American Journal of Clinical Nutrition, Vol 65, 1397-1402, Copyright © 1997 by The American Society for Clinical Nutrition, Inc

ORIGINAL RESEARCH COMMUNICATIONS

Effects of inulin and lactose on fecal microflora, microbial activity, and bowel habit in elderly constipated persons

B Kleessen, B Sykura, HJ Zunft and M Blaut
German Institute of Human Nutrition, Potsdam-Rehbrucke, Germany. kleessen@www.dife.de

Constipation is an ailment encountered often in elderly people. A study was initiated to test the effects of lactose or inulin on the bowel habits of constipated elderly patients and to correlate these effects with several variables measured in feces such as microflora composition, concentration of lactate and short-chain fatty acids (SCFAs), pH, and the activities of beta-glucosidase and beta- glucuronidase, Groups of 15 and 10 patients received lactose and inulin, respectively, for a period of 19 d. The dose, 20 g/d from days 1 to 8, was gradually increased to 40 g/d from days 9 to 11 and was kept at this dose from days 12 to 19. There was considerable interindividual variations with this kind of dietary intervention. Inulin increased bifidobacteria significantly from 7.9 to 9.2 log10/g dry feces, but decreased enterococci in number and enterobacteria in frequency. In individuals consuming lactose, a noticeable increase in fecal counts of enterococci and a decrease in lactobacilli and clostridia was detected. Total bacterial counts remained unchanged. No changes in the concentrations of fecal SCFAs and lactate were observed. SCFAs showed a slight trend toward higher molar ratios of acetate to butyrate in response to the intake of lactose or inulin. The fecal pH and the beta-glucosidase and beta-glucuronidase activities were not influenced by sugar intake. Inulin showed a better laxative effect than lactose and reduced functional constipation with only mild discomfort.

This article has been cited by other articles:

				R. Shadid, M. Haarman, J. Knol, W. Theis, C. Beermann, D. Rjosk-Dendorfer, D. J Schendel, B. V Koletzko, and S. Krauss-Etschmann Effects of galactooligosaccharide and long-chain fructooligosaccharide supplementation during pregnancy on maternal and neonatal microbiota and immunity a randomized, double-blind, placebo-controlled study Am. J. Clinical Nutrition, November 1, 2007; 86(5): 1426 - 1437. [Abstract] [Full Text] [PDF]

				M. B. Roberfroid Inulin-Type Fructans: Functional Food Ingredients J. Nutr., November 1, 2007; 137(11): 2493S - 2502S. [Abstract] [Full Text] [PDF]

				S. Kolida and G. R. Gibson Prebiotic Capacity of Inulin-Type Fructans J. Nutr., November 1, 2007; 137(11): 2503S - 2506S. [Abstract] [Full Text] [PDF]

				K. M. Tuohy Inulin-Type Fructans in Healthy Aging J. Nutr., November 1, 2007; 137(11): 2590S - 2593S. [Abstract] [Full Text] [PDF]

				J.L. Balcazar Probiotics in health maintenance: do they really work? Journal of Infection Prevention, July 1, 2007; 8(3): 26 - 29. [Abstract] [PDF]

				M. P. Velez, T. L. A. Verhoeven, C. Draing, S. Von Aulock, M. Pfitzenmaier, A. Geyer, I. Lambrichts, C. Grangette, B. Pot, J. Vanderleyden, et al. Functional Analysis of D-Alanylation of Lipoteichoic Acid in the Probiotic Strain Lactobacillus rhamnosus GG Appl. Envir. Microbiol., June 1, 2007; 73(11): 3595 - 3604. [Abstract] [Full Text] [PDF]

				C. L. Kien, R. Blauwiekel, C. H. Williams, J. Y. Bunn, and R. K. Buddington Lactulose Feeding Lowers Cecal Densities of Clostridia in Piglets JPEN J Parenter Enteral Nutr, May 1, 2007; 31(3): 194 - 198. [Abstract] [Full Text] [PDF]

				M. Roberfroid Prebiotics: The Concept Revisited J. Nutr., March 1, 2007; 137(3): 830S - 837S. [Abstract] [Full Text] [PDF]

				K. C. Mountzouris, P. Tsirtsikos, E. Kalamara, S. Nitsch, G. Schatzmayr, and K. Fegeros Evaluation of the Efficacy of a Probiotic Containing Lactobacillus, Bifidobacterium, Enterococcus, and Pediococcus Strains in Promoting Broiler Performance and Modulating Cecal Microflora Composition and Metabolic Activities Poult. Sci., February 1, 2007; 86(2): 309 - 317. [Abstract] [Full Text] [PDF]

				S. P. van Tongeren, J. P. J. Slaets, H. J. M. Harmsen, and G. W. Welling Fecal Microbiota Composition and Frailty Appl. Envir. Microbiol., October 1, 2005; 71(10): 6438 - 6442. [Abstract] [Full Text] [PDF]

