Effects of Probiotics on Chemotherapy-induced Diarrhea

Abstract

Chemotherapy-induced diarrhea (CID) is a common adverse event in cancer patients, which, unless treated, may lead to drug discontinuation and treatment failure. Some probiotics such as Lactobacillus, Bifidobacterium, and Saccharomyces species have been gaining clinical attention in alleviating chemotherapy-induced adverse events including diarrhea. This comprehensive review provides an overview and discusses preventive approaches of probiotics with respect to CID in several types of cancers. The potential mechanisms of probiotics may comprise regulation of intestinal microbiota, modulation of immune functions, or reduction of proinflammatory cytokines. The efficacy and safety precautions of probiotics in immunocompromised cancer patients are discussed. The non-pharmacological strategy using probiotics could reduce the use of anti-diarrheal or antibiotic agents. Some individuals experienced shorter length of hospital stay, better gastrointestinal function, and reduced incidence of chemotherapy dose reduction after probiotic administration. Nonetheless, some studies failed to report the benefits of probiotics in certain patients. This review also highlights preventive protocols and therapeutic implications by considering the potential influencing factors, particularly types of probiotic strains, dosages of probiotics, duration of their administration, patients’ tolerability, and variations in probiotic effects over the cancer stages.

Author contributions

Daylia Thet: Conceptualization, methodology, formal analysis, data curation, investigation, original draft preparation, writing reviewing, and editing. Nutthada Areepium: Conceptualization, supervision, original draft preparation, writing reviewing, and editing. Tippawan Siritientong: Conceptualization, methodology, data curation, data interpretation, supervision, critical appraisal, original draft preparation, writing reviewing, and editing.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article.

Additional information

Funding

This work was supported by the graduate scholarship program for ASEAN or non-ASEAN countries, Chulalongkorn University.