Review article: prebiotics in the gastrointestinal tract
Article first published online: 16 AUG 2006
Alimentary Pharmacology & Therapeutics
Volume 24, Issue 5, pages 701–714, September 2006
How to Cite
MACFARLANE, S., MACFARLANE, G. T. and CUMMINGS, J. H. (2006), Review article: prebiotics in the gastrointestinal tract. Alimentary Pharmacology & Therapeutics, 24: 701–714. doi: 10.1111/j.1365-2036.2006.03042.x
- Issue published online: 16 AUG 2006
- Article first published online: 16 AUG 2006
- Publication data Submitted 2 May 2006 First decision 4 June 2006 Resubmitted 15 June 2006 Accepted 24 June 2006
Prebiotics are short-chain carbohydrates that alter the composition, or metabolism, of the gut microbiota in a beneficial manner. It is therefore expected that prebiotics will improve health in a way similar to probiotics, whilst at the same time being cheaper, and carrying less risk and being easier to incorporate into the diet than probiotics.
To review published evidence for prebiotic effects on gut function and human health.
We searched the Science Citation Index with the terms prebiotic, microbiota, gut bacteria, large intestine, mucosa, bowel habit, constipation, diarrhoea, inflammatory bowel disease, Crohn's disease, ulcerative colitis, pouchitis, calcium and cancer, focussing principally on studies in humans and reports in the English language. Search of the Cochrane Library did not identify any clinical study or meta-analysis on this topic.
Three prebiotics, oligofructose, galacto-oligosaccharides and lactulose, clearly alter the balance of the large bowel microbiota by increasing bifidobacteria and Lactobacillus numbers. These carbohydrates are fermented and give rise to short-chain fatty acid and intestinal gas; however, effects on bowel habit are relatively small. Randomized-controlled trials of their effect in a clinical context are few, although animal studies show anti-inflammatory effects in inflammatory bowel disease, while calcium absorption is increased.
It is still early days for prebiotics, but they offer the potential to modify the gut microbial balance in such a way as to bring direct health benefits cheaply and safely.