Early Signs of Impaired Gut Function Affect Daily Functioning in Patients With Advanced Cancer Undergoing Chemotherapy

Barbara S Van der Meij, Nicolaas E P Deutz, Ramon E. Rodriguez, Marielle P. Engelen

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Aims
Gastrointestinal symptoms are common during chemotherapy, but underlying disturbances in gut function and impact on daily life are unclear. This study investigates gut function in a heterogenous group of cancer patients with gastrointestinal symptoms during chemotherapy, and the relation with anabolic response, muscle health, and daily functioning.

Methods

In 16 patients with solid tumors (mostly stage III+IV) undergoing chemotherapy (T) and 16 healthy matched controls (H), small intestinal membrane integrity was measured by urine sugar tests. Protein digestion, absorption and anabolic response to a conventional protein supplement were analyzed by stable tracer methods. Muscle mass and strength and daily functioning were assessed.

Results
Eighty‐one percent of T reported gastrointestinal symptoms. Small intestinal membrane permeability was similar, but active glucose transport lower in T (T: 35.5 ± 3.4% vs. H: 48.4 ± 4.7%, P = 0.03). Protein digestion and absorption tended to be lower in T (0.67 ± 0.02 vs. 0.80 ± 0.04, P = 0.08). Net protein anabolic response to feeding was comparable, although lower in cancer patients with recent weight loss. Gut permeability negatively correlated to handgrip strength, global health and physical functioning and active transport capacity positively correlated to global health in T.

Conclusions

Advanced cancer patients with gastrointestinal symptoms during chemotherapy, particularly those with recent weight loss, show signs of impaired gut function, negatively affecting muscle health, daily functioning, and anabolic response to feeding.
Original languageEnglish
JournalJournal of Parenteral and Enteral Nutrition
Early online date8 Jun 2020
DOIs
Publication statusE-pub ahead of print - 8 Jun 2020

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  • Projects

    Nutrition Research for Digestive Health

    Marshall, S., Crichton, M., Campbell, K., Lohning, A., Marx, W., Van der Meij, B., Angus, R. & Canavan, R.

    1/01/14 → …

    Project: Research

    Oncology Nutrition Research

    Isenring, E., Marshall, S., Van der Meij, B., Teleni, L. & Crichton, M.

    1/01/14 → …

    Project: Research

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