Early Low Volume Oral Synbiotic/Prebiotic Supplemented Enteral Stimulation of the Gut in Patients with Severe Acute Pancreatitis: A Prospective Feasibility Study

Abstract

Background : Experience with administration of synbiotics (prebiotics/probiotics) in patients with severe acute pancreatitis (SAP) has demonstrated immunomodulatory capacity. The aim of this trial was evaluation of the feasibility and perspective of early clinical application of oral synbiotic/prebiotic supplements in patients with SAP. Methods : 90 SAP patients were enrolled during the period from 2005–2008. Patients were stratified according to the feeding mode. CONTROL (n = 32) group received standard whole protein feeding formula. SYNBIO (n = 30) and FIBRE groups (n = 28) received early (within first 24–48 hours) synbiotic or prebiotic supplements. Oral administration of synbiotics or prebiotics was commenced when patients were able to sip water.

Results : Daily provided average volume and calories of synbiotic/prebiotic blends were smaller compared to the CONTROL, p = 0.001. Oral administration of synbiotic/prebiotic supplements was associated with lower infection rate (pancreatic and peripancreatic necrosis) compared to the CONTROL, (p = 0.03; p = 0.001), lower rate of surgical interventions, p = 0.005, shorter ICU (p = 0.05) and hospital stay (p = 0.03). Synbiotic supplemented enteral stimulation of the gut resulted in reduced mortality rate compared to the CONTROL, p = 0.02.

Conclusion : Early low volume oral synbiotic/prebiotic supplemented enteral stimulation of the gut seems to be a potentially valuable complement to the routine treatment protocol of SAP.

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Notes on contributors

H. Plaudis

H. Plaudis Riga Eastern Clinical University Hospital “Gailezers” 2 Hipokrata Street Riga, Latvia, LV 1038 Tel.: [phone] Fax: [phone] E-mail: [email protected]