report conflicting results, perhaps as a result of major methodological weaknesses, including small sample sizes, the additional use of enemas or laxatives and the reliance on traditional bacterial culture (Winitz et al 1970;Attebery et al 1972;Bornside & Cohn, 1975).…”

Section: Enteral Tube Feeding and The Colonic Microbiotamentioning

confidence: 99%

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Enteral-tube-feeding diarrhoea: manipulating the colonic microbiota with probiotics and prebiotics

Whelan

2007

Proc. Nutr. Soc.

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Diarrhoea is a common and serious complication of enteral tube feeding. Its pathogenesis involves antibiotic prescription, enteropathogenic colonization and abnormal colonic responses, all of which involve an interaction with the colonic microbiota. Alterations in the colonic microbiota have been identified in patients receiving enteral tube feeding and these changes may be associated with the incidence of diarrhoea. Preventing negative alterations in the colonic microbiota has therefore been investigated as a method of reducing the incidence of diarrhoea. Probiotics and prebiotics may be effective because of their suppression of enteropathogenic colonization, stimulation of immune function and modulation of colonic metabolism. Randomized controlled trials of probiotics have produced contrasting results, althoughSaccharomyces boulardiihas been shown to reduce the incidence of diarrhoea in patients in the intensive care unit receiving enteral tube feeding. Prebiotic fructo-oligosaccharides have been shown to increase the concentration of faecal bifidobacteria in healthy subjects consuming enteral formula, although this finding has not yet been confirmed in patients receiving enteral tube feeding. Furthermore, there are no clinical trials investigating the effect of a prebiotic alone on the incidence of diarrhoea. Further trials of the efficacy of probiotics and prebiotics, alone and in combination, in preventing diarrhoea in this patient group are warranted.

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Section: Enteral Tube Feeding and The Colonic Microbiotamentioning

confidence: 99%

“…receiving ETF (Whelan et al 2004a). Consumption of an enteral formula supplemented with FOS (10 g/l) was shown to result in an increase in faecal bifidobacteria in nine healthy subjects (Garleb et al 1996).…”

Section: Reduction In Phmentioning

confidence: 99%

Enteral-tube-feeding diarrhoea: manipulating the colonic microbiota with probiotics and prebiotics

Whelan

2007

Proc. Nutr. Soc.

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“…Oligofructose and inulin stimulate growth and activity of bifidobacteria and lactobacilli without inducing similar changes in anaerobes, clostridia, coliform flora, and the genus Bacteroides [62,63]. Oligofructose partially prevents the decrease of intestinal short-chain fatty acids in subjects on enteral nutrition [64].…”

Section: Prebioticsmentioning

confidence: 99%

Probiotics and prebiotics — renaissance of a therapeutic principle

Frič

2007

Open Medicine

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AbstractProbiotics are nonpathogenic microorganisms mostly of human origin which, when administered in adequate amounts, confer a health benefit on the host and enable to prevent or improve some diseases. Probiotics may be a natural temporary constituent of the resident intestinal microflora, but their concentration is not sufficient for therapeutic purposes. The microbiota, the intestinal epithelium, and the mucosal immune system constitute the gastrointestinal ecosystem. All three components are essential for complete functional and developmental maturity of the system. The viability of intestinal microflora (including probiotic strains) requires the availability of nutritional substrates (prebiotics), i.e. various types of fiber and oligosaccharides. Prebiotics are cleaved by microbial enzymes to numerous substances (short-chain fatty acids, aminoacids, polyamines, growth factors, vitamins and antioxidants) indispensable for metabolic and functional activities of the intestinal mucosa. The principal probiotics in use include lactobacilli, bifidobacteria, some nonpathogenic strains of Escherichia coli, and Saccharomyces boulardii. These microbiota display favourable effects which qualify them for therapeutic use. For this purpose, probiotics have to fulfill a series of requirements verifying their efficacy and safety. Experimental and clinical studies examine the prerequisites for the administration of probiotics in digestive diseases, allergic and atopic affections, as well as in some extraintestinal conditions. Future goals of probiotic application include genomic analysis, controlled postnatal colonisation of the digestive tract, the use of probiotics as carriers of peroral vaccines, and recombinant probiotics with in-situ production and targeted application of therapeutic molecules.

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“…Due to the lack of a standardized definition, especially in earlier studies, the reported incidences of diarrhoea vary over a very wide range from 2 to 95% [38]. Diarrhoea is, however, a significant problem in intensive care patients which interferes with the adequacy of enteral nutrition [39].…”

Section: Diarrhoeamentioning

confidence: 99%

Abdominal signs and symptoms in intensive care patients

Blaser

Starkopf²,

Malbrain

2015

Anaesthesiol Intensive Ther

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Abdominal problems, both as a primary reason for admission or developing as a part of multiple organ dysfunction syndrome during an ICU stay, are common in critically ill patients. The definitions, assessment, incidence and outcome of different abdominal signs, symptoms and syndromes are assessed in the current review. General abdominal signs and symptoms include abdominal pain and distension, as well as other signs assessed during the physical examination (e.g. palpation, percussion). Gastrointestinal (GI) symptoms include vomiting, high gastric residual volumes, diarrhoea, GI bleeding, paralysis of the lower GI tract, bowel dilatation and absent bowel sounds. Although around half of patients suffer from these symptoms, the reported incidences of single symptoms vary within a large range due to variable definitions and case-mix. In a few studies, the total number of coincident GI symptoms was associated with increased mortality. Although acute abdomen is a well-recognized severe syndrome in emergency medicine, its incidence in ICUs is not known. Next to subjective clinical evaluation, intra-abdominal pressure, as a reproducible numerical variable, provides useful assistance in the assessment of the abdominal compartment, whereas intra-abdominal hypertension has been shown to impair the outcome of the critically ill. In conclusion, abdominal symptoms occur in half of patients in ICUs. Clinical evaluation, albeit largely subjective, remains the main bedside tool to detect abdominal problems and to assess GI function in the critically ill. IAP is a useful additional tool in the assessment of abdominal complications in ICUs.

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Enteral feeding: the effect on faecal output, the faecal microflora and SCFA concentrations

Cited by 53 publications

References 72 publications

Enteral-tube-feeding diarrhoea: manipulating the colonic microbiota with probiotics and prebiotics

Enteral-tube-feeding diarrhoea: manipulating the colonic microbiota with probiotics and prebiotics

Probiotics and prebiotics — renaissance of a therapeutic principle

Abdominal signs and symptoms in intensive care patients

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