Impact of probiotic supplementation on chemotherapy and radiotherapy-associated diarrhea and quality of life - Research Article

Q: What is the study objective regarding Lactobacillus prophylaxis?

To determine whether prophylactic oral Lactobacillus reduces chemotherapy- and radiotherapy-associated diarrhea and helps preserve quality of life in adults starting anticancer treatment.

Q: How were participants assigned and what intervention was used?

Adults receiving their first chemotherapy and/or radiotherapy cycle were enrolled in a prospective two-group observational design. The Nonprobiotic Group received standard care, while the Probiotic Group received standard care plus Lactobacillus 60 million CFU twice daily for 6 weeks.

Q: What were the main outcomes at 6 weeks?

Grade ≥2 diarrhea occurred less often with probiotics (4% vs 28%), rescue loperamide use was lower (24% vs 44%), VAS pain decreased over time in both groups, and physical functioning at 6 weeks was slightly better with probiotics.

Sep 22, 2026

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OBJECTIVES: Evaluate whether prophylactic oral Lactobacillus supplementation reduces chemotherapy- and radiotherapy-associated diarrhea and helps preserve quality of life (QoL) in adults starting anticancer treatment. MATERIALS AND METHODS: Prospective two-group observational study in adults (18–75) receiving first-cycle chemotherapy and/or radiotherapy. Nonprobiotic group received standard care; probiotic group received standard care plus Lactobacillus 60 million CFU twice daily for 6 weeks. Diarrhea graded with NCI CTCAE v5.0; rescue loperamide, 10-cm VAS pain, and EORTC QLQ-C30 recorded at baseline and 6 weeks. RESULTS: At 6 weeks, Grade ≥2 diarrhea occurred in 28% vs 4% and loperamide use in 44% vs 24%. CONCLUSION: Lactobacillus prophylaxis was associated with milder diarrhea, reduced rescue loperamide, and small early physical-functioning gains.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Abstract

Objectives

Materials and Methods

Results

Conclusion

Introduction

Background and Rationale

Quality of Life Assessment

Role of Probiotics

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[www.ijp-online.com](www.ijp-online.com) | | DOI:
10.4103/ijp. ijp_465_25 | Department of Pharmacology, AIIMS, Vijaypur, 1Department of Pharmacology, SMVDIME, Kakryal, 2Department of Pharmacology, GMC, Jammu, 3Department of Anaesthesia, GMC, Kathua, Jammu and Kashmir, India Address for correspondence: Dr. Nikhil Menia, Department of Pharmacology, AIIMS, Vijaypur, Jammu and Kashmir, India. E-mail: nikhilmenia@ [gmail.com](gmail.com) Submitted: 13-May-2025 Revised: 10-Jan-2026 Accepted: 12-Jan-2026 Published: 01-Jul-2026 Research Article Impact of probiotic supplementationon chemotherapy and radiotherapy‑associated diarrhea and quality of life Nikhil Menia, Nancy Khajuria1, Seema Gupta2, Sucheta Hans3, Rajesh Kumar2 Abstract: OBJECTIVES: To evaluate whether prophylactic oral Lactobacillus supplementation reduces chemotherapy‑ and radiotherapy‑associated diarrhea and helps preserve quality of life (QoL) in adults starting anticancer treatment. MATERIALS AND METHODS: This prospective two‑group observational study included adults (18– 75 years) receiving their first cycle of chemotherapy and/or radiotherapy at a tertiary cancer center. The Nonprobiotic Group received standard care without probiotics, and the Probiotic Group received standard care plus oral Lactobacillus 60 million colony‑forming units twice daily for 6 weeks. Diarrhea was graded using the National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0. Use of rescue loperamide, pain on a 10‑cm Visual Analog Scale (VAS), and scores on the European Organisation for Research and Treatment of Cancer QoL Questionnaire Core 30 (EORTCQLQ‑C30) were recorded at baseline and at 6 weeks. RESULTS: One hundred patients completed follow‑up (50 per group) . At 6 weeks, Grade ≥ 2 diarrhea occurred in 28% of the Nonprobiotic and 4% of the Probiotic Group. Mean diarrhea score was higher without probiotics (1.26 ± 0.49 vs. 0.78 ± 0.51, P < 0.001), and loperamide use was more frequent (44% vs. 24%, P = 0.034) . VAS pain scores decreased significantly over time in both groups. Physical functioning at 6 weeks was slightly better in the probiotic group, while other EORTCQLQ‑C30 domains were broadly comparable. CONCLUSION: Prophylactic Lactobacillus supplementation was associated with milder treatment‑related diarrhoea, reduced rescue loperamide use, and small early gains in physical functioning during chemoradiotherapy. Keywords: Cancer supportive care, chemotherapy‑induced diarrhea, gastrointestinal toxicity, Lactobacillus, probiotics, radiotherapy‑induced diarrhea Introduction Cancer burden keeps rising, and many patients still die despite better surgery, chemotherapy, and radiotherapy with about 19 million new cases and nearly 10 million deaths worldwide in 2020.[1] With improving cancer survival, Th i s i s an o p en access articl e d i stri b utedunde r the te r m s of the Cre ative Com m ons Attribution‑NonCommercial‑NoDerivatives 4.0 License (CC BY‑NC‑ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. [For reprintscontact:](For reprintscontact:WKHLRPMedknow_reprints@wolterskluwer.com)[WKHLRPMedknow_reprints@wolterskluwer.com](For reprintscontact:WKHLRPMedknow_reprints@wolterskluwer.com) more patients live long‑enough to develop chronic treatment‑related toxicities that mainly affect daily functioning and health‑related quality of life (QoL) rather than mortality. [2] Chemotherapy and radiotherapy injure intestinal mucosa, disturb gut microbiota, and trigger inflammation, so diarrhea becomes avery common dose‑limiting toxicity in oncology. [3] In pelvic and abdominal cancers with multi‑drug chemo plus How to cite this article: Menia N, Khajuria N, Gupta S, Hans S, Kumar R. Impact of probiotic suppl

FAQs

What is the study objective regarding Lactobacillus prophylaxis?

To determine whether prophylactic oral Lactobacillus reduces chemotherapy- and radiotherapy-associated diarrhea and helps preserve quality of life in adults starting anticancer treatment.

How were participants assigned and what intervention was used?

Adults receiving their first chemotherapy and/or radiotherapy cycle were enrolled in a prospective two-group observational design. The Nonprobiotic Group received standard care, while the Probiotic Group received standard care plus Lactobacillus 60 million CFU twice daily for 6 weeks.

What were the main outcomes at 6 weeks?

Grade ≥2 diarrhea occurred less often with probiotics (4% vs 28%), rescue loperamide use was lower (24% vs 44%), VAS pain decreased over time in both groups, and physical functioning at 6 weeks was slightly better with probiotics.

Sep 22, 2026

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