The role of probiotics and prebiotics in the management of diarrhoea associated with enteral tube feeding

Whelan, Kevin; Gibson, Glenn R.; Judd, Patricia A.; Taylor, Moira A.

doi:10.1046/j.1365-277x.2001.00322.x

Cited by 31 publications

(14 citation statements)

References 70 publications

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“…Amylase-resistant starch added to ORS improves diarrhea even in patients with cholera (Ramakrishna et al, 2000). The suppressive effect of dietary fiber on diarrhea has been mainly applied in the clinical setting (Joanne and Norman, 2003;Meier et al, 2003;Whelan et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

Suppressive effect of partially hydrolyzed guar gum on transitory diarrhea induced by ingestion of maltitol and lactitol in healthy humans

et al. 2007

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Objectives: To estimate the suppressive effect of partially hydrolyzed guar gum (PHGG) on transitory diarrhea induced by ingestion of a sufficient amount of maltitol or lactitol in female subjects. Design: The first, the minimal dose level of maltitol and lactitol that would induce transitory diarrhea was estimated separately for each subject. Individual subject was administered a dose that increased by 5 g stepwise from 10 to 45 g until diarrhea was experienced. Thereafter, the suppressive effect on diarrhea was observed after each subject ingested a mixture of 5 g of PHGG and the minimal dose level of maltitol or lactitol. Setting: Laboratory of Public Health Nutrition, Department of Nutrition and Health Sciences, Siebold University of Nagasaki. Subjects: Thirty-four normal female subjects (21.370.9 years; 49.575.3 kg). Main outcome measurement: Incidence of diarrhea caused by the ingestion of maltitol or lactitol and the ratio of suppression achieved by adding PHGG for diarrhea. Results: The ingestion of amounts up to 45 g of maltitol, diarrhea caused in 29 of 34 subjects (85.3%), whereas the ingestion of lactitol caused diarrhea in 100%. The diarrhea owing to maltitol was improved in 10 of 28 subjects by the addition of 5 g of PHGG to minimal dose-induced diarrhea, and that owing to lactitol was in seven of 19 subjects. Adding 10 g of PHGG strongly suppressed the diarrhea caused by maltitol, and the cumulative ratio was 82.1% (23/28). Conclusion: The transitory diarrhea caused by the ingestion of maltitol or lactitol was clearly suppressed by the addition of PHGG. These results strongly suggest that diarrhea caused by the ingestion of a sufficient amount of non-digestible sugar substitute can be suppressed by the addition of dietary fiber.

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Section: Introductionmentioning

confidence: 99%

Suppressive effect of partially hydrolyzed guar gum on transitory diarrhea induced by ingestion of maltitol and lactitol in healthy humans

et al. 2007

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“…Diarrhoea is the most frequent complication in enteral tube feeding (Whelan et al, 2001). Alterations in the colonic microflora have been identified in patients receiving enteral tube feeding and these changes may be associated with the diarrhoea incidence (Schneider et al, 2000).…”

Section: Diarrhoea In Patients With Total Enteral Feedingmentioning

confidence: 99%

Saccharomyces boulardiieffects on gastrointestinal diseases

Zanello

Meurens²,

Berri³

et al. 2009

Current Issues in Molecular Biology

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Health benefits attributed to probiotics have been described for decades. They include the treatment and the prevention of gastrointestinal diseases, vaginal and urinary infections and allergies. Saccharomyces boulardii, a species of yeast widely distributed, has been described as a biotherapeutic agent since several clinical trials displayed its beneficial effects in the prevention and the treatment of intestinal infections and in the maintenance of inflammatory bowel disease. All these diseases are characterized by acute diarrhoea. Administration of the yeast in combination or not with an antibiotherapy has shown to decrease significantly the duration and the frequency of diarrhoea. Experimental studies elucidated partially the molecular mechanisms triggered to improve the host health. The discovery of its anti-inflammatory and immuno-modulatory activities in correlation with the advances in the understanding of mucosal immunology opens a new field of perspectives in S. boulardii therapeutic applications.

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“…Once a probiotic has survived gastrointestinal transit it must then function to reduce the incidence of diarrhoea, possibly through the suppression of enteropathogenic colonization, immune stimulation and modulation of colonic metabolism (Whelan et al 2001; Table 1). …”

Section: Probiotics In Enteral Tube Feedingmentioning

confidence: 99%

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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The role of probiotics and prebiotics in the management of diarrhoea associated with enteral tube feeding

Cited by 31 publications

References 70 publications

Suppressive effect of partially hydrolyzed guar gum on transitory diarrhea induced by ingestion of maltitol and lactitol in healthy humans

Suppressive effect of partially hydrolyzed guar gum on transitory diarrhea induced by ingestion of maltitol and lactitol in healthy humans

Saccharomyces boulardiieffects on gastrointestinal diseases

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

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