Effects of dietary fibers or probiotics on functional constipation symptoms and roles of gut microbiota: a double-blinded randomized placebo trial

Apr 20, 2023Gut microbes

How dietary fiber and probiotics may affect constipation symptoms and gut bacteria in a blinded placebo trial

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Abstract

A total of 242 participants completed a 4-week trial evaluating dietary fibers and probiotics for relief.

No significant changes were observed in bowel movement frequency, stool consistency, or defecation straining between groups during the trial.
Participants receiving dietary fibers or probiotics experienced mean increases in stool consistency scores, with a range of 0.95-1.05 compared to placebo.
Group D showed a marginal decrease in plasma serotonin levels, which may be associated with constipation relief.
Group A had a higher abundance of certain gut bacteria compared to placebo at weeks 2 and 4.
Fourteen specific types of gut bacteria displayed trends in response to the interventions, with some linked to increased bowel movement frequency.

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Dietary fibers/probiotics may relieve constipation via optimizing gut microbiome, yet with limited trial-based evidences. We aimed to evaluate the effects of formulas with dietary fibers or probiotics on symptoms, and to identify modulations of gut microbiota of relevance. We conducted a 4-week double-blinded randomized placebo-controlled trial in 250 adults with functional constipation. Intervention: A: polydextrose; B: psyllium husk; C: wheat bran + psyllium husk; D:subsp.HN019 + HN001; Placebo: maltodextrin. Oligosaccharides were also included in group A to D. 16S rRNA sequencing was used to assess the gut microbiota at weeks 0, 2, and 4. A total of 242 participants completed the study. No time-by-group effect was observed for bowel movement frequency (BMF), score (BSS), and degree of defecation straining (DDS), while BSS showed mean increases of 0.95-1.05 in group A to D (all < 0.05), but not significantly changed in placebo ( = 0.170), and 4-week change of BSS showed similarly superior effects of the interventions as compared placebo. Group D showed a marginal reduction in plasma 5-hydroxytryptamine. Group A resulted in a higherabundance than placebo at week 2 and 4. Fourteen genera showed intervention-specific increasing or decreasing trends continuously, among whichshowed increasing trends in groups B and C, associated with BMF increase. Random forest models identified specific baseline microbial genera panels predicting intervention responders. In conclusion, we found that the dietary fibers or probiotics may relieve hard stool, with intervention-specific changes in gut microbiota relevant to constipation relief. Baseline gut microbiota may predispose the intervention responsiveness.number, NCT04667884. Bifidobacterium animalis lactis Lacticaseibacillus rhamnosus P P Bifidobacterium Anaerostipes ClincialTrials.gov

Key numbers

0.95–1.05

Mean Increase in

Change in scores across intervention groups.

242

Participants Completing the Study

Total number of participants who completed the 4-week intervention.

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Effects of dietary fibers or probiotics on functional constipation symptoms and roles of gut microbiota: a double-blinded randomized placebo trial

Abstract

Key numbers

Full Text

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