Prebiotic ingestion does not improve gastrointestinal barrier function in burn patients.
Prebiotics increase intestinal levels of health-promoting bacteria implicated in decreasing pathogen colonization, stimulating immune functions and stabilizing gut barrier functions, parameters which are altered in burn patients. We propose that regular intake of a prebiotic, oligofructose (OF), might help to improve the altered gastrointestinal (GI) permeability observed in burn patients. A randomized, double-blind, controlled clinical trial was carried out in 41 burn patients (mean burn surface area=17.1+/-8.2%) who ingested daily 6 g of oligofructose (OF group) or sucrose as placebo (Control group) during 15 days. Gastrointestinal permeability to sucrose and lactulose/mannitol (L/M) was evaluated on days 1 (before treatment) 3, 7, 14 and 21. A permeability test was also performed in 18 healthy subjects as controls. Thirty-one patients completed the protocol (dropout rate=24.4%). Healthy subjects had a basal sucrose excretion of 21.3 mg (14.0-32.5 mg) and a basal L/M ratio of 0.017% (0.009-0.022%). Sucrose excretion increased 5-fold and L/M ratio 4.4-fold in burn patients on day 1 and these high levels of marker excretion decreased significantly throughout the study (p=0.016 and 0.000001, respectively). No differences between the OF and Control groups were observed for sucrose excretion or L/M ratio. In conclusion, the normalization of gastrointestinal permeability is not accelerated by prebiotic intake.
Olguin
F
F
Gastroenterology Unit, INTA, University of Chile, Santiago, Chile.
Araya
M
M
Hirsch
S
S
Brunser
O
O
Ayala
V
V
Rivera
R
R
Gotteland
M
M
D000328:Adult; D000704:Analysis of Variance; D002056:Burns / Q000188:drug therapy* / Q000503:physiopathology* / Q000652:urine; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005753:Gastric Mucosa / Q000503:physiopathology; D006801:Humans; D007408:Intestinal Absorption / Q000187:drug effects*; D007413:Intestinal Mucosa / Q000503:physiopathology; D007421:Intestine, Small; D007792:Lactulose / Q000652:urine; D008297:Male; D008353:Mannitol / Q000652:urine; D008875:Middle Aged; D009844:Oligosaccharides / Q000008:administration & dosage*; D013395:Sucrose / Q000008:administration & dosage / Q000652:urine; D017211:Treatment Failure
D009844:Oligosaccharides; C120489:oligofructose; D008353:Mannitol; D007792:Lactulose; D013395:Sucrose