Brief Reports
Copyright ©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 21, 2005; 11(39): 6165-6169
Published online Oct 21, 2005. doi: 10.3748/wjg.v11.i39.6165
Effects of Saccharomyces boulardii on fecal short-chain fatty acids and microflora in patients on long-term total enteral nutrition
Stéphane M Schneider, Fernand Girard-Pipau, Jérôme Filippi, Xavier Hébuterne, Dominique Moyse, Gustavo Calle Hinojosa, Anne Pompei, Patrick Rampal
Stéphane M Schneider, Jérôme Filippi, Xavier Hébuterne, Gustavo Calle Hinojosa, Patrick Rampal, Department of Hepato-Gastroenterology and Clinical Nutrition, Archet University Hospital, Nice, France
Fernand Girard-Pipau, Anne Pompei, Bacteriology Laboratory, Archet University Hospital, Nice, Franc
Dominique Moyse, Biostatistician, Paris, France
Gustavo Calle Hinojosa, Patrick Rampal, Department of Hepato-Gastroenterology, Princess Grace Hospital, Monte-Carlo, Monaco
Author contributions: All authors contributed equally to the work.
Supported by a research grant from Laboratoires Biocodex, Montrouge, France, EU
Correspondence to: Dr. Stéphane M Schneider, Department of Gastroenterology and Clinical Nutrition, Archet University Hospital, BP 3079, F-06202 Nice Cedex 3, France.stephane.schneider@unice.fr
Telephone: +33-4-92-03-61-68 Fax: +33-4-92-03-65-75
Received: January 12, 2005
Revised: June 1, 2005
Accepted: June 2, 2005
Published online: October 21, 2005
Abstract

AIM: To assess the effects of Sb on fecal flora and short-chain fatty acids (SCFA) in patients on long-term TEN.

METHODS: Ten patients (3 females, 7 males, 59±5.5 years), on TEN for a median of 13 mo (1-125), and 15 healthy volunteers (4 females, 11 males, 32±2.0 years) received Sb (0.5 g bid PO) for 6 d. Two stool samples were taken before, on the last 2 d and 9-10 d after treatment, for SCFA measurement and for culture and bacterial identification. Values (mean±SE) were compared using sign tests and ANOVA.

RESULTS: Fecal butyrate levels were lower in patients (10.1±2.9 mmol/kg) than in controls (19.2±2.9, P = 0.02). Treatment with Sb increased total fecal SCFA levels in patients (150.2±27.2vs 107.5?8.2 mmol/kg, P = 0.02) but not in controls (129.0±28.6 vs 113.0±15.2 mmol/kg, NS). At the end of treatment with Sb, patients had higher fecal butyrate (16.0±4.4 vs 10.1 [2.9] mmol/kg, P = 0.004). Total SCFAs remained high 9 d after treatment was discon-tinued. Before the treatment, the anaerobe to aerobe ratio was lower in patients compared to controls (2.4±2.3 vs 69.8±1.8, P = 0.003). There were no significant changes in the fecal flora of TEN patients.

CONCLUSION: Sb-induced increase of fecal SCFA concentrations (especially butyrate) may explain the preventive effects of this yeast on TEN-induced diarrhea.

Keywords: Enteral nutrition; Diarrhea; Saccharomyces boulardii; Short-chain fatty acids; Intestinal microbiota