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A yeast fermentate improves gastrointestinal discomfort and constipation by modulation of the gut microbiome: results from a randomized double-blind placebo-controlled pilot trial.

Abstract Constipation and symptoms of gastrointestinal discomfort such as bloating are common among otherwise healthy individuals, but with significant impact on quality of life. Despite the recognized contribution of the gut microbiome to this pathology, little is known about which group(s) of microorganism(s) are playing a role. A previous study performed in vitro suggests that EpiCor® fermentate has prebiotic-like properties, being able to favorably modulate the composition of the gut microbiome. Therefore, the aim of this study was to investigate the effects of EpiCor fermentate in a population with symptoms of gastrointestinal discomfort and reduced bowel movements and to evaluate its effect at the level of the gut microbiome.
PMID
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Authors

Mayor MeshTerms

Gastrointestinal Microbiome

Keywords

Bacteroides

Bacteroidetes

Constipation

EpiCor fermentate

GI transit time

Gastrointestinal discomfort

Gut microbiome

Human study

Prevotella

Saccharomyces cerevisiae

Journal Title bmc complementary and alternative medicine
Publication Year Start




PMID- 28870194
OWN - NLM
STAT- MEDLINE
DA  - 20170905
DCOM- 20170908
LR  - 20170908
IS  - 1472-6882 (Electronic)
IS  - 1472-6882 (Linking)
VI  - 17
IP  - 1
DP  - 2017 Sep 04
TI  - A yeast fermentate improves gastrointestinal discomfort and constipation by
      modulation of the gut microbiome: results from a randomized double-blind
      placebo-controlled pilot trial.
PG  - 441
LID - 10.1186/s12906-017-1948-0 [doi]
AB  - BACKGROUND: Constipation and symptoms of gastrointestinal discomfort such as
      bloating are common among otherwise healthy individuals, but with significant
      impact on quality of life. Despite the recognized contribution of the gut
      microbiome to this pathology, little is known about which group(s) of
      microorganism(s) are playing a role. A previous study performed in vitro suggests
      that EpiCor(R) fermentate has prebiotic-like properties, being able to favorably 
      modulate the composition of the gut microbiome. Therefore, the aim of this study 
      was to investigate the effects of EpiCor fermentate in a population with symptoms
      of gastrointestinal discomfort and reduced bowel movements and to evaluate its
      effect at the level of the gut microbiome. METHODS: This pilot study was
      performed according to a randomized, double-blind, placebo-controlled parallel
      design. Eighty subjects with symptoms of gastrointestinal discomfort and
      constipation were allocated to one of two trial arms (placebo or EpiCor
      fermentate). Randomization was done in a stratified manner according to symptom
      severity, resulting in two subgroups of patients: severe and moderate. Daily
      records of gastrointestinal symptoms were assessed on a 5-point scale, and also
      stool frequency and consistency were documented during a 2-week run-in and a
      6-week intervention phases. Averages over two-week intervals were calculated.
      Constipation-associated quality of life and general perceived stress were
      assessed at baseline and after 3 and 6 weeks of intervention. Fecal samples were 
      also collected at these same time points. RESULTS: EpiCor fermentate led to a
      significant improvement of symptoms such as bloating/distension (p = 0.033 and p 
      = 0.024 after 2 and 4 weeks of intervention, respectively), feeling of fullness
      (p = 0.004 and p = 0.023 after 2 and 4 weeks of intervention, respectively) and
      general daily scores (p = 0.046 after 2 weeks of intervention) in the moderate
      subgroup. A significant improvement in stool consistency was observed for the
      total population (p = 0.023 after 2 weeks of intervention) as well as for the
      severe subgroup (p = 0.046 after 2 weeks of intervention), and a nearly
      significant increase in stool frequency was detected for the total cohort (p =
      0.083 and p = 0.090 after 2 and 4 weeks of intervention, respectively). These
      effects were accompanied by an improvement in constipation-associated quality of 
      life and general perceived stress, particularly in the moderate subgroup. Members
      of the families Bacteroidaceae and Prevotellaceae, two groups of bacteria that
      have been previously reported to be deficient in constipated patients, were found
      to increase with EpiCor fermentate in the severe subgroup. In the moderate
      subgroup, a significant increase in Akkermansia muciniphila was observed.
      CONCLUSIONS: Despite the relatively low dose administered (500 mg/day),
      particularly when comparing to the high recommended doses for prebiotic fibers,
      EpiCor fermentate was able to modulate the composition of the gut microbiome,
      resulting in improvement of constipation-associated symptoms. Conversely, the
      reported increase in bowel movements may have altered the gut microbial community
      by increasing those groups of bacteria that are better adapted to a faster
      gastrointestinal transit time. TRIAL REGISTRATION: NCT03051399 at
      ClinicalTrials.gov. Retrospectively registered. Registration date: 13 February
      2017.
FAU - Pinheiro, Iris
AU  - Pinheiro I
AD  - ProDigest, Technologiepark 3, 9052, Ghent, Belgium.
FAU - Robinson, Larry
AU  - Robinson L
AD  - Embria Health Sciences, 2105 SE Creekview Dr, Ankeny, IA, 50021, USA.
FAU - Verhelst, An
AU  - Verhelst A
AD  - ProDigest, Technologiepark 3, 9052, Ghent, Belgium.
FAU - Marzorati, Massimo
AU  - Marzorati M
AD  - Center of Microbial Ecology and Technology (CMET), University of Ghent, Coupure
      Links 653, 9000, Ghent, Belgium.
FAU - Winkens, Bjorn
AU  - Winkens B
AD  - Department of Methodology and Statistics, Faculty of Health Medicine and Life
      Sciences, University of Maastricht, Maastricht, 6200 MD, The Netherlands.
FAU - den Abbeele, Pieter Van
AU  - den Abbeele PV
AD  - ProDigest, Technologiepark 3, 9052, Ghent, Belgium.
FAU - Possemiers, Sam
AU  - Possemiers S
AUID- ORCID: http://orcid.org/0000-0002-6893-5780
AD  - ProDigest, Technologiepark 3, 9052, Ghent, Belgium. [email protected]
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20170904
PL  - England
TA  - BMC Complement Altern Med
JT  - BMC complementary and alternative medicine
JID - 101088661
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Biological Therapy
MH  - Constipation/*microbiology/physiopathology/*therapy
MH  - Defecation
MH  - Double-Blind Method
MH  - Female
MH  - *Gastrointestinal Microbiome
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pilot Projects
MH  - Saccharomyces cerevisiae/*metabolism
MH  - Young Adult
PMC - PMC5584023
OTO - NOTNLM
OT  - Bacteroides
OT  - Bacteroidetes
OT  - Constipation
OT  - EpiCor fermentate
OT  - GI transit time
OT  - Gastrointestinal discomfort
OT  - Gut microbiome
OT  - Human study
OT  - Prevotella
OT  - Saccharomyces cerevisiae
EDAT- 2017/09/06 06:00
MHDA- 2017/09/09 06:00
CRDT- 2017/09/06 06:00
PHST- 2017/05/10 [received]
PHST- 2017/08/24 [accepted]
AID - 10.1186/s12906-017-1948-0 [doi]
AID - 10.1186/s12906-017-1948-0 [pii]
PST - epublish
SO  - BMC Complement Altern Med. 2017 Sep 4;17(1):441. doi: 10.1186/s12906-017-1948-0.