Fructo-oligosaccharides and fibre in enteral nutrition has a beneficial influence on microbiota and gastrointestinal quality of life

Objective. Intestinal microbiota is important in health and disease. The aim of this study was to evaluate the effect of fructo-oligosaccharides (FOS) and fibre-enriched tube feeding on quality of life and intestinal microbiota (faecal Bifidobacteria). Material and methods. Nineteen out of 59 home-living, tube-feeding-dependent, adult patients and matched healthy controls were included in this randomized, double-blind study. After a washout period, patients received either no residue tube feeding (non-FOS group) or FOS and fibre-enriched tube feeding (FOS group). Quality of life as defined by the Gastrointestinal Quality of Life Index (GIQLI) and quantification of faecal Bifidobacteria were determined. Results. At baseline, GIQLI scores in controls and patients were 88 +/- 12 and 67 +/- 14, respectively (p =0.001). Following 6 weeks' intervention, GIQLI scores remained stable (65 +/- 14 versus 67 +/- 17) in the FOS group, whereas the non-FOS group values decreased (68 +/- 17 versus 64 +/- 19). Baseline faecal samples contained 2.1 x 10(7) +/- 3.5 x 10(7) and 2.1 x 10(6) +/- 5.6 x 10(6) Bifidobacteria (p = 0.002) in controls and patients, respectively, with no differences between patient groups. During the intervention, this number remained stable in the FOS group (0.7 x 10(6) +/- 1.3 x 10(6) versus 1.0 x 10(6) +/- 1.3 x 10(6) baseline versus end-point), but decreased in the non-FOS group (3.6 x 10(6) +/- 8.0 x 10(6) versus 2.5 x 10(4) +/- 4.0 x 10(4)). GIQLI scores were correlated with the number of faecal Bifidobacteria (r =0.41, p =0.007). Conclusions. The GIQL score for the tubefed patients increased with the number of faecal Bijidobacteria, although in a non-linear way, and addition of FOS increased the number of Bifidobacteria. This suggests that prebiotic tube feeding may lead to a change in intestinal microbiota that could induce an increased quality of life in these patients.