Effect of polydextrose-containing beverage on bowel habits and gastrointestinal symptoms of constipated subjects: a pilot study

@#Introduction: Indonesians have a low intake of dietary fibre, a key component for an increased incidence in constipation. Available data have documented the benefits of polydextrose (PDX) in healthy subjects. However, data on constipated subjects are lacking. This study aimed to investigate the effect of consuming a PDX (prebiotic) beverage on bowel habits and gastrointestinal symptoms of constipated subjects over seven days. Methods: This was a randomised, non-blinded, nonplacebo-controlled parallel design study involving 24 subjects, divided equally into two groups. Group A (active control group) consisted of 12 subjects, consuming one serving size of 6g PDX beverage. While Group B (intervention group) consisted of 12 subjects, consuming two servings of the same product, containing 12g PDX beverage. Changes in bowel habits (constipation score, stool frequency and stool consistency) and gastrointestinal symptoms (abdominal pain, bloating and flatulence) were monitored. Results: Within seven days, Group B showed 4.9% more reduction in overall constipation mean score than that of Group A. Positive improvement in gastrointestinal symptoms were reported: i.e. abdominal pain (∆M = -0.08±0.43), bloating (∆M = -0.29±0.37) and flatulence (∆M = -0.17±0.47). Majority of subjects had desirable stool frequency (87.5%, >3 defecations/week) and stool consistency (58.3%, type 4). These improvements were due to the fact that PDX provides physiological effects consistent with prebiotic fibre, which alters the gut microbiota composition during the fermentation cycle in the large intestine. Conclusion: Findings of this study suggested that daily PDX beverage consumption effectively improved bowel habits, with fewer constipated subjects reporting of gastrointestinal symptoms.

Prevalence and predictors of changes in bowel habits after laparoscopic cholecystectomy / Prevalência e preditores de alterações do hábito intestinal pós-colecistectomia videolaparoscópica

ABSTRACT Background: The incidence of cholecystolithiasis is approximately 15% of the population. It is believed that between 30-40% of cholecystectomy patients have symptoms after surgery, being changes in bowel habits the most common among them. Aim: 1) Defining the prevalence, and 2) identifying predictors of changes in bowel habits after laparoscopic cholecystectomy. Methods: This is a retrospective cross-sectional study with an initial sample of 150 patients diagnosed with cholecystolithiasis operated between July and September 2014. Patients were submitted to a questionnaire about the presence of gastrointestinal symptoms and changes in stools consistency before and after the surgical procedure. They were divided into two groups (with or without changes in bowel habits) being combined with the following variables: high blood pressure, body mass index, hypothyroidism, adherence to postoperative dietary orientations, previous abdominal and bariatric surgery. Results: The prevalence of changes in bowel habits in the study population was 35.1%. The association between it and gastrointestinal symptoms was demonstrated to be statistically significant (‰2=7.981; p=0.005), and people who did not have gastrointestinal symptoms had 2.34 times the odds of not presenting changes in bowel habits. None of the other investigated factors had shown to be a predictor of risk for post-cholecystectomy changes in bowel habits. Conclusion: 1) There was a high prevalence of changes in bowel habits, and 2) there was association between changes in bowel habits and the presence of gastrointestinal symptoms.

RESUMO Racional: A incidência da colecistopatia calculosa é de aproximadamente 15% da população brasileira. Acredita-se que entre 30-40% dos pacientes colecistectomizados apresentem sintomas pós-operatório, sendo a alteração do hábito intestinal o mais comum. Objetivo: 1) Determinar a prevalência, e 2) identificar preditores de mudanças do hábito intestinal pós-colecistectomia videolaparoscópica. Métodos: Estudo transversal retrospectivo com amostra inicial de 150 pacientes diagnosticados com colecistopatia calculosa, operados entre julho e setembro de 2014. Os pacientes foram submetidos a um questionário sobre a presença de sintomas gastrointestinais após a operação, e a alterações do aspecto das fezes antes e depois do procedimento. A amostra foi dividida em dois grupos (com ou sem mudanças do hábito intestinal) sendo realizadas associações com as seguintes variáveis: hipertensão arterial, IMC, hipotireoidismo, seguimento de dieta no pós-operatório, operação abdominal prévia e operação bariátrica. Resultados: A prevalência de mudanças do hábito intestinal na população estudada foi de 35,1%. A associação entre elas e sintomas gastrointestinais demonstrou-se estatisticamente significativa (‰2=7,981; p=0,005), sendo que as pessoas que não apresentavam os sintomas tinham 2,34 vezes mais chances de não apresentarem mudanças do hábito intestinal. Nenhum dos demais fatores investigados demonstrou ser preditor de risco para mudanças do hábito intestinal pós-colecistectomia. Conclusões: 1) Observou-se alta prevalência de mudanças do hábito intestinal, e 2) houve associação entre mudança do hábito intestinal e a presença de sintomas gastrointestinais.

