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Prebiotics backed to help recovery from intestinal failure

By Nathan Gray , 17-Oct-2012

A combination of ‘the right’ pre- and probiotcs could help people suffering with intestinal failure to grow a new and improved gut ecosystem, say researchers.

The new animal study – published in the Journal of Parenteral and Enteral Nutrition – investigates whether the use of pre- and probiotics could be a clinically feasible way to help stimulate intestinal adaptations in people who are suffering from intestinal failure (also known as short bowel syndrome).

Led by Professor Kelly Tappenden from the University of Illinois, the research team tested how piglets with a model of intestinal failure responded to various feeding combinations of pre- and probiotics – finding that use of a prebiotic fructooligosacharide (FOS) alone was effective in increasing intestinal function and structure, while addition of ‘the right’ probiotic could boost functions even further.  

"When we fed the carbohydrate fructooligosacharide (FOS) as a prebiotic, the gut grew and increased in function," said Tappenden.

"The study showed that using the correct pre- and probiotic in combination could enhance these results even more."

Butyrate benefit

The authors revealed that butyrate – a short chain fatty acid important for cell functions in the gut – has been shown by previous researchers to stimulate intestinal adaptation when added to parenteral nutrition (PN) following intestinal failure or small bowel resection – however the fatty acid is not available in current formulations.

Tappenden said that because current solutions don't contain butyrate and the process of adding it would now entail drug development trials and regulatory red tape, she wanted to see if adding FOS to the diet while continuing to provide most nutrients intravenously would cause the gut to start producing butyrate on its own.

It worked, she said – explaining that as FOS enters the intestines, bacteria convert it into butyrate, which in turn improves the guts ability to digest and absorb nutrients.

Study details

Tappenden and her team tested the idea that pre-and probiotics might help to stimulate butyrate production using newborn piglet – which is an excellent model for the human infant in metabolism and physiology.

Piglets with intestinal failure were assigned to one of four groups: a control group; a group whose diet contained FOS; a probiotic; 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," said Tappenden.

The team revealed that FOS alone was found to increase gut functioning and new growth, whilst the probiotics were found to have mixed effects: "The probiotic that we used in one of the groups eliminated the beneficial effect of the prebiotic,” said Tappenden.

“That shows us that we need to be exceptionally careful in selecting the probiotic we use,” she added, noting that while many consumers believe all probiotics are equal, the effect of specific bacterial strains can be very different. "At this point, we can only recommend consumption of the FOS prebiotic alone.
Source: Journal of Parenteral and Enteral Nutrition
Published online ahead of print, doi: 10.1177/0148607112444131
“Intestinal Adaptation Is Stimulated by Partial Enteral Nutrition Supplemented With the Prebiotic Short-Chain Fructooligosaccharide in a Neonatal Intestinal Failure Piglet Model”
Authors: Jennifer L. Barnes, Bolette Hartmann, Jens J. Holst, Kelly A. Tappenden

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