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Prebiotic qualities refer to inulin’s ability to act as food for good bacteria in the gut,
encouraging their growth and activity (Alexiou and Franck 2008).
(a) Prebiotic Properties: Inulin remains undigested and unabsorbed in the small
intestine, traversing through to the colon in an almost intact state, where it
serves as a benecial substrate for bidobacteria and lactobacilli. This bene-
cial bacteria ferment inulin, resulting in the production of short-chain fatty
acids (SCFAs) such as acetate, propionate, and butyrate, all of which harbor
diverse health benets (Apolinario etal. 2014).
(b) Digestive Health: By virtue of its prebiotic nature, inulin frequently correlates
with improved digestive health. It aids in the regulation of bowel movements,
the alleviation of constipation, and the promotion of the proliferation of bene-
cial gut bacteria. Some research studies propose that inulin might also mitigate
the symptoms experienced by individuals with irritable bowel syndrome (IBS)
(Tawck etal. 2022).
(c) Blood Sugar Regulation: Scientic evidence indicates that inulin exerts a favor-
able inuence on blood sugar levels. This is primarily due to its ability to slow
down the absorption of glucose in the intestines, thereby potentially preventing
abrupt spikes in post-meal blood sugar levels. Consequently, inulin exhibits
potential benets for individuals affected by diabetes or those who are at risk of
developing the condition (Meyer and Stasse-Wolthuis 2009).
(d) Weight Management: The incorporation of inulin into one’s diet may contribute
substantially to weight regulation endeavors. As inulin is categorized as a
dietary ber, its ingestion can augment sensations of repletion and diminish the
urge to consume, thereby possibly curtailing the total caloric intake. Moreover,
inulin’s fermentative breakdown within the intestinal milieu yields short-chain
fatty acids (SCFAs), which are theorized to exert modulatory effects upon the
mechanisms governing hunger (Akram etal. 2019).
(e) Bone Health: An array of scholarly inquiries posits that inulin exerts a bene-
cial inuence on skeletal well-being. Empirical evidence stemming from zoo-
logical studies indicates that dietary inclusion of inulin enhances calcium
absorption from the gastrointestinal tract, potentially culminating in an elevated
bone mineral density. Nevertheless, to ascertain its denitive inuence on
human bone health, further scientic scrutiny is imperative (Hiel etal. 2019a).
(f) Food Applications: Leveraging its multiple health-promoting attributes, inulin
has risen to prominence as a quintessential food additive. It is seamlessly inte-
grated into an extensive assortment of consumables such as yogurts, granola
bars, confectioneries, and beverages with the intent of boosting dietary ber
content and ameliorating their nutritive value. In addition, inulin nds applica-
tion as a substitute for traditional fats or sugars within certain culinary concoc-
tions (Jenkins et al. 1999). Percentage of inulin present in plant sources is
presented in Table11.1.
Due to the resilience of the glycosidic linkages interconnecting the fructosyl
units against gastric acid, alongside the absence of human digestive enzymes
11 Inulin andGastrointestinal Disorders
218
Table 11.1 Clinical trials of prebiotics in IBD
Treatment
Study
Duration of
treatment
Clinical
condition
Result
Dietary inulin
24g/day
Double blind placebo-
controlled trial
6weeks Clinical
pouchitis
Effective in treatment
of chronic pouchitis
Synergy 15g/
day
Open-labeled trial 3weeks Active CD Reduction of disease
activity
equipped to cleave these bonds, inulins and fructo-oligosaccharides (FOS) traverse
the alimentary canal from oral cavity to small intestine unscathed. Upon arrival in
the colon, these substances undergo comprehensive fermentation by the resident
bacterial ora. This particular characteristic underpins the classication of inulins
as dietary bers (Kalyani Nair et al. 2010). The fermentation yields metabolic
byproducts such as short-chain fatty acids (SCFA), including acetic, propionic, and
butyric acid, which the host organism assimilates and metabolizes. This metabolic
salvage operation releases a portion of the energy inherent in these carbohydrates,
albeit at a rate of roughly one-third of the caloric yield typical of digestible carbo-
hydrates. Consequently, inulins and oligofructose are recognized as low-caloric
ingredients, offering an energy value of approximately 1.5 kcal/g (Kaur and
Gupta 2002).
This colonic fermentation instigates a modication in the composition of the
colonic microbiota, most notably promoting the proliferation of bidobacteria (and
to a lesser extent lactobacilli), leading to an augmented presence of these bacterial
genera. Such an effect is evident both in pediatric and adult populations. The fer-
mentation of inulins may also precipitate a multitude of other physiological bene-
ts, some of which are attributable to the ber’s intrinsic functions, while others are
more directly connected to the enhancement of health-promoting bacteria (Qin
etal. 2023a).
