Abstract

Patients with difficulty swallowing require long-term nutritional support. This involves the administration of essential nutrients, in liquid form, through a feeding tube directly into the stomach or small bowel. Enteral tube feeding (ETF) bypasses the innate defence mechanisms in the upper gastrointestinal (GI) tract predisposing the individual to microbial overgrowth, which in turn is associated with an increased risk of microbial translocation and sepsis. Complications of enteral feeding include gastrostomy, site infection and GI disturbances, most commonly diarrhoea. Probiotics have been shown to suppress the overgrowth of pathogens in the proximal GI tract, reducing the risk of microbial translocation. Prebiotics alter the colonic microflora, stimulating the growth of probiotic bacteria, and have been shown to reduce the incidence of enteral tube feeding-related diarrhoea. Such beneficial effects would be combined through the use of synbiotics, thus reducing the incidence of septic complications and diarrhoea in patients receiving enteral nutrition.

Keywords: enteral nutrition, microbial overgrowth, microbial translocation, biofilm, probiotic, prebiotic, synbiotic

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