Systematic Reviews
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 7, 2015; 21(17): 5372-5381
Published online May 7, 2015. doi: 10.3748/wjg.v21.i17.5372
Fiber and prebiotic supplementation in enteral nutrition: A systematic review and meta-analysis
Mazuin Kamarul Zaman, Kin-Fah Chin, Vineya Rai, Hazreen Abdul Majid
Mazuin Kamarul Zaman, Hazreen Abdul Majid, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
Kin-Fah Chin, Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
Vineya Rai, Department of Anaesthesiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
Author contributions: Kamarul Zaman M and Majid HA analyzed the data, and drafted and wrote the paper; Chin KF, Rai V and Majid HA designed the study and revised the manuscript; all authors approved the final version submitted for publication.
Supported by The University of Malaya Research Grant (No. PG127-2013A, No. UMRP022A-14HTM and No. UMRG 388-11HTM).
Conflict-of-interest: The authors declare that they have no conflicts of interest.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hazreen Abdul Majid, PhD, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia. hazreen.abdulmajid@gmail.com
Telephone: +60-37-9674757 Fax: +60-37-9674975
Received: October 24, 2014
Peer-review started: October 25, 2014
First decision: November 14, 2014
Revised: December 7, 2014
Accepted: January 30, 2015
Article in press: January 30, 2015
Published online: May 7, 2015
Core Tip

Core tip: Despite the importance of enteral nutrition (EN) for patients, diarrhea is a common complication in those receiving EN. Meta-analysis conducted in this review revealed that fiber supplementation in EN reduces diarrhea incidence. However, the positive effect is only seen in stable patients, and is not observed in critically ill patients. In addition, the effect of fiber and prebiotic supplementation towards fecal microbiota and short-chain fatty acids remain disputable due to the mixed findings. The heterogeneity of study populations, antibiotics therapies, and variation of the dosage for fiber and prebiotics likely explain such outcomes.