The effects of regular consumption of short-chain fructo-oligosaccharides on digestive comfort of subjects with minor functional bowel disorders

Abstract

A comparative, randomised, double-blind trial was performed in the medical departments of five hospitals to study the effects of regular consumption of short-chain fructo-oligosaccharides (sc-FOS) on the digestive comfort of subjects with minor functional bowel disorders (FBD). In step 1, 2235 subjects were questioned to assess the incidence and intensity of digestive disorders. In step 2, 105 of these patients diagnosed with minor FBD were randomised into two groups to receive either 5 g sc-FOS or 5 g placebo (sucrose and maltodextrins) per d over a 6-week period. The incidence and intensity of digestive disorders were assessed at the end of the treatment period (day 43) using the step 1 questionnaires. A qualityof-life questionnaire was also completed at the start and end of the treatment period to assess potential effects on well-being and social performance. In step 1, 44 % of the subjects questioned presented FBD, of whom 57·1 % suffered from minor FBD. In step 2, on day 43, the intensity of digestive disorders decreased by 43·6 % in the sc-FOS group v. a 13·8 % increase in the placebo group (P¼0·026). Symptoms were experienced less frequently by 75·0 % of subjects in the sc-FOS group, while 53·8 % of controls experienced no change (P¼0·064). Using the functional digestive disorders quality of life questionnaire, the discomfort item scores increased in the sc-FOS group (P¼ 0·031). However, expressed as change in quality of life (improvement, worsening or unchanged), daily activities were significantly improved in the sc-FOS group (P¼ 0.022). Regular consumption of sc-FOS may improve digestive comfort in a working population not undergoing medical treatment. Short-chain fructo-oligosaccharides: Quality of life: Functional bowel disordersFunctional bowel disorders (FBD) are diagnosed on the basis of characteristic symptoms in the digestive system persisting for at least 12 weeks over the last 12 months in the absence of any structural or biochemical explanation 1 . The five main symptoms reported by patients are abdominal bloating, rumbling, transit disorders (occasional constipation and/or diarrhoea, possibly alternating), abdominal pains and flatulence. FBD have been reported as being chronic, non-life-threatening conditions, but having a marked impact on daily activities, wellbeing and social performance, even during symptom-free periods, mainly due to apprehension about impending pain 2 -6 .These functional disorders, influenced by psychological and environmental factors 7 , are common, with a reported prevalence of up to 61 % in the French population aged over 15 years 6 . Functional disorders thus lead to a high number of general medical and gastroenterology consultations, respectively accounting for 10 and 50 % of all medical consultations 4 -6,8 -11 . However, two-thirds of subjects with FBD never consult a doctor for their disorder. A nutritional approach therefore appears a good alternative to medication for subjects with minor FBD or individuals rejecting medical therapy. Amongst the few already ...

The intestinal microbiome, probiotics and prebiotics in neurogastroenterology

“…81 Nevertheless, two other published studies of adequate size have reported beneficial effects of a prebiotic in IBS. 82,83 In the double blind placebo controlled study by Paineau et al 82 that included 105 IBS subjects, treatment with a short chain inulin-type fructan at 5 g/day over 6 weeks reduced the incidence and intensity of GI symptoms as compared with the placebo. Prebiotic treatment also improved functional digestive disorders related quality of life.…”

Modulation of the gut microbiota: a focus on treatments for irritable bowel syndrome

“…Similarly, fecal Bifidobacterium levels significantly increased with the prebiotic mixture 3.5 g/d and 7 g/d compared with placebo after 4 weeks of treatment (P < 0.005 for both) [67]. FOS obtained by enzymatic synthesis from sucrose are naturally found in onions, bananas, and artichokes [61,68]. A randomized, double-blind study of healthy individuals with mild functional bowel symptoms demonstrated that regular consumption of short-chain FOS 5 g/day reduced the frequency and intensity of digestive symptoms and improved intestinal discomfort and QOL compared with placebo after 6 weeks [68].…”

“…FOS obtained by enzymatic synthesis from sucrose are naturally found in onions, bananas, and artichokes [61,68]. A randomized, double-blind study of healthy individuals with mild functional bowel symptoms demonstrated that regular consumption of short-chain FOS 5 g/day reduced the frequency and intensity of digestive symptoms and improved intestinal discomfort and QOL compared with placebo after 6 weeks [68]. Others have proposed that use of prebiotics may lead to short-term, potentially deleterious alterations in the microbiota, as was suggested by an increased number and volume of anal gas evacuations 2 days after initiation of supplementation with GOS by healthy individuals; however, after 3 weeks, the number and volume of evacuations decreased to pretreatment levels, suggesting that gut microbiota adapted to the prebiotics [69].…”

Effect of a prebiotic galactooligosaccharide mixture (B‐GOS®) on gastrointestinal symptoms in adults selected from a general population who suffer with bloating, abdominal pain, or flatulence

“…However, these prebiotics have been tested in IBS population at much lower dose of 2-5 g per day, when worsening of the symptoms was not observed but neither was an improvement. 21,22 At the same dose of 1.37 g per day of an active ingredient, B-GOS® was previously shown to reduce bloating, flatulence, and abdominal pain, with no effect on stool consistency, in IBS populations after 4 weeks of supplementation. 28 The treatment period was shorter here than in the IBS study, however selective increases in bifidobacteria, and at much higher rate than other types of GOS, after 1 week of supplementation with B-GOS in healthy adults was previously shown.…”

“…Similarly, prebiotics such as inulin and FOS also contain fructose and, regardless of their positive effect upon GI environment, have been shown to either result in side effects such as increased bloating, flatulence, or abdominal pain or to have no impact on these GI symptoms in healthy adults and those with IBS. [18][19][20][21][22] B-GOS (Bimuno®) is composed of galactose chains and it has been shown to have a potent prebiotic effect with high selectivity toward bifidobacteria and a variety of other beneficial effects in humans. [23][24][25][26][27] In IBS sufferers, it reduced bloating and abdominal pain without changes to their diets, 28 and in healthy adults, it was shown not to result in GI symptoms.…”