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Nutrition Therapy for Diarrhea in Cancer and Severe Illness in Patients

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (25 February 2022) | Viewed by 14324

Special Issue Editors

Dr. Salvatore Artale

E-Mail Website
Guest Editor
Oncology Departement, Ospedale di Gallarate, ASST Valle Olona, 4-21013 Gallarate, Italy
Interests: neuroendocrine tumours; colorectal cancer; nutrition; vitamin deficiencies; vitamin D deficiency; niacin; fat-soluble vitamins; malnutrition; chemotherapy-induced diarrhea; dietary habits; food intolerance; lifestyle; mediterranean diet
Special Issues, Collections and Topics in MDPI journals
Dr. Riccardo Caccialanza

E-Mail Website
Guest Editor
Clinical Nutrition and Dietetics Unit, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
Interests: nutrition; metabolism; nutrition assessment; clinical nutrition; malnutrition nutritional medicine; dietetics; nutritional status; nutritional biochemistry; nutritional requirements; nutrition performance
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

As you know, diarrhea is a severe and common problem among cancer patients both during and after treatment for the disease, which may lead to treatment interruptions and even discontinuation. The main cause of chronic diarrhea is represented by cytotoxic agents, but targeted drugs, radiotherapy and immunotherapy can also cause this condition. Treatment-induced diarrhea can be severe and be associated with malnutrition, dehydration and electrolyte abnormalities with significant impact on quality of life and social functioning. Given the significant clinical impact of malnutrition on cancer patients, nutritional therapy should be an integral part of cancer treatment as a supportive measure. This support can lead to an improvement in the nutritional status and suppression of the gluconeogenesis associated with cancer cachexia. Nutritional support has also been shown to positively impact clinical outcomes, including improvement in tolerance to therapy, reduced hospitalizations, reduction in operative morbidity and mortality and improved sense of well-being.

In this Special Issue of Nutrients, we would like to invite experts to contribute with original research or review articles that investigate :

  • the role of nutritional therapy in the management of diarrhea in cancer patients;
  • the impact of cancer and its treatment on nutritional factors with emphasis on malnutrition, dietary approaches and quality of life.
Dr. Salvatore Artale
Dr. Riccardo Caccialanza
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Cancer
  • Chemotherapy
  • Radiotherapy
  • Immunotherapy
  • Toxicity
  • Malnutrition
  • Diarrhea
  • Nutrition
  • Vitamin D
  • Intestinal microbiota
  • Probiotics

Published Papers (4 papers)

