Synbiotics and Gastrointestinal Function-related Quality of Life After Elective Colorectal Cancer Resection

Background: Synbiotics (combination of prebiotics and probiotics) may serve as a supportive dietary supplement-based strategy after colectomy for cancer. The potential benefits of early postoperative administration of synbiotics on the gastrointestinal function-related quality of life inpatients were explored.

Methods: Patients who underwent elective colectomy were prospectively enrolled and randomized to receive either synbiotics (n=38) or placebo (n=37) on the day they tolerated liquid diet and for 15 days thereafter. Primary endpoints were Gastro-Intestinal Quality of Life Index (GIQLI) questionnaire assessments at 1, 3 and 6 months postoperatively. Secondary endpoints were functional bowel disorders ("diarrhea", "constipation") assessed by EORTC QLQ-C30.

Results: Patients under synbiotics had a better GIQLI "Global score" compared with those who received placebo [77±1.67 vs. 71.36±1.69, P=0.01 (1 month); 77±1.7 vs. 72.5±1.73, P=0.03 (3 months); 79.23±1.82 vs. 72.75±1.85, P=0.01 (6 months)]. Multivariate linear mixed model analysis showed that synbiotics administration was the only independent significant factor for the "Global score" amelioration (b: 5.42, SE (b)1.8, 95%CI 1.78-9.1, P=0.004). The EORTC QLQ-C30 "diarrhea" domain score differences from baseline were better after synbiotics administration after 3 (P=0.04) and 6 months (P=0.003). No significant effect on "constipation" scores was observed.

Conclusion: Synbiotics administration may have a beneficial effect on the postcolectomy gastrointestinal function.