Fructooligosaccharides for Relieving Functional Constipation: A Systematic Review and Meta-Analysis of Randomized...

Area of Science:

• Gastroenterology
• Nutritional Science
• Microbiology

Background:

• Constipation is a prevalent gastrointestinal disorder affecting quality of life.
• Prebiotics, such as fructooligosaccharides (FOS), are recognized for their potential to modulate gut microbiota and improve bowel function.
• Dietary supplementation with FOS is being explored as a non-pharmacological approach to manage constipation.

Purpose of the Study:

• To systematically review and meta-analyze randomized controlled trials (RCTs) evaluating the efficacy of fructooligosaccharides (FOS) as a dietary supplement for constipation.
• To assess the impact of FOS on bowel movement frequency, stool consistency, gastrointestinal transit time, and associated symptoms.
• To identify any adverse events related to FOS consumption.

Main Methods:

• A comprehensive search of major databases (Cochrane Library, PubMed, EMBASE, Web of Science) was conducted up to March 2, 2024.
• Included RCTs were assessed for bias risk using the Cochrane Risk of Bias tool.
• Data were synthesized using random-effects or fixed-effects models, with outcomes reported as odds ratios (OR), weighted mean differences (MD), or standardized mean differences (SMD) with 95% confidence intervals (CI).

Main Results:

• The meta-analysis included 17 RCTs with 713 participants.
• FOS intake significantly increased bowel movement frequency (p < 0.00001) and improved stool consistency (SMD: 0.36).
• Reduced effort and pain during defecation were observed (SMD: -0.60), with mild bloating reported as the primary adverse event (OR: 10.36).

Conclusions:

• Fructooligosaccharides demonstrate potential as a dietary supplement to enhance bowel movement frequency and improve constipation symptoms.
• While FOS appears generally safe, mild gastrointestinal discomfort like bloating should be considered.
• Further high-quality RCTs are needed to establish optimal dosages and confirm efficacy for functional constipation treatment.