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Research

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9 pages, 677 KiB  
Article
A Nutritional Approach for the Management of Chemotherapy-Induced Diarrhea in Patients with Colorectal Cancer
by Salvatore Artale, Nunziata Grillo, Stefano Lepori, Chiara Butti, Antonella Bovio, Sabrina Barzaghi, Andrea Colombo, Elena Castiglioni, Lucia Barbarini, Laura Zanlorenzi, Paola Antonelli, Riccardo Caccialanza, Paolo Pedrazzoli, Mauro Moroni, Sabrina Basciani, Rebecca Azzarello, Francesco Serra and Alessandra Trojani
Nutrients 2022, 14(9), 1801; https://doi.org/10.3390/nu14091801 - 26 Apr 2022
Cited by 6 | Viewed by 2622
Abstract
This study aimed to determine if dietary modifications using a nutritional regimen could prevent or reduce the incidence of cancer therapy-induced diarrhea in patients with metastatic colorectal cancer and to evaluate the relationship of Vitamin D blood levels with diarrhea severity. Patients with [...] Read more.
This study aimed to determine if dietary modifications using a nutritional regimen could prevent or reduce the incidence of cancer therapy-induced diarrhea in patients with metastatic colorectal cancer and to evaluate the relationship of Vitamin D blood levels with diarrhea severity. Patients with metastatic colorectal cancer were enrolled. A Mediterranean diet, containing some special limitations aiming to reduce the risk of diarrhea, was administered before and during the entire chemotherapy program. Enrolled patients numbering 60/137 (44%) had diarrhea during chemotherapy. Adherence to the diet was high in 36 (26.3%) patients, medium in 94 (68.6%), and low in 7 (5.1%). Mean adherence to the diet was significantly lower in patients who experienced diarrhea with maximum grade 2–3 compared to those who had no diarrhea or grade 1 diarrhea (score = 5.4 ± 1.9 vs. 7.1 ± 1.5, p < 0.001). Patients with higher adherence to the diet had a lower risk of grade 2–3 diarrhea (odds ratio: 0.5 (95% CI: 0.3–0.7, p < 0.001)). In addition, patients who completed a higher number of chemotherapy cycles had an increased risk of grade 2–3 diarrhea (odds ratio: 1.2 (95% CI: 1.0–1.5, p = 0.02)). Of note, a lower level of Vitamin D correlated with an increased risk of G2-G3 diarrhea (p = 0.03). A diet based on vegetables with a controlled fiber content, Mediterranean Modified Healthy Diet (MMHD), is useful to control the incidence of cancer therapy-induced diarrhea. Full article
(This article belongs to the Special Issue Nutrition Therapy for Diarrhea in Cancer and Severe Illness in Patients)
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11 pages, 1133 KiB  
Article
Management of Dietary Habits and Diarrhea in Fap Individuals: A Mediterranean Low-Inflammatory Dietary Intervention
by Ciniselli Chiara Maura, Bruno Eleonora, Oliverio Andreina, Baldassari Ivan, Pastori Marta, Signoroni Stefano, Vitellaro Marco, Ricci Maria Teresa, Milione Massimo, Cattaneo Laura, Gariboldi Manuela, Mancini Andrea, Rivoltini Licia, Morelli Daniele, Pasanisi Patrizia and Verderio Paolo
Nutrients 2021, 13(11), 3988; https://doi.org/10.3390/nu13113988 - 09 Nov 2021
Cited by 2 | Viewed by 2124
Abstract
Background: A total colectomy and a frequent life-long endoscopic surveillance are guaranteed to patients with Familial Adenomatous Polyposis (FAP) to reduce their risk of duodenal and rectal stump cancers. However, after surgery, individuals with FAP suffer from an increased number of diarrheal discharges [...] Read more.
Background: A total colectomy and a frequent life-long endoscopic surveillance are guaranteed to patients with Familial Adenomatous Polyposis (FAP) to reduce their risk of duodenal and rectal stump cancers. However, after surgery, individuals with FAP suffer from an increased number of diarrheal discharges that force them to dietary restrictions. A non-randomized pilot study was conducted to assess whether a three-month low-inflammatory Mediterranean dietary intervention reduces gastro-intestinal markers of inflammation in FAP individuals. The aim of the present work is to evaluate the participant’s adherence to the proposed dietary recommendations and the change in their number of diarrheal discharges. Methods: 26 FAP individuals aged >18 years, who underwent a total colectomy with ileo-rectal anastomosis and were involved in the surveillance program at the Fondazione IRCCS Istituto Nazionale Tumori of Milan, were included in the present analysis. Results: FAP individuals significantly reduced the Not recommended foods (p-value: 0.002) and increased the consumption of the Recommended ones (p-value: 0.075). The adherence to the proposed dietary recommendations was accompanied by a significant decrease in the number of diarrheal discharges (p-value: 0.008). Conclusions: This study suggests that adhering to a low-inflammatory Mediterranean diet has a potential protective effect on the number of diarrheal discharges in FAP individuals. Full article
(This article belongs to the Special Issue Nutrition Therapy for Diarrhea in Cancer and Severe Illness in Patients)
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11 pages, 643 KiB  
Article
Lactobacillus Kefiri LKF01 (Kefibios®) for Prevention of Diarrhoea in Cancer Patients Treated with Chemotherapy: A Prospective Study
by Michele Ghidini, Mariaceleste Nicoletti, Margherita Ratti, Gianluca Tomasello, Veronica Lonati, Mara Ghilardi, Maria Chiara Parati, Karen Borgonovo, Mary Cabiddu and Fausto Petrelli
Nutrients 2021, 13(2), 385; https://doi.org/10.3390/nu13020385 - 27 Jan 2021
Cited by 11 | Viewed by 2886
Abstract
Diarrhoea is one of the main side effects that cancer patients face. The literature showsthat the incidence of chemotherapy (CT)-induced diarrhoea (grade 3–4) in treated patients is in the range of 10–20%, particularly after 5-fluorouracil (5-FU) bolus or some combination therapies of irinotecan [...] Read more.
Diarrhoea is one of the main side effects that cancer patients face. The literature showsthat the incidence of chemotherapy (CT)-induced diarrhoea (grade 3–4) in treated patients is in the range of 10–20%, particularly after 5-fluorouracil (5-FU) bolus or some combination therapies of irinotecan and fluoropyrimidines. The aim of the present study was to evaluate the clinical effectiveness of Lactobacillus kefiri LKF01 (Kefibios®) in the prevention or treatment of CT-related diarrhoea in the cancer population. We conducted a prospective observational study. Patients enrolled were adults treated for at least four months with 5-FU-based CT. Kefibios® was administered to patients every day. The primary outcome was the evaluation of the incidence of grade 3–4 CT-induced diarrhoea. We included 76 patients in the final analysis. A 6.6% incidence of high-grade diarrhoea was found in the evaluated population (4.7% of patients treated with 5-FU-based therapy and 8.5% of patients treated with capecitabine-based CT). The overall incidence of high-grade diarrhoea observed was higher in the 1st and 2nd cycles (3.9%), with a subsequent sharp reduction from the 3rd cycle (1.3%) and negativisation from the 5th cycle. Lactobacillus kefiri LKF01 (Kefibios®) is safe and effective in preventing severe diarrhoea in cancer patients receiving 5-FU or capecitabine-based treatment. Full article
(This article belongs to the Special Issue Nutrition Therapy for Diarrhea in Cancer and Severe Illness in Patients)
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Review

