title: Early low volume oral synbiotic/prebiotic supplemented enteral stimulation of the gut in patients with severe acute pancreatitis: a prospective feasibility study.
abstract: BACKGROUND
  Experience with administration of synbiotics (prebiotics/probiotics) in patients with severe acute pancreatitis (SAP) has demonstrated immunomodulatory capacity. The aim of this trial was evaluation of the feasibility and perspective of early clinical application of oral synbiotic/prebiotic supplements in patients with SAP.
  
  
  METHODS
  90 SAP patients were enrolled during the period from 2005-2008. Patients were stratified according to the feeding mode. CONTROL (n = 32) group received standard whole protein feeding formula. SYNBIO (n = 30) and FIBRE groups (n = 28) received early (within first 24-48 hours) synbiotic or prebiotic supplements. Oral administration of synbiotics or prebiotics was commenced when patients were able to sip water.
  
  
  RESULTS
  Daily provided average volume and calories of synbiotic/prebiotic blends were smaller compared to the CONTROL, p = 0.001. Oral administration of synbiotic/prebiotic supplements was associated with lower infection rate (pancreatic and peripancreatic necrosis) compared to the CONTROL, (p = 0.03; p = 0.001), lower rate of surgical interventions, p = 0.005, shorter ICU (p = 0.05) and hospital stay (p = 0.03). Synbiotic supplemented enteral stimulation of the gut resulted in reduced mortality rate compared to the CONTROL, p = 0.02.
  
  
  CONCLUSIONS
  Early low volume oral synbiotic/prebiotic supplemented enteral stimulation of the gut seems to be a potentially valuable complement to the routine treatment protocol of SAP.
authors.affiliation: Department of Surgery, Riga Eastern Clinical University Hospital "Gailezers", Riga, Latvia. hplaudis@gmail.com
authors.forename: H
authors.initials: H
authors.lastname: Plaudis
authors.forename: G
authors.initials: G
authors.lastname: Pupelis
authors.forename: K
authors.initials: K
authors.lastname: Zeiza
authors.forename: V
authors.initials: V
authors.lastname: Boka
mesh_terms: D000208:Acute Disease; D016022:Case-Control Studies; D004043:Dietary Fiber / Q000008:administration & dosage / Q000627:therapeutic use*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D010195:Pancreatitis / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D019936:Probiotics / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D058616:Synbiotics / Q000706:statistics & numerical data; D016896:Treatment Outcome