Prebiotic relieves constipation and changes the microbiota

bowel movement has always been an integral part of well -being, and this study provides further evidence that it is actually of central importance for health.

The frequency of bowel movements (BM) was recorded based on a 6-point scale, which is referred to as stool frequency score (0–5): less than 1 BM = 0 points on the scale; 1 to <2 BM per week = 1; 2 to <3 bm = 2; 3 to <4 bm = 3; 4 to <5 bm = 4; and 5 or more BM for the week = 5.

assessment of the gastrointestinal (gi) symptoms

The participants gave the following parameters as worsened, unchanged or improved:

• chair consistency
• feeling of incomplete emptying
• Time required for the evacuation
• flatulence

The researchers measured markers for endotoxemia, including lipopolysaccharide (LPS) and its receptor, differentiation cluster 14 (CD14).

They also determined the concentrations of the 3 most important short-chain fatty acids (SCFA) acetate, propionate and butyrat using standard gaschromatography mass spectrometry. The researchers determined the relative frequency of SCFA-producing bacteria using 11 representative bacteria:

• acetate producing bacteria bifidobacterium longum , bifidobacterium adolescentis ( b. Adolescentis ), and bifidobacterium catenulatum ( b. Catula );
• Propionate producing bacteria Prevotella ruminicola ( p. Ruminicola ), propionibacterium acidipropionici ( p. Acidipropionici ), and propionibacterium joyful kingdom ( p. Freudenreichii );
• Butyrat-producing bacteria faecalibactterium prausnitzii ( f. Prausnitzii ), clostridium leptum ( c. Leptum ), and roseburia hominis ( r. Hominis ))
• prebiotic-sensitive bacteria bifidobacterium lactis ( b. Lactis ) and lactobacillus acidophilus ( l. Acidophilus )

important knowledge

The chair ability score improved both in the prebiotic ( p = 0.001) and the placebo ( p = 0.002) groups after 4 weeks of intervention compared to the initial value. While the prebiotic group had fewer GI symptoms, this did not achieve statistical significance between the groups.

The Serum LPS concentration and the CD14 concentration decreased in both groups about the 4-week study, but only achieved in the prebiotic group (LPS, p <0.001; CD14, p = 0.012). The reduction of the LPS was also significantly larger in the prebiotic group compared to the reduction in the placebo group ( p <0.001).

The SCFA concentration did not differ between the two groups after 4 weeks. The only type of bacteria that significantly increased was the butyrat-producing r. Hominis (who increased by 15.3 %) after 4 weeks with those who received the prebiotic. This increase was significantly larger than that in the placebo group ( p = 0.045).

of the 20 participants in the prebiotic group were considered 12 as "responders", defined as those who experienced a shortening of their evacuation time and their serum CD14 concentration decreased by> 10 %. The subgroup analysis of the responders compared to the non -responders resulted in many differences in subordinate taxa between the groups, such as: B. a decrease in the tribe firmicutes ( p = 0.031), the class Clostridien ( p = 0.058) and the order Clostridien ( p = 0.058) and increases in several other bacteria, including Prevotella stercorea , bacteroides plebeius and bacteroides stercoris .

practice implications

In this study, there were measurable changes in the microbiota and the frequency of bowel movements after only 4 weeks of nutritional supplements with soluble fiber. A change in intestinal function with 13 grams of supplementary fiber may not be surprising for practitioners. The net effect of frequent evacuations and microbial population shifts reduced endotoxemia (ie LPS and its receptor, CD14, in the circulation). This result is the most fascinating aspect of the study. A reduction in endotoxemia has probably affected the entire body. Stool has always been an essential part of well -being, and this study provides further evidence that it is actually of central importance for health.

lipopolysaccharides (LPS), which are part of the cell membranes of gram -negative bacteria, are often synonymous with endotoxins. As soon as the bacteria are damaged (i.e. lysates), LPS is recognized as a pathogen-associated molecule that is responsible for initiating the host against these bacteria. ^{1 The immune response is stimulated when LPS Toll-Like receptors (TLRS) binds a class of protein that triggers inflammation. In the case of bacterial infections, acute inflammation is necessary to eliminate the pathogen and eliminate the infection. This LPS-induced inflammatory process is necessary to protect us from infections with gram-negative bacteria and some gram-positive infections. So what happens when LPS is found chronically in the circulation? The presence of endotoxins (ie LPS) in the blood is the definition of endotoxemia. It is not surprising that LPS is higher when the emptying frequency is lower due to the absorption of intestinal bacterial components, including LPS, while bacteria go through their life cycle in the intestine. In the study currently reviewed, every participant who received the prebiotic had a decrease in his circulating LPs. It is scientifically scientific whether it was a shifting of the bacterial type in the intestine or the adsorption of LPS to soluble fiber, which led to a reduction in the circulating LPs. From a clinical point of view, this combination of soluble fiber achieved a desirable effect, the reduction in endotoxemia.}

lps is a remarkably reliable stimulator of the inflammatory process, as is suggested by its extensive use in animal test models of systemic inflammation. The cascade is as follows: LPS binds TLR-4, which the mediator is when activating NF-κB (Kappa light chain enhancers of the core factor activated B cells) and AP-1 (activator protein 1), both master cell cells. Switch ”that lead to the expression of hundreds of genes that are involved in inflammation. ^{3 Ultimately, cytokines such as TNF-α (tumor necrosis factor alpha), IL-1β (interleukin 1 beta) and IL-6 (interleukin 6) are all as part of the inflammatory process. The inflammation chronic, and chronic inflammation is based on many disease processes.}

A restriction of the current study was that the duration was only 4 weeks. If the changes observed in the prebiotic group stop over time and the assumed reduction in systemic inflammation occurs, then one would expect many chronic inflammatory states. This can include frequent symptoms such as pain due to osteoarthritis and more insidious (and painless) processes such as atherosclerosis. In fact, a similarly designed study that includes life quality measurements, pain scales and additional laboratory measurements of inflammation over a longer period of time could be revealing.

There is 1 reservation to the product used in this study. It contained a little more than 34 % Lactitol, a sugar alcohol that is sometimes used as a sweetener. Inulin, which made the majority of the prebiotic used in this study, is a Fruktan. A subgroup of people cannot tolerate these fermentable carbohydrates, such as: B. People with bacterial overgrowth of the small intestine (SIBO) or irritable bowel syndrome (IBS). While practitioners have to be careful not to recommend fiber in this population group, the ultimate goal is a complete tolerance towards all prebiotics as part of a healthy, diverse vegetable diet. The tolerance compared to fermentable carbohydrates, including all fodmap food (fermentable oligo, di-, monosaccharides and polyols), should always be the goal. The removal or permanent avoidance of prebiotic foods, which may be necessary to relieve acute intestinal complaints, should not take place in the long term. As this study indicates and proving clinical studies, taking a broad spectrum of prebiotics/soluble fiber for the general health and the prevention of diseases is essential.