Prebiotic may help patients with intestinal failure grow new and better gut

Adding the right prebiotic to the diets of pediatric patients with intestinal failure could replace intravenous feeding, says a new University of Illinois study.

"When we fed the carbohydrate fructooligosacharide (FOS) as a , the grew and increased in function," said Kelly A. Tappenden, a U of I professor of nutrition and gastrointestinal physiology. "The study showed that using the correct pre- and probiotic in combination could enhance these results even more."

When FOS enters the intestines, bacteria convert it into butyrate, a short-chain fatty acid that increases the size of the gut and its ability to digest and absorb nutrients, she said.

But today's IV solutions don't contain butyrate and adding it would entail drug development trials and regulatory red tape. She wanted to see if adding this carbohydrate to the diet while continuing to provide most nutrients intravenously would cause the gut to start producing butyrate on its own. It worked.

According to Tappenden, at least 10,000 U.S. patients are totally reliant on intravenous feeding because their intestines have been surgically shortened.

Many of these patients are who develop necrotizing enterocolitis, a kind of gangrene of the intestine. In the U.S., one in eight infants is a preemie, and removing necrotized, or dead, intestine is the most common surgical emergency in these babies.

"Surgery saves their lives, but with so much removed, they're unable to digest or absorb nutrients. These babies are also at risk for long-term complications, such as bone demineralization and . Our goal is to take kids who've had this resection and cause their gut to grow and adapt," she said.

She tested her hypothesis about butyrate using newborn piglets, an excellent model for the human infant in metabolism and physiology. Piglets with intestinal failure were assigned to one of four groups: a ; a group whose diet contained FOS, a carbohydrate given as a prebiotic to stimulate the production of butyrate by beneficial bacteria; a probiotic, or actual live bacteria; and a combination of pre- and probiotics.

"We believed that bacteria in the gut would use the prebiotic to make butyrate and support intestinal growth. But we thought that might only happen in the group that received both pre- and probiotics because we didn't know if the newborn gut would have enough bacteria to make this important short-chain fatty acid."

Actually, the neonatal piglets did have enough in their guts, and the prebiotic alone was effective in increasing intestinal function and structure, she said.

"In fact, the probiotic that we used in one of the groups eliminated the beneficial effect of the prebiotic. That shows us that we need to be exceptionally careful in selecting the probiotic we use, matching it to the specific disease," she noted. Many consumers believe all probiotics are equal, but the effect of specific bacterial strains is different, she said.

"At this point, we can only recommend consumption of the FOS prebiotic alone," she added.

More information: The article appears in the September 2012 issue of the Journal of Parenteral and Enteral Nutrition and is available online at http://pen.sagepub.com/content/current. Jennifer L. Barnes of the U of I and Bolette Hartmann and Jens J. Holst of the University of Copenhagen, Copenhagen, Denmark, are co-authors of the study, which was funded by grants from the National Institutes of Health.

Related Stories

Prebiotic potential of almonds

Jun 27, 2008

Almonds, as well as being high in vitamin E and other minerals, are also thought to have other health benefits, such as reducing cholesterol. Recently published work by the Institute of Food Research has identified potential ...

Prebiotic potential of almonds

Jun 27, 2008

Almonds, as well as being high in vitamin E and other minerals, are also thought to have other health benefits, such as reducing cholesterol. Recently published work by the Institute of Food Research has ...

Changing pigs' diets alters the gut microbiota

Jun 21, 2012

Including chicory in cereal-based diets of pigs results in profound changes in gut micro-environment, morphology, and microbial population of pigs, according to a study in the June 2012 Applied and Environmental Microbiology. Some o ...

Recommended for you

A hybrid vehicle that delivers DNA

17 hours ago

A new hybrid vehicle is under development. Its performance isn't measured by the distance it travels, but rather the delivery of its cargo: vaccines that contain genetically engineered DNA to fight HIV, cancer, ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.