Prebiotic supplementation beneficial in mild to moderate ulcerative colitis

Oral supplementation with 1-kestose in patients with mild to moderate ulcerative colitis (UC) helps modulate the gut microbiome, which in turn contributes to clinical improvement, as reported in a study.

A total of 40 patients with mild to moderate active UC were randomly assigned to receive either 1-kestose (n=20) or maltose (placebo, n=20) supplements. These supplements were taken orally for 8 weeks in addition to standard treatment.

Outcomes included the Lichtiger clinical activity index and Ulcerative Colitis Endoscopic Index of Severity. Faecal samples were also obtained and analysed to assess the gut microbiome and metabolites.

At week 8, the clinical activity index was significantly lower in the 1-kestose group than in the placebo group (mean, 3.8 vs 5.6; p=0.026). Significantly more patients in the 1-kestose group achieved clinical remission (55 percent vs 20 percent; p=0.048) and response (60 percent vs 25 percent; p=0.054).

However, the Ulcerative Colitis Endoscopic Index of Severity did not differ between the two groups (mean, 2.8 vs 3.5; p=0.145).

Examination of the faecal samples showed that the 1-kestose group had significantly reduced alpha-diversity, with the relative abundance of several bacteria, including the Ruminococcus gnavus group, being decreased. Meanwhile, the short-chain fatty acid levels were similar in the 1-kestose and placebo groups.

There was no between-group difference in the frequency of adverse events.