Effect of Honey on Diarrhea and Fecal Microbiotain in Critically Ill Tube-Fed Patients: A Single Center Randomized Controlled Study

BACKGROUND: In patients admitted to the Intensive Care Unit (ICU), Enteral Nutrition (EN) is the first choice for feeding support, however, it is often complicated by gastrointestinal side effects, such as diarrhea. There are no studies that have specifically evaluated effect of a prebiotic, which prevents diarrhea during enteral nutrition. OBJECTIVE: This study aimed at evaluating the effect of honey in enteral diet during occurrence of diarrhea and fecal microbiotain in critically ill patients. MATERIALS AND METHODS: In this double-blind, randomized controlled single-center study, 32 patients were randomly selected to receive a high protein kitchen enteral diet and the study group had honey as 10% of its carbohydrate intake. Quantitative analyses of bifidobacterium and Lactobacillus species of fecal samples were assessed by Real-Time Polymerase Chain Reaction (PCR) on days 0 and 7. RESULTS: Patients in the honey group showed an insignificant increase in the frequency of bifidobacterium DNA by study day 7 in comparison with the control group. In the honey group, there was a considerable reduction in diarrhea (P = 0.09). A significant difference was found in length of Intensive Care Unit (ICU) stay (P = 0.001) and Sequential Organ Failure Assessment (SOFA) score (P = 0.04) in favor of the honey group. CONCLUSIONS: Enteral nutrition with honey might reduce the length of stay at the ICU and development of organ failure in critically ill patients. It seems that honey helps reduce the incidence of diarrhea.