Clinical trial: the effects of a trans-galactooligosaccharide prebiotic on faecal microbiota and symptoms in irritable bowel syndrome.
BACKGROUND
Gut microflora-mucosal interactions may be involved in the pathogenesis of irritable bowel syndrome (IBS).


OBJECTIVE
To investigate the efficacy of a novel prebiotic trans-galactooligosaccharide in changing the colonic microflora and improve the symptoms in IBS sufferers.


METHODS
In all, 44 patients with Rome II positive IBS completed a 12-week single centre parallel crossover controlled clinical trial. Patients were randomized to receive either 3.5 g/d prebiotic, 7 g/d prebiotic or 7 g/d placebo. IBS symptoms were monitored weekly and scored according to a 7-point Likert scale. Changes in faecal microflora, stool frequency and form (Bristol stool scale) subjective global assessment (SGA), anxiety and depression and QOL scores were also monitored.


RESULTS
The prebiotic significantly enhanced faecal bifidobacteria (3.5 g/d P < 0.005; 7 g/d P < 0.001). Placebo was without effect on the clinical parameters monitored, while the prebiotic at 3.5 g/d significantly changed stool consistency (P < 0.05), improved flatulence (P < 0.05) bloating (P < 0.05), composite score of symptoms (P < 0.05) and SGA (P < 0.05). The prebiotic at 7 g/d significantly improved SGA (P < 0.05) and anxiety scores (P < 0.05).


CONCLUSIONS
The galactooligosaccharide acted as a prebiotic in specifically stimulating gut bifidobacteria in IBS patients and is effective in alleviating symptoms. These findings suggest that the prebiotic has potential as a therapeutic agent in IBS.
Silk
D B A
DB
Department of Academic Surgery, Imperial College Healthcare NHS Trust, London, UK. David.Silk@nwlh.nhs.uk
Davis
A
A
Vulevic
J
J
Tzortzis
G
G
Gibson
G R
GR
D000328:Adult; D000368:Aged; D001644:Bifidobacterium / Q000187:drug effects* / Q000254:growth & development; D015169:Colony Count, Microbial; D005243:Feces / Q000382:microbiology*; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000178:diet therapy*; D008297:Male; D008875:Middle Aged; D009844:Oligosaccharides / Q000008:administration & dosage* / Q000378:metabolism; D019936:Probiotics / Q000627:therapeutic use*; D011788:Quality of Life; D013223:Statistics as Topic; D016896:Treatment Outcome
D009844:Oligosaccharides