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.<p>
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.<p>
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.<p>
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.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:SSU.etd-04142009-211137 |
| Date | 21 April 2009 |
| Creators | Tumback, Lindsay Nora Theresa |
| Contributors | Kendall, Cyril, Bandy, Brian, Zello, Gordon, Dahl, Wendy, Hamilton, Don |
| Publisher | University of Saskatchewan |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://library.usask.ca/theses/available/etd-04142009-211137/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Saskatchewan or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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