Gastroenteric tube feeding: Techniques, problems and solutions

Table 4 Randomized controlled trials measuring the impact of probiotics on enteral nutrition-related diarrhea

Ref.	Study population	Treatment groups	Sample size (placebo)	Daily dose	Outcome
					Probiotics	Controls
Heimburger et al[204]	Adults starting EN	Lactobacillus acidophilus and L. bulgaricus	41 (23)	3000 CFU/d	31% developed diarrhea	11% developed diarrhea
Alberda et al[205]	Adults startingEN on ICU	VSL#3 - live cells	10/9 (9)	9 × 1011 mg/d	14%/12%1 of days with diarrhea	23% of days with diarrhea
Frohmader et al[206]	Adults startingEN on ICU	VSL#3	45 (25)	9 × 1011 mg/d	0.5 liquid stools/d	1.1 liquid stools/d
Ferrie et al[207]	Adults with diarrhea during EN on ICU	L. rhamnosus GG	36 (18)	(2 × 1010 cells/d) and inulin (560 mg/d)	3.8 d duration of diarrhea	2.6 d duration of diarrhea
Barraud et al[208]	Adults starting EN on ICU	Ergyphilus	167 (80)	(2 × 1010 CFU/d	55% developed diarrhea	53% developed diarrhea
Bleichner et al[209]	Adults starting EN on ICU	Saccharomyces boulardii	128 (64)	4 × 1010 CFU/d	7.7% of days with diarrhea	9.1% of days with diarrhea
Schlotterer et al[210]	Burnt adults	Saccharomyces boulardii	18 (9)	4 × 1010 CFU/d	1.5% of days with diarrhea	14% of days with diarrhea
Tempe et al[211]	Adults in ICU	Saccharomyces boulardii	40 (20)	1 × 1010 CFU/d	8.7% of days with diarrhea	16.9% of days with diarrhea

¹Viable probiotics/probiotic sonicates. VSL#3 consists of Lactobacillus casei, Lactobacillus plantarum, Lactobacillus acidophilus, Lactobacillus delbrueckii, Bifidobacterium longum, Bifidobacterium breve, Bifidobacterium infantis, and Streptococcus salivarius. Ergyphilus consists of mainly Lactobacillus rhamnosus GG, Lactobacillus casei, Lactobacillus acidophilus, and Bifidobacterium bifidum.