The Effect of Inulin Supplementation on the Quality of Life of Patients with Ileal Pouch Anal Anastomosis
Date
2009
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
ORCID
Type
Degree Level
Masters
Abstract
Objectives: Ileal pouch anal anastomosis (IPAA), the removal of the colon and formation of a reservoir from ileum, is the surgery of choice for ulcerative colitis and familial adenomatous polyposis. Yet, 10 to 35% of patients develop pouchitis, an inflammation of the pouch mucosa. Microbial imbalances are observed in pouchitis and inulin has been suggested as a prebiotic treatment. Our objectives were to determine the effect of inulin supplementation on quality of life (QOL), and its practicality and safety as a treatment in IPAA patients.
Methods: Adults with IPAA (n= 8) consented to a blinded, placebo-controlled trial of inulin supplementation. Baseline symptoms were measured for 1 month prior to supplementation, followed by a blinded low-dose (5 g of inulin) or placebo (maltodextrin) for 2 weeks and a higher-dose (10 g) for 5.5 months. Participants recorded any symptoms that they experienced in a diary and QOL was assessed using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ) at the beginning and end of the study.
Results: Two participants in the same group developed significant side effects on the 10 g supplementation; abdominal discomfort, severe gas, and small amounts of blood with defecation were reported. Unblinding determined that these participants were taking the active treatment (inulin); therefore, the study was stopped early. No differences were observed in SIBDQ scores.
Implications & Conclusions: In this pilot study, inulin appeared to be ineffective in improving QOL and may have contributed to unpleasant side effects. Future research should explore synbiotic therapy in IPAA, by combining prebiotics and probiotics for optimal results.
Description
Keywords
Ileal Pouch Anal Anastomosis, Inulin, Prebiotics, Pouchitis
Citation
Degree
Master of Science (M.Sc.)
Department
College of Pharmacy and Nutrition
Program
College of Pharmacy and Nutrition