Synbiotics and gastrointestinal function-related quality of life after elective colorectal cancer resection
Background Synbiotics (combination of prebiotics and probiotics) may serve as a supportive dietary supplement-based strategy after colectomy for cancer. The potential benefits of early postoperative administration of synbiotics on the gastrointestinal function-related quality of life inpatients were explored.
Methods Patients who underwent elective colectomy were prospectively enrolled and randomized to receive either synbiotics (n=38) or placebo (n=37) on the day they tolerated liquid diet and for 15 days thereaft er. Primary endpoints were Gastro-Intestinal Quality of Life Index (GIQLI) questionnaire assessments at 1, 3 and 6 months postoperatively. Secondary endpoints were functional bowel disorders ("diarrhea", "constipation") assessed by EORTC QLQ-C30.
Results Patients under synbiotics had a better GIQLI "Global score" compared with those who received placebo [77Â±1.67 vs. 71.36Â±1.69, P=0.01 (1 month); 77Â±1.7 vs. 72.5Â±1.73, P=0.03 (3 months); 79.23Â±1.82 vs. 72.75Â±1.85, P=0.01 (6 months)]. Multivariate linear mixed model analysis showed that synbiotics administration was the only independent signifi cant factor for the "Global score" amelioration (b: 5.42, SE (b)1.8, 95%CI 1.78-9.1, P=0.004). The EORTC QLQ-C30 "diarrhea" domain score differences from baseline were better after synbiotics administration after 3 (P=0.04) and 6 months (P=0.003). No significant effect on "constipation" scores was observed.
Conclusion Synbiotics administration may have a beneficial effect on the postcolectomy gastrointestinal function.
Keywords Synbiotics, colorectal cancer, health-related quality of life, gastrointestinal quality of life index
Ann Gastroenterol 2016; 29 (1): 56-62