Effect of a Symbiotic Gel (Lactobacillus acidophilus plus Bifidobacterium lactis plus Inulin) on Presence and Severity of Gastrointestinal Symptoms in Hemodialysis Patients

Objective: The study aimed to assess the effect of a symbiotic gel on presence and severity of gastrointestinal symptoms (GIS) in hemodialysis patients. Design: A double-blinded, placebo-controlled, randomized, clinical trial was designed. The study was conducted at 2 public hospitals in Guadalajara, Mexico. Subjects and Intervention: Twenty-two patients were randomized to the intervention group (nutritional counseling 1 symbiotic gel) and 20 patients were randomized to the control group (nutritional counseling 1 placebo), during 2 months of follow-up. Main Outcome Measure: Presence and monthly episodes of GIS were assessed by direct interview and severity by using the self-administered GIS questionnaire. Additionally, biochemical parameters, inflammatory markers, and nutritional status (dietary intake, subjective global assessment, anthropometry, and body composition) were evaluated. Results: After a 2-month treatment, intervention group had a significant reduction in prevalence and monthly episodes of vomit, heartburn, and stomachache, as well as a significant decrease in GIS severity compared with control group. Moreover, intervention group had a greater yet not significant decrease in the prevalence of malnutrition and a trend to reduce their C-reactive protein and tumor necrosis factor a levels compared with control group. No symbiotic-related adverse side effects were shown in these patients. Clinical studies with longer follow-up and sample size are needed to confirm these results. Conclusions: We concluded that administration of a symbiotic gel is a safe and simple way to improve common GIS in dialysis patients. (C) 2015 by the National Kidney Foundation, Inc. All rights reserved.