Beneficial effects of lactitol on the composition of gut microbiota in constipated patients.

Abstract

OBJECTIVE:

To explore the changes in microbial composition and the corresponding impact after lactitol treatment in constipated patients.

METHODS:

Altogether 29 consecutive outpatients diagnosed with chronic constipation from three centers were recruited and stratified based on their history of diabetes mellitus. All patients were administered with oral lactitol for 2 weeks, and a symptoms diary of constipation was recorded. Fecal samples were collected before and after lactitol treatment, and were analyzed by 16S rRNA sequencing and real-time polymerase chain reaction (PCR) to detect gut microbiota.

RESULTS:

Twenty patients with diabetes mellitus and nine without, all with chronic constipation, were enrolled in this study. After 2-week administration of lactitol, their subscale scores and constipation symptoms significantly decreased (P < 0.05). An analysis of fecal flora using 16S rRNA sequencing found an increasing trend of abundance of Bifidobacterium in the post-lactitol group (P = 0.08). Actinobacteria, Actinobacteria, Bifidobacteriales, Bifidobacteriaceae and Bifidobacterium were significantly more abundant after lactitol administration. Real-time PCR showed significantly high DNA copy numbers of Bifidobacterium after lactitol treatment (1.39 × 1010 vs 2.74 × 109 copies/μL, P = 0.01). The results of 16S rRNA sequencing and real-time PCR illustrated an increasing trend of Bifidobacterium in both patients with and without diabetes. In addition, Bifidobacterium was negatively correlated with constipation subscale scores.

CONCLUSIONS:

Alterations in fecal flora composition after lactitol supplementation, especially in terms of an increasing trend of Bifidobacterium, alleviated constipation symptoms. Lactitol may be a promising prebiotic candidate for patients with constipation, regardless of diabetes mellitus.

• Authors: Xiao Qing Li, Xu Min Zhang, Xi Wu, Yu Lan, Le Xu, Xiang Chen Meng, Jing Nan Li
• Journal: Journal of digestive diseases (J Dig Dis) Vol. 21 Issue 8 Pg. 445-453 (Aug 2020) ISSN: 1751-2980 [Electronic] Australia
• PMID: 32483935 (Publication Type: Clinical Trial, Journal Article, Multicenter Study)
• Copyright: © 2020 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

Chemical References

• Prebiotics
• RNA, Ribosomal, 16S
• Sugar Alcohols
• lactitol

Topics

• Adolescent
• Adult
• Aged
• Bifidobacterium (drug effects)
• Chronic Disease
• Constipation (microbiology, therapy)
• Diabetes Mellitus (microbiology)
• Feces (microbiology)
• Female
• Gastrointestinal Microbiome (drug effects)
• Humans
• Male
• Middle Aged
• Prebiotics (administration & dosage)
• RNA, Ribosomal, 16S
• Sugar Alcohols (administration & dosage)
• Young Adult