Pre and Probiotics in Tube Feeding

Pre and Probiotics in Tube Feeding

By Bushra Hassan, MBA, RD, LDN
Medline Dietitian

The Clinical use of Prebiotics and Probiotics

Prebiotics and probiotics work within the gastrointestinal tract in a symbiotic way.Probiotics are live organisms which provide new bacteria to the host, the gutmicrobiome while prebiotics support the composition of existing microorganisms through supporting the growth of beneficial bacteria. Our microbiome is made up oftrillions of microorganisms which is responsible for supporting our immune system,metabolism, and of course, our digestion. In order to thrive, we must have a healthybalance of good and bad bacteria.

Examples of prebiotics include fructooligosaccharides (FOS) and inulin. Prebioticsferment in the colon and produce short chain fatty acids which aid in digestivehealth, allowing the body to absorb and utilize nutrients more effectively. Prebioticsare readily available through a whole foods diet, as foods such as bananas, onionsand artichoke hearts.

The most common commercially available probiotics are the bacteria lactobacilli, bifidobacteria, Saccharomyces boulardii. Food sources oflactobacilli andbifidobacteria include sauerkraut, yogurt and kimchi, while mangostein and lycheecontain the benefical probiotic, Saccharomyces boulardii.

Prebiotics and Probiotics in tube feeding:

Lifestyle choices, medication, dietary intake along with environmental factors candisrupt the finely tuned bacterial balance within the gut. Including food sources ofprobiotics and prebiotics is an excellent way to ensure there is a wide variety ofspecies and types of bacteria. Everytime we eat we are feeding our gut microbiome,which further supports our immune system, synthesizes vitamins and minerals andproduction of short-chain fatty acids. When our diet is lacking in beneficial bacteriathere is more opportunity for pathogenic bacteria to step in and create chaos.Including pre and probiotics have been shown to support the immune system andmood, improve bloating other gastrointestinal symptoms. When choosing asupplement, it is often recommended to use one which includes a variety of differentspecies and different forms of prebiotics and probiotics.

Slowly adding pre and probiotics isimperativeto ensure there is no gastrointestinaldiscomfort. Working with your doctor about a starting dose is recommended,typically starting with a¼of the dose and then increase to full dose over a period of 7-14 days.

Probiotics have been shown to support gastrointestinal symptoms such as diarrhea, constipation, feelings of nausea and vomiting. Additionally, in enteral nutrition, the use of prebiotic and p robiotic foods has been shown to offer support in the prevention and treatment of diarrhea, including Clostridioides difficile associated diarrhea. Both probiotics and prebiotics can be received through feeding a whole foods based diet or supplementation.


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