Stool characteristics of infants receiving short-chain galactooligosaccharides and long-chain fructo-oligosaccharides:A review

Human milk is considered to be the optimal source of infant nutrition. Some of the benefits of breastfeeding have been ascribed to human milk oligosaccharides(HMO). For instance, HMO can affect faecal characteristics such as stool consistency and stool frequency. Such effects on stool characteristics can be beneficial for young infants as hard stools and even constipation is common in that age group. Prebiotics in infant milk formulas have been introduced to exert similar functionalities. A specific mixture of prebiotics consists of a combination of short chain galacto-oligosaccharides and long-chain fructo-oligosaccharides(scGOS/lcFOS) in a ratio of 9:1. This specific mixture has been developed to closely resemble the molecular size composition of HMO. Many studies have been done with scGOS/lcFOS, and indicators for digestive comfort have often been included as secondary outcomes. This review summarizes the effects of scGOS/lcFOS(9:1) on stool consistency,stool frequency and transit time in healthy term and preterm infants. In several of the studies with scGOS/lcFOS in a ratio of 9:1 in infant milk formulas, positive effects of this mixture on stool characteristics such as stool consistency and stool frequency were observed. As stool consistency was shown to be correlated to whole gut transit time, scGOS/lcFOS can be hypothesised to have a role in reducing the risk of constipation.

Effect of a fermented milk containing Bifidobacterium lactis DN-173010 on Chinese constipated women

AIM: To investigate the effect of a fermented milk containing Bifidobacterium lactis DN-173010 and yogurt strains (BIO) on adult women with constipation in Beijing.METHODS: A total of 135 adult females with constipation were randomly allocated to consume for 2 wk either 100 g of the test fermented milk or 100 g of an acidified milk containing non-living bacteria (control).Stool frequency,defecation condition scores,stool consistency and food intake were recorded at baseline and after 1 and 2 wk in an intention-to-treat population of 126 subjects.In parallel,safety evaluation parameters were performed.RESULTS: At baseline,no differences were found between groups.Following consumption of test product,stool frequency was significantly increased after 1 wk (3.5 ± 1.5 vs 2.4 ± 0.6,P < 0.01) and 2 wk (4.1 ± 1.7 vs 2.4 ± 0.6,P < 0.01),vs baseline.Similarly,after 1 and 2 wk,of test product consumption,defecation condition (1.1 ± 0.9 vs 1.9 ± 1.2,P < 0.01 and 0.8 ± 1.0 vs 1.9 ± 1.2,P < 0.01,respectively) and stool consistency (1.0 ± 0.8 vs 1.5 ± 1.1,P < 0.01 and 0.6 ± 0.8 vs 1.5 ± 1.1,P < 0.01,respectively) were significantly improved.Compared with the control group,stool frequency was also significantly increased (3.5 ± 1.5 vs 2.5 ± 0.9,P < 0.01 and 4.1 ± 1.7 vs 2.6 ± 1.0,P < 0.01,respectively),and defecation condition (1.1 ± 0.9 vs 1.6 ± 1.1,P < 0.01 and 0.8 ± 1.0 vs 1.6 ± 1.1,P < 0.01,respectively) and stool consistency (1.0 ± 0.8 vs 1.4 ± 1.0,P < 0.05 and 0.6 ± 0.8 vs 1.3 ± 1.0,P < 0.01,respectively) significantly decreased after 1 and 2 wk of product consumption.During the same period,food intake did not change between the two groups,and safety parameters of the subjects were within normal ranges.CONCLUSION: This study suggests a beneficial effect of a fermented milk containing B.lactis DN-173010 on stool frequency,defecation condition and stool consistency in adult women with constipation constipated women after 1 and 2 wk of consumption.

Effect of dietary fiber on constipation:A meta analysis

AIM:To investigate the effect of dietary fiber intake on constipation by a meta-analysis of randomized controlled trials(RCTs).METHODS:We searched Ovid MEDLINE(from 1946 to October 2011),Cochrane Library(2011),PubMed for articles on dietary fiber intake and constipation using the terms:constipation,fiber,cellulose,plant extracts,cereals,bran,psyllium,or plantago.References of important articles were searched manually for relevant studies.Articles were eligible for the meta-analysis if they were high-quality RCTs and reported data on stool frequency,stool consistency,treatment success,laxative use and gastrointestinal symptoms.The data were extracted independently by two researchers(Yang J and Wang HP) according to the described selection criteria.Review manager version 5 software was used for analysis and test.Weighted mean difference with 95%CI was used for quantitative data,odds ratio(OR)with 95%CI was used for dichotomous data.Both I2 statistic with a cut-off of ≥ 50% and the χ2 test with a P value < 0.10 were used to define a significant degree of heterogeneity.RESULTS:We searched 1322 potential relevant articles,19 of which were retrieved for further assessment,14 studies were excluded for various reasons,five studies were included in the analysis.Dietary fiber showed significant advantage over placebo in stool frequency(OR = 1.19;95%CI:0.58-1.80,P < 0.05).There was no significant difference in stool consistency,treatment success,laxative use and painful defecation between the two groups.Stool frequency were reported by five RCTs,all results showed either a trend or a significant difference in favor of the treatment group,number of stools per week increased in treatment group than in placebo group(OR = 1.19;95%CI:0.58-1.80,P < 0.05),with no significant heterogeneity among studies(I2= 0,P = 0.77).Four studies evaluated stool consistency,one of them presented outcome in terms of percentage of hard stool,which was different from others,so we included the other three studies for analysis.Two studies reported treatment success.There was significant heterogeneity between the studies(P < 0.1,I2 > 50%).Three studies reported laxative use,quantitative data was shown in one study,and the pooled analysis of the other two studies showed no significant difference between treatment and placebo groups in laxative use(OR = 1.07;95%CI 0.51-2.25),and no heterogeneity was found(P = 0.84,I2= 0).Three studies evaluated painful defecation:one study presented both quantitative and dichotomous data,the other two studies reported quantitative and dichotomous data separately.We used dichotomous data for analysis.CONCLUSION:Dietary fiber intake can obviously increase stool frequency in patients with constipation.It does not obviously improve stool consistency,treatment success,laxative use and painful defecation.