Plain language summary
Functional gastrointestinal diseases (FGIDs) are the most common cause of gastrointestinal disturbance in global population. Probiotic supplementation is a valid approach to maintain the balance of the intestinal microbiota [micro-organisms], the composition of which could be altered by several factors. The aim of this study is to investigate the effects of a novel formulation of Bifidobacterium longum BB536 and Lactobacillus rhamnosus HN001 [probiotics] with vitamin B6 (ZR) on symptoms, gut microbiota, and metabolome in a cohort of patients with persisting FGIDs on a lactose-free diet. The study is a cross-over randomised double-blind placebo-controlled study which enrolled 23 subjects. Subjects were randomly assigned to one of the two groups: ZR or placebo. Results indicate consistent amelioration of some gastrointestinal symptoms, intestinal microbiota, and related metabolism with ZR, compared with placebo. Moreover, faecal microbiome differed between the ZR and placebo group, and ZR drove the enrichment of several genera involved in lactose [sugar naturally found in milk] digestion including Bifidobacerium. Authors conclude that probiotic and vitamin B6 treatment may be useful to alleviate symptoms in subjects with lactose intolerance and persistent FGIDs through a positive modulation of gut microbial composition and relative metabolism.
Abstract
Functional gastrointestinal symptoms are frequent, and may be driven by several pathogenic mechanisms. Symptoms may persist in lactose intolerant (LI) patients (i.e., subjects with intestinal lactase deficiency, lactose malabsorption producing symptoms), after a lactose-free diet. Our hypothesis was that probiotic and vitamin B6 treatment may be useful to alleviate symptoms in LI patients through a positive modulation of gut microbial composition and relative metabolism. We aimed to test the efficacy of a novel formulation of Bifidobacterium longum BB536 and Lactobacillus rhamnosus HN001 plus vitamin B6 (ZR) in 23 LI subjects with persistent symptoms during a lactose-free diet. Symptoms, microbiome, and metabolome were measured at baseline and after 30 days in a crossover, randomized, double-blind study of ZR versus placebo (PL). Compared with PL, the administration of probiotics and vitamin B6 significantly decreased bloating (p = 0.028) and ameliorated constipation (p = 0.045). Fecal microbiome differed between ZR and PL. ZR drove the enrichment of several genera involved in lactose digestion including Bifidobacerium. Moreover, the relative abundance of acetic acid, 2-methyl-propanoic acid, nonenal, and indolizine 3-methyl increased, while phenol decreased. Our findings highlight the importance of selected probiotics and vitamin B6 to alleviate symptoms and gut dysbiosis in lactose intolerant patients with persistent functional gastrointestinal symptoms.
Methodological quality
Jadad score
:
5
Allocation concealment
:
Yes
