What This Means
This paper describes the design of a clinical trial, not yet started, that will test whether giving probiotics directly into the inactive portion of the bowel before a temporary ostomy is closed can improve bowel function in rectal cancer patients. When patients with rectal cancer have surgery, surgeons sometimes create a temporary loop ileostomy — a diversion that allows part of the bowel to rest and heal. When this temporary ostomy is closed, the previously inactive bowel segment must resume normal function, but patients often experience significant bowel problems collectively called Low Anterior Resection Syndrome (LARS), which includes symptoms like urgency, frequent bowel movements, clustering of stools, and fecal incontinence. The researchers hypothesize that flushing probiotics into the inactive bowel segment daily for two weeks before closure might help restore a healthier gut environment and reduce these symptoms.
The trial will randomly assign eligible patients to receive either a probiotic solution (Lacidofil mixed in saline) or saline alone, delivered once daily through the ileostomy for two weeks before it is surgically closed. The main outcome researchers will track is the LARS score — a validated measure of bowel dysfunction — at three months after the ostomy is closed. They will also track complication rates, bowel recovery speed, stool habits, lab values, and hospital stay length. The study will be conducted at a single hospital in South Korea, with enrollment planned from 2026 to 2029.
This research suggests that a simple, low-risk intervention delivered during the waiting period before ostomy closure could potentially make a meaningful difference in quality of life for rectal cancer survivors. Because LARS affects a large proportion of patients after this type of surgery and significantly impacts daily life, finding effective prevention strategies is an important clinical priority. This trial will provide prospective evidence on whether probiotic bowel stimulation is both safe and effective, filling a current gap in the medical literature.