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Effects of sc FOS on the composition of fecal microbiota and anxiety in patients with irritable bowel syndrome: a randomized, double blind, placebo controlled study
Author(s) -
Azpiroz F.,
Dubray C.,
BernalierDonadille A.,
Cardot J.M.,
Accarino A.,
Serra J.,
Wagner A.,
Respondek F.,
Dapoigny M.
Publication year - 2017
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.12911
Subject(s) - irritable bowel syndrome , placebo , medicine , gastroenterology , randomized controlled trial , gut flora , rectum , constipation , defecation , feces , enema , anxiety , psychiatry , immunology , pathology , biology , paleontology , alternative medicine
Background Short‐chain fructooligosaccharides (sc FOS ) have beneficial effects in subjects with minor digestive complaints, but the potential mechanisms involved have not been elucidated. The aim of the study was to evaluate changes in rectal sensitivity related to the clinical effects of sc FOS in a selected group of patients with irritable bowel syndrome ( IBS ) and rectal hypersensitivity. Methods In 79 IBS patients (defined by Rome III criteria) with rectal hypersensitivity (defined as discomfort threshold ≤44 g) a parallel, placebo‐controlled, randomized, and double‐blind study was performed to assess the effects of dietary supplementation (5 g d −1 ) with sc FOS vs placebo for 4 weeks on rectal sensitivity (primary outcome: tolerance to increasing wall tension applied by a tensostat), clinical outcomes ( IBS , anxiety/depression and quality of life scores) and composition of fecal microbiota. Key Results Rectal discomfort threshold, and IBS and quality of life scores, significantly improved during treatment, but in a similar manner in both sc FOS and placebo groups; a post‐hoc analysis showed that the effect of sc FOS on rectal sensitivity was more pronounced in constipation‐predominant‐ IBS patients ( P =.051 vs placebo). Contrary with placebo, sc FOS significantly reduced anxiety scores and increased fecal Bifidobacteria ( P <.05 for both) without modifying other bacterial groups. Conclusions & Interfences The effect of sc FOS on anxiety may be related to modulation of the gut microbiota; demonstration of effects of sc FOS on rectal sensitivity may require higher doses and may depend on the IBS subgroup.