Effects of 12-week Vegetarian Diet on the Nutritional Status, Stress Status and Bowel Habits in Middle School Students and Teachers

This study investigated the effect of switching normal diet to vegetarian diet rich in vegetables and fruits for school foodservice and home meal on the nutritional status, bowel habit improvement and stress reduction of teachers and adolescents. A total of 40 research subjects (26 students, 14 teachers) from one middle school voluntarily participated in the research. Questionnaire surveys and blood analysis were conducted before and after a 12-week vegetarian diet period. The participants were asked on their dietary habit, bowel habit and stress measurement. After 12 weeks, reduction of BMI (kg/m2) in the students (p < 0.05) and reduction of TC (mg/dL) in both teachers and students (p < 0.05) were observed. Also reduction of LDL-C (mg/dL) was observed in the teachers (p < 0.05) whereas serum calcium and Vitamin B12 was increased in the students and teachers (p < 0.005). The teacher's stress level was reduced (p < 0.05) after the 12-week vegetarian diet. As for the changes in bowel habit, the number of the students and teachers classified as experiencing functional constipation was decreased respectively from 10 to 7, from 7 to 5. Based on the result, it is considered that the vegetarian diet rich in fruits and vegetables improved general health status of study subjects suggesting that such a dietary habit would substantially contribute to improving nutritional status and bowel habit.

Effects of Routine Haecho Bibimbab Consumption on the Improvement of Bowel Habits during Short Period

The purpose of this study was to evaluate the effects of routine haecho bibimbab (boiled rice with assorted seaweed mixtures) consumption on the bowel habits in humans. Forty free-living adults (female 38, male 2) participated in this study (mean age 41.2 +/- 7.5). After a baseline survey on general characteristics, life style and dietary habits, the participants were asked to consume haecho bibimbab during two-week period for lunch. Habitual bowel movements were checked out every day by a questionnaire and nutrient intake was estimated by a 24-hour recalls before and after the study. After 2 weeks of clinical trial, the bowel habits had improved. Haecho bibimbab increased the number of bowel movements, changed hard stools into softer ones. It also lessen the sense of incomplete evacuation, and abdominal pain during defecation, increased water intake (p < 0.001) and improved gastrointestinal problem. The participants believed that haecho bibimbab was effective in improving their constipation symptoms and bowel habits (p < 0.01). Routine haecho bibimbab consumption tended to increase especially vitamin A, E and folate intake (p < 0.01). The present findings suggest that routine seaweed-based lunch meal (haecho bibimbab) consumption may improve bowel habits without side effects.

Prevalence of Constipation, Bowel Habits and Nutrient Intakes of College Students in Incheon Area

This study was conducted to estimate the prevalence of constipation, bowel habits and nutrient intakes of college students. The subjects were 353 college students (166 males and 187 females) aged 19 to 29 years in Incheon area. The subjects were asked about bowel habits and dietary intake using questionnaires during march, 2008 and the prevalence of functional constipation (FC) was based on the Rome II criteria. The prevalence of FC in male and female students was 12.7% and 28.9%, respectively. The prevalence of self-reported constipation in male and female students was 12.0% and 36.9%, respectively. Both were higher in female students compared to male students. Among the subjects that have self-reported constipation, proportions of FC were 35.0% in male students and 55.1% in female students. Of subjects that did not self-reported constipation, the proportions of FC were 9.6% in male students and 13.6% in female students. Over 90% of respondents that self-reported constipation in male students, had neither visited a hospital and nor used laxatives or functional foods for constipation relief. Seventy five point three percent of male students, and 40.1% of female students, had a defecation frequency of over 5 times per week (p < 0.001). Ratios intaken under the estimated average requirement (EAR) of Vit A, Vit C, folic acid and Ca were over the 50% regardless of functional constipation. Mean daily consumption of total dietary fiber was 15.0 g/day in male students and 13.5 g/day in female students. According to these results, both functional constipation and self-reported constipation are more frequent in female college students and further studies are required in case-control study and related to psychological factors as well as nutrients to relieve of constipation.