Synbiotics and gastrointestinal function-related quality of life after elective colorectal cancer resection

Authors George E. Theodoropoulos, Nikolaos A. Memos, Kiriaki Peitsidou, Theodoros Karantanos, Basileios G. Spyropoulos, George Zografos.


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 [77±1.67 vs. 71.36±1.69, P=0.01 (1 month); 77±1.7 vs. 72.5±1.73, P=0.03 (3 months); 79.23±1.82 vs. 72.75±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

Original Articles