Sa2031 The Effects of Two Weeks Synbiotic Supplementation on Intestinal Permeability: A Randomized Controlled Trial

Abstract

Introduction: The intestinal barrier consists of an epithelial, mucus, and immunological barrier. Impaired intestinal barrier function may lead to the infiltration of noxious luminal substances into the intestinal mucosa. This may induce local immune activation or stimulate afferent nerve endings and, subsequently, cause symptoms such as abdominal pain. Pro, preand especially synbiotics are suggested to exert beneficial effects on the intestinal barrier, thereby decreasing intestinal epithelial permeability. The objective of this study was to assess the influence of two weeks synbiotic supplementation on intestinal permeability in vivo in healthy adults. We hypothesized that two weeks synbiotic supplementation will reinforce intestinal barrier function, as reflected by a decrease in intestinal permeability in vivo. Methods: Twenty healthy adults completed a double-blind, placebo-controlled, randomized parallel design study. Groups either received synbiotic (scFOS+Ecologic® 825) or placebo supplements twice daily for two weeks. Intestinal segment specific permeability was assessed non-invasively by oral administration of multiple sugar probes and, subsequently, assessing the excretion of these probes in urine. This test was conducted prior to and after intervention in the absence and, on separate test days, in the presence of an indomethacin challenge. The non-steroidal anti-inflammatory drug indomethacin has been shown to induce reversible damage to the upper gastrointestinal tract, and was applied as a model to study the effects of the supplementation on compromised intestinal barrier function. Results: Gastroduodenal and small intestinal permeability were significantly increased in the indomethacin stressed condition, compared with the unstressed condition, as assessed by urinary sucrose recovery (0.248 [0.206-0.318] vs. 0.363 [0.291-0.637] P<0.05) and urinary lactulose/rhamnose excretion ratio (0.047 [0.039-0.069] vs. 0.118 [0.082-0.165] P<0.001). Indomethacin did not affect colonic permeability as determined by sucralose/erythritol excretion ratio. The synbiotic supplementation did not affect gastroduodenal, small intestinal, and colonic permeability as reflected by urinary sucrose recovery, lactulose/rhamnose excretion ratio and sucralose/erythritol excretion ratio, respectively. These findings were not different among the stressed and unstressed conditions. Conclusion: We confirmed that indomethacin causes damage to the stomach and small intestine. Further, we conclude that two weeks supplementation of scFOS+Ecologic® 825 does not reinforce gastroduodenal, small intestinal or colonic permeability in a healthy gut, nor in a compromised gut.