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

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


METHODS
Twenty-nine consecutive outpatients diagnosed with chronic constipation from three centers were recruited. The enrolled patients were stratified based on their diabetes history. All subjects were administered oral lactitol for two weeks, and a symptom diary of constipation was recorded. Fecal samples were collected before and after lactitol treatment, followed by 16S rRNA sequencing and real-time PCR to detect the gut microbiota.


RESULTS
Twenty diabetic and nine non-diabetic patients with chronic constipation were enrolled in this study. After administration of lactitol for two weeks, all subscale scores and constipation symptom scores of the patients significantly decreased (P < 0.05). Species composition analysis of fecal flora using 16S rRNA sequencing revealed an increased abundance of Bifidobacterium in the post-lactitol group (P = 0.08). Further linear discriminant analysis effect size analysis showed that Actinobacteria, Actinobacteria, Bifidobacteriales, Bifidobacteriaceae and Bifidobacterium were significantly more abundant after lactitol administration. Real-time PCR results demonstrated 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 RT-PCR illustrated an increasing trend of Bifidobacterium in both diabetic and non-diabetic patients. In addition, Bifidobacterium had a negative correlation 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 might be a promising prebiotic candidate for both diabetic and non-diabetic patients with constipation. This article is protected by copyright. All rights reserved.