				K. Sonoyama, H. Watanabe, J. Watanabe, N. Yamaguchi, A. Yamashita, H. Hashimoto, E. Kishino, K. Fujita, M. Okada, S. Mori, et al. Allergic Airway Eosinophilia Is Suppressed in Ovalbumin-Sensitized Brown Norway Rats Fed Raffinose and {alpha}-Linked Galactooligosaccharide J. Nutr., March 1, 2005; 135(3): 538 - 543. [Abstract] [Full Text] [PDF]

				Y. Bouhnik, L. Raskine, G. Simoneau, E. Vicaut, C. Neut, B. Flourie, F. Brouns, and F. R Bornet The capacity of nondigestible carbohydrates to stimulate fecal bifidobacteria in healthy humans: a double-blind, randomized, placebo-controlled, parallel-group, dose-response relation study Am. J. Clinical Nutrition, December 1, 2004; 80(6): 1658 - 1664. [Abstract] [Full Text] [PDF]

				S J Langlands, M J Hopkins, N Coleman, and J H Cummings Prebiotic carbohydrates modify the mucosa associated microflora of the human large bowel Gut, November 1, 2004; 53(11): 1610 - 1616. [Abstract] [Full Text] [PDF]

				E. J. Woodmansey, M. E. T. McMurdo, G. T. Macfarlane, and S. Macfarlane Comparison of Compositions and Metabolic Activities of Fecal Microbiotas in Young Adults and in Antibiotic-Treated and Non-Antibiotic-Treated Elderly Subjects Appl. Envir. Microbiol., October 1, 2004; 70(10): 6113 - 6122. [Abstract] [Full Text] [PDF]

				J M T Hamilton-Miller Probiotics and prebiotics in the elderly Postgrad. Med. J., August 1, 2004; 80(946): 447 - 451. [Abstract] [Full Text] [PDF]

				S. Bartosch, A. Fite, G. T. Macfarlane, and M. E. T. McMurdo Characterization of Bacterial Communities in Feces from Healthy Elderly Volunteers and Hospitalized Elderly Patients by Using Real-Time PCR and Effects of Antibiotic Treatment on the Fecal Microbiota Appl. Envir. Microbiol., June 1, 2004; 70(6): 3575 - 3581. [Abstract] [Full Text] [PDF]

				M. Schultz, K. Munro, G. W. Tannock, I. Melchner, C. Gottl, H. Schwietz, J. Scholmerich, and H. C. Rath Effects of Feeding a Probiotic Preparation (SIM) Containing Inulin on the Severity of Colitis and on the Composition of the Intestinal Microflora in HLA-B27 Transgenic Rats Clin. Vaccine Immunol., May 1, 2004; 11(3): 581 - 587. [Abstract] [Full Text] [PDF]

				A D G Anderson, C E McNaught, P K Jain, and J MacFie Randomised clinical trial of synbiotic therapy in elective surgical patients Gut, February 1, 2004; 53(2): 241 - 245. [Abstract] [Full Text] [PDF]

				I M J Bovee-Oudenhoven, S J M ten Bruggencate, M L G Lettink-Wissink, and R van der Meer Dietary fructo-oligosaccharides and lactulose inhibit intestinal colonisation but stimulate translocation of salmonella in rats Gut, November 1, 2003; 52(11): 1572 - 1578. [Abstract] [Full Text] [PDF]

				S. J. M. Ten Bruggencate, I. M. J. Bovee-Oudenhoven, M. L. G. Lettink-Wissink, and R. Van der Meer Dietary Fructo-Oligosaccharides Dose-Dependently Increase Translocation of Salmonella in Rats J. Nutr., July 1, 2003; 133(7): 2313 - 2318. [Abstract] [Full Text] [PDF]

				M. J. Hopkins and G. T. Macfarlane Nondigestible Oligosaccharides Enhance Bacterial Colonization Resistance against Clostridium difficile In Vitro Appl. Envir. Microbiol., April 1, 2003; 69(4): 1920 - 1927. [Abstract] [Full Text] [PDF]

				S. H. Duncan, K. P. Scott, A. G. Ramsay, H. J. M. Harmsen, G. W. Welling, C. S. Stewart, and H. J. Flint Effects of Alternative Dietary Substrates on Competition between Human Colonic Bacteria in an Anaerobic Fermentor System Appl. Envir. Microbiol., February 1, 2003; 69(2): 1136 - 1142. [Abstract] [Full Text] [PDF]

				E. A. Flickinger, T. F. Hatch, R. C. Wofford, C. M. Grieshop, S. M. Murray, and G. C. Fahey Jr. In Vitro Fermentation Properties of Selected Fructooligosaccharide-Containing Vegetables and In Vivo Colonic Microbial Populations Are Affected by the Diets of Healthy Human Infants J. Nutr., August 1, 2002; 132(8): 2188 - 2194. [Abstract] [Full Text] [PDF]

