Effects of fiber and probiotics on diarrhea associated with enteral nutrition in gastric cancer patients: A prospective randomized and controlled trial

Background and objectives:Diarrhea is a common complication of enteral nutrition (EN), which affects recovery and prolongs the length of hospital stay (LOHS). To investigate the effect of fiber and probiotics in reducing diarrhea associated with EN in postoperative patients with gastric cancer (GC), the authors designed this prospective randomized-controlled trial.Methods and study design:This study included 120 patients with GC, and the patients were classified into 3 groups via random picking of envelopes: fiber-free nutrition formula (FF group, n=40), fiber-enriched nutrition formula (FE group, n=40), and fiber- and probiotic-enriched nutrition formula (FEP group, n=40). All patients were given EN formulas for 7 consecutive days after surgery.Results:The number of diarrhea cases was higher in the FF group than in the FE group (P=.007). The FEP group had a lower number of diarrhea cases compared with the FE group (P=.003). Patients in the FE group had a significantly shorter first flatus time than the FF group (P=.002). However, no significant difference was observed between the FE group and FEP group (P=.30). Intestinal disorders were similar between the FE group and FF group (P=.38). The FEP group had a lower number of intestinal disorder cases than the FF group (P=.03). LOHS in the FE and FEP groups was shorter than that in the FF group (P=.004; P<.001). However, no significant difference was observed between the FE and FEP groups (P=.28). In addition, no significant difference was observed between the 3 groups in terms of total lymphocyte count, albumin, prealbumin, and transferrin levels on day 7 of enteral feeding.Conclusions:The combination of fiber and probiotics was significantly effective in treating diarrhea that is associated with EN in postoperative patients with GC.