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15 pages, 1344 KiB  
Review
Skin Manifestations and Coeliac Disease in Paediatric Population
by Flavia Persechino, Gloria Galli, Severino Persechino, Francesco Valitutti, Letizia Zenzeri, Angela Mauro, Vito Domenico Corleto, Pasquale Parisi, Chiara Ziparo, Melania Evangelisti, Giovanna Quatrale and Giovanni Di Nardo
Nutrients 2021, 13(10), 3611; https://doi.org/10.3390/nu13103611 - 15 Oct 2021
Cited by 12 | Viewed by 5670
Abstract
Celiac disease (CD) is an immune-mediated enteropathy caused by gluten ingestion, affecting approximately 1% of the worldwide population. Extraintestinal symptoms may be present as the first signs of CD, years before the CD diagnosis is made. A great variety of extraintestinal manifestations may [...] Read more.
Celiac disease (CD) is an immune-mediated enteropathy caused by gluten ingestion, affecting approximately 1% of the worldwide population. Extraintestinal symptoms may be present as the first signs of CD, years before the CD diagnosis is made. A great variety of extraintestinal manifestations may be associated with CD. Cutaneous manifestations represent the main extraintestinal manifestations, with dermatitis herpetiformis being the most common in patients with CD. In adults, it has been demonstrated that the role of a gluten-free diet is crucial not only for the recovery of signs and symptoms associated with CD but also for cutaneous manifestations, which often improve after gluten avoidance. In children with CD, the association with skin disorders is well documented regarding dermatitis herpetiformis, but studies considering other dermatological conditions, such as psoriasis and atopic dermatitis, are few. The prevalence and manifestations of dermatological disorders in celiac children are often different from those in adults, explaining the gap between these populations. In addition, the therapeutic role of a gluten-free diet in the improvement in skin alterations is not fully understood in children and in adult population except for dermatitis herpetiformis. Therefore, cutaneous CD symptoms need to be known and recognized by physicians despite their specialties to improve early CD diagnosis, which is critical for a better prognosis. This review describes the current scientific evidence on skin manifestations associated with CD in the pediatric population. Full article
(This article belongs to the Special Issue Nutrition Therapy for Diarrhea in Cancer and Severe Illness in Patients)
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