				C. Duggan, J. Gannon, and W A. Walker Protective nutrients and functional foods for the gastrointestinal tract Am. J. Clinical Nutrition, May 1, 2002; 75(5): 789 - 808. [Abstract] [Full Text] [PDF]

				K. S. Swanson, C. M. Grieshop, E. A. Flickinger, L. L. Bauer, H.-P. Healy, K. A. Dawson, N. R. Merchen, and G. C. Fahey Jr Supplemental Fructooligosaccharides and Mannanoligosaccharides Influence Immune Function, Ileal and Total Tract Nutrient Digestibilities, Microbial Populations and Concentrations of Protein Catabolites in the Large Bowel of Dogs J. Nutr., May 1, 2002; 132(5): 980 - 989. [Abstract] [Full Text] [PDF]

				D. L. Topping and P. M. Clifton Short-Chain Fatty Acids and Human Colonic Function: Roles of Resistant Starch and Nonstarch Polysaccharides Physiol Rev, July 1, 2001; 81(3): 1031 - 1064. [Abstract] [Full Text] [PDF]

				M. B Roberfroid Prebiotics: preferential substrates for specific germs? Am. J. Clinical Nutrition, February 1, 2001; 73(2): 406S - 409. [Abstract] [Full Text] [PDF]

				J. H Cummings, G. T Macfarlane, and H. N Englyst Prebiotic digestion and fermentation Am. J. Clinical Nutrition, February 1, 2001; 73(2): 415S - 420. [Abstract] [Full Text] [PDF]

				K. E Scholz-Ahrens, G. Schaafsma, E. G. van den Heuvel, and J. Schrezenmeir Effects of prebiotics on mineral metabolism Am. J. Clinical Nutrition, February 1, 2001; 73(2): 459S - 464. [Abstract] [Full Text] [PDF]

				K. Orrhage, S. Sjostedt, and C. E. Nord Effect of supplements with lactic acid bacteria and oligofructose on the intestinal microflora during administration of cefpodoxime proxetil J. Antimicrob. Chemother., October 1, 2000; 46(4): 603 - 612. [Abstract] [Full Text] [PDF]

				E. Menne and N. Guggenbuhl Fn-type Chicory Inulin Hydrolysate Has a Prebiotic Effect in Humans J. Nutr., May 1, 2000; 130(5): 1197 - 1199. [Abstract] [Full Text]

				J. Noack, G. Dongowski, L. Hartmann, and M. Blaut The Human Gut Bacteria Bacteroides thetaiotaomicron and Fusobacterium varium Produce Putrescine and Spermidine in Cecum of Pectin-Fed Gnotobiotic Rats J. Nutr., May 1, 2000; 130(5): 1225 - 1231. [Abstract] [Full Text]

				G. R. Gibson and R. Fuller Aspects of In Vitro and In Vivo Research Approaches Directed Toward Identifying Probiotics and Prebiotics for Human Use J. Nutr., February 1, 2000; 130(2): 391 - 391. [Abstract] [Full Text]

				M. B. Roberfroid Concepts in Functional Foods: The Case of Inulin and Oligofructose J. Nutr., July 1, 1999; 129(7): 1398 - 1398. [Abstract] [Full Text]

				G. R. Gibson Dietary Modulation of the Human Gut Microflora Using the Prebiotics Oligofructose and Inulin J. Nutr., July 1, 1999; 129(7): 1438 - 1438. [Abstract] [Full Text]

				A. V. Rao Dose-Response Effects of Inulin and Oligofructose on Intestinal Bifidogenesis Effects J. Nutr., July 1, 1999; 129(7): 1442 - 1442. [Abstract] [Full Text]

				J. O. Hunter, Q. Tuffnell, and A. J. Lee Controlled Trial of Oligofructose in the Management of Irritable Bowel Syndrome J. Nutr., July 1, 1999; 129(7): 1451 - 1451. [Abstract] [Full Text]

				Y. Bouhnik, K. Vahedi, L. Achour, A. Attar, J. Salfati, P. Pochart, P. Marteau, B. Flourie, F. Bornet, and J.-C. Rambaud Short-Chain Fructo-Oligosaccharide Administration Dose-Dependently Increases Fecal Bifidobacteria in Healthy Humans J. Nutr., January 1, 1999; 129(1): 113 - 116. [Abstract] [Full Text] [PDF]

				J. Noack, B. Kleessen, J. Proll, G. Dongowski, and M. Blaut Dietary Guar Gum and Pectin Stimulate Intestinal Microbial Polyamine Synthesis in Rats J. Nutr., August 1, 1998; 128(8): 1385 - 1391. [Abstract] [Full Text]

				M. B. Roberfroid, J. A. E. Van Loo, and G. R. Gibson The Bifidogenic Nature of Chicory Inulin and Its Hydrolysis Products J. Nutr., January 1, 1998; 128(1): 11 - 19. [Abstract] [Full Text]