A Fermented Milk Product with B. lactis CNCM I-2494 and Lactic Acid Bacteria Improves Gastrointestinal Comfort in Response to a Challenge Diet Rich in Fermentable Residues in Healthy Subjects

Abstract

Background: Healthy plant-based diets rich in fermentable residues may induce gas-related symptoms. Our aim was to determine the potential of a fermented milk product with probiotics in improving digestive comfort with such diets. Methods: In an open design, a 3-day high-residue diet was administered to healthy subjects (n = 74 included, n = 63 completed) before and following 28 days consumption of a fermented milk product (FMP) containing Bifidobacterium animalis subsp. lactis CNCM I-2494 and lactic acid bacteria. Main outcomes: digestive sensations, number of daytime anal gas evacuations, and gas volume evacuated during 4 h after a probe meal. Results: As compared to the habitual diet, the high-residue diet induced gas-related symptoms (flatulence score 4.9 vs. 1.2; p ≤ 0.0001), increased the daily number of anal gas evacuations (20.7 vs. 8.7; p < 0.0001), and impaired digestive well-being (1.0 vs. 3.4; p < 0.05). FMP consumption reduced flatulence sensation (by −1.7 [−1.9; −1.6]; p < 0.0001), reduced the number of daily evacuations (by −5.8 [−6.5; −5.1]; p < 0.0001), and improved digestive well-being (by +0.6 [+0.4; +0.7]; p < 0.05). FMP consumption did not affect the gas volume evacuated after a probe meal. Conclusion: In healthy subjects, consumption of a FMP containing B. lactis CNCM I-2494 and lactic acid bacteria improves the tolerance of a flatulogenic diet by subjective and objective criteria (sensations and number of anal gas evacuations, respectively).

A Fermented Milk Product Containing B. lactis CNCM I-2494 Improves the Tolerance of a Plant-Based Diet in Patients with Disorders of Gut–Brain Interactions

“…Microbial ecology and statistical analyses were performed using QIIME and R software (3.4.3v). Spearman correlations were used to assess correlations between changes in clinical parameters and faecal microbiota composition, as previously described [8].…”

“…and all participants provided written informed consent. The protocol was also registered with ClinicalTrials.gov (NCT02936713) and included separate pilot studies in healthy subjects [8] and in patients with disorders of gut-brain interactions (reported here). All authors had access to the study data and reviewed and approved the final manuscript.…”

“…Half of the participants were scheduled for colonic gas content measurements. Colonic gas content during consumption of the plant-based diet was measured by abdominal magnetic resonance imaging (MRI) in the run-in phase (day 18) and in the administration phase (day 46), following the procedure described previously [8].…”

Gastrointestinal Contributions to the Postprandial Experience

“…Specific residues, that may be classified as prebiotics, such as inulin [ 59 ], fructooligosaccharides [ 60 ] and galactooligosaccharides [ 58 ] modify colonic microbiota and influence digestive sensations, anxiety and mood. Not only prebiotics, but also specific living microorganisms, classified as probiotics, administered in the diet, improve the tolerance to a challenge diet in healthy subjects [ 61 ] and symptoms in patients with functional gut disorders [ 62 , 63 , 64 ].…”

Abdominothoracic Postural Tone Influences the Sensations Induced by Meal Ingestion

“…In the past both terms were used indistinctively, and this unprecise terminology contributed to the confusion [ 1 ]. However, patients clearly distinguish between the subjective sensation of increased abdominal pressure/fullness (i.e., bloating) and visible abdominal distension [ 11 , 12 , 13 ]. Since patients frequently relate distension to bloating sensation, it could be speculated that the somatic response is a conditioned protective attempt to mitigate the visceral sensation, somewhat analogous to the abdominal contraction covering peritoneal irritation, but the attempt turns out ineffective and the distension becomes then a major complaint.…”