Background: Diarrhea is a well-recognized side effect associated with pelvic radia on; however, there is not any effec ve common treatment for radia on-induced diarrhea. A popular alterna ve is probio cs, which have been used in several gastrointes nal disorders. Probio cs are live microbial food supplements. Furthermore, honey is a puta ve nutri onal with a variety of health effects, including an bacterial, an oxidant, an-inflammatory and prebio c. The present study evaluated the effects of probio c with or without honey on radia on-induced diarrhea. Materials and Methods: Sixty-seven adult pa ents with pelvic cancer underwent radiotherapy for four weeks. They randomized to receive probio c (n = 22), probio c plus honey (n = 21) or placebo (n = 24) from one week before radiotherapy for five weeks. Diarrhea grade and stool consistency score were recorded weekly according to the Common Toxicity Criteria system and the Bristol scales, respec vely. Results: The results showed a decrease in the daily number of bowel movements (p = 0.003 and 0.006), diarrhea grade (p = 0.001 and 0.001) and the need for an diarrheal medica on (p = 0.021 and 0.041) also an increase in the stool consistency (p = 0.004 and 0.005) in pa ents who either used probio c or probio c plus honey (respec vely), these were significant in weeks 4 and 5 of treatment. Conclusion: Probio cs with or without honey can reduce the incidence of radia on-induced diarrhea and the need for an diarrheal medica on.

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Background:Radiotherapy is frequently used in treatment approaches of pelvic malignancies. Nevertheless, it has some known systemic effects on blood cells and the immune system that possibly results in their susceptibility to infection. Probiotics are live microbial food ingredients that provide a health advantage to the consumer. Honey has prebiotic properties. The aim of this clinical trial was to investigate probable effects of probiotic or probiotics plus honey on blood cell counts and serum IgA levels in patients receiving pelvic radiotherapy.Materials and Methods:Sixty-seven adult patients with pelvic cancer were enrolled. Patients were randomized to receive either: (1) Probiotic capsules (including: Lactobacillus casei, Lactobacillus acidophilus, Lactobacillus rhamnosus, Lactobacillus bulgaricus, Bifidobacterium breve, Bifidobacterium longum, and Streptococcus thermophiles) (n = 22), (2) probiotic capsules plus honey (n = 21) or (3) placebo capsules (n = 24) all for 6 weeks. Blood and serum samples were collected for one week before radiotherapy and 24-72 h after the end of radiotherapy.Results:White blood cells (WBC), red blood cells (RBC), platelet counts, and serum IgA level were not significantly changed in patients taking probiotic (alone or plus honey) during pelvic radiotherapy. The mean decrease in RBC count was 0.52, 0.18, and 0.23 × 106 cells/μL, WBC count was 2.3, 1.21, and 1.34 × 103 cells/μL and platelet count was, 57.6, 53.3, and 66.35 × 103 cells/μL for the probiotic, probiotic plus honey, and placebo groups, respectively. The mean decrease of serum IgA was 22.53, 29.94, and 40.73 mg/dL for the probiotic, probiotic plus honey, and placebo groups, respectively.Conclusion:The observed nonsignificant effect of probiotics may be in favor of local effects of this product in the gut rather than systemic effects, however, as a trend toward a benefit was indicated, further studies are necessary in order to extract effects of probiotics or probiotic plus honey on hematologic and immunologic parameters in patients receiving pelvic radiotherapy.