The ber-related benets include contributions to an ameliorated defecation pat-
tern and a fecal bulking inuence. The bidogenic effect may also contribute to
these outcomes. Furthermore, the inherent non-digestibility of the ber is instru-
mental in moderating the glycemic response elicited by inulins and FOS. The gly-
cemic response of inulins is notably subdued: the purest commercially available
form of inulin exhibits a glycemic response of 5, while native inulin has a slightly
higher response of approximately (Vandeputte etal. 2017). This positions inulin as
an optimal component for diabetic-friendly dietary options and the formulation of
low glycemic response food products. Additionally, the fermentation of inulins can
induce a localized reduction in pH, thereby enhancing the solubility of various min-
eral salts and improving their bioavailability for absorption. Notably, human studies
have demonstrated that the consumption of inulin or FOS can lead to increased
absorption of calcium and magnesium (Carlson etal. 2017).
Dietary ber, such as inulin, is regarded as a crucial component of a nutritious
diet for the majority of individuals. The gut microbiota metabolizes inulin and other
forms of dietary ber into short-chain fatty acids, which activate regulatory T cells,
a kind of immune cell. These cells play a role in reducing inammation and exert
S. K. Kadiri et al.
219
other advantageous effects in the body. As a result, there was a signicant increase
in the utilization of dietary ber as an ingredient in both food products and supple-
ments. Puried inulin or inulin-rich chicory root is frequently used as the primary
source of this ber. The intestine serves as the primary barrier of the body’s immune
system and is constantly exposed to various diseases and bacteria. The intestinal
immune system, sometimes referred to as the mucosal immune system, is the largest
immunological organ in the body. It primarily consists of intestinal epithelial cells
(IECs), lamina propria-lymphocytes, intraepithelial lymphocytes, and the Peyer’s
patch. Consuming a diet high in inulin has been shown to enhance the performance
of the intestinal barrier and regulate the immune system (Yuan etal. 2022).
11.2 The Role ofInulin inMaintaining
Gastrointestinal Health
Inulin contributes to the well-being of the gastrointestinal health in several key ways:
Prebiotic Benets: Inulin acts as prebiotic dietary ber, feeding the good bacteria
residing in the gut. These bacteria break down inulin through fermentation, result-
ing in the production of short-chain fatty acids (SCFAs) such as acetate, propionate,
and butyrate. These SCFAs are crucial for maintaining gut health, with butyrate
playing a pivotal role as the primary energy source for colon cells, thereby fostering
their vitality and functionality (Guarner 2005).
Gut Flora Enhancement: Inulin encourages the proliferation of favorable gut
bacteria like bidobacteria and lactobacilli. A diverse and well-balanced gut ora is
linked with improved digestion, better immune system performance, and over-
all health.
Improved Digestive Regularity: Inulin can help to amplify stool volume and
enhance digestive regularity, contributing to the fecal matter and aiding in the pro-
duction of stools that are softer and pass more smoothly. This can be especially
helpful for those dealing with constipation or inconsistent bowel movements.
Nutrient Absorption Boost: Inulin is known to improve the body’s capability to
absorb vital minerals, including calcium and magnesium, by increasing their solu-
bility in the intestinal tract (Akram etal. 2019; Leenen and Dieleman 2007; Valcheva
etal. 2019; Schaafsma and Slavin 2015; Liu et al. 2020). This leads to enhanced
nutrient absorption and utilization, which is benecial for health and well-being.
Immune System Support: The gut’s microbiota is signicant in immune regula-
tion, and inulin’s support of a balanced gut bacterial environment can indirectly
bolster immune health. Furthermore, butyrate produced from inulin fermentation is
known for its anti-inammatory properties and can aid in modulating immune
responses.
Blood Glucose Control: Inulin can positively affect blood glucose management
by decelerating the uptake of glucose in the small intestine, which helps in prevent-
ing blood sugar spikes post-eating. This is crucial for metabolic health and could
potentially lower the risk of developing insulin resistance and type 2 diabetes (Bărboi
etal. 2020). Wilson etal. (2011) conducted a randomized controlled experiment to
11 Inulin andGastrointestinal Disorders
220
examine the impact of inulin on symptoms of irritable bowel syndrome (IBS). The
study revealed that the addition of inulin to the diet enhanced the frequency of bowel
movements and decreased abdominal distension in individuals diagnosed with irri-
table bowel syndrome (IBS). Nevertheless, certain individuals encountered aug-
mented gas production as a secondary consequence. Inulin can be advantageous for
those with irritable bowel syndrome (IBS) as it supports the growth of benecial
bacteria in the gut and enhances bowel function. However, it is worth noting that
some individuals may feel discomfort as a result of increased gas production.
A study conducted by Micka etal. (2017) assessed the inuence of chicory inulin
on constipation. The participants who ingested inulin had notable enhancements in
both the frequency and consistency of their bowel movements in comparison to the
group who received the placebo. Inulin can effectively cure constipation by promot-
ing more frequent bowel movements and enhancing the consistency of stool.
Inulin supports gastrointestinal health by acting as a prebiotic, adjusting the
composition of gut bacteria, fostering consistent bowel movements, improving the
uptake of nutrients, regulating immune responses, and stabilizing blood glucose.
Adding foods or supplements high in inulin to one’s dietary regimen can be an
effective approach to enhance gut health and promote general vitality. Among all
the ecosystems in nature, the large intestine has the highest population density. The
gut microbiota is incredibly diverse and contains a vast number of microorganisms.
Within estimations from scientic literature range from 500 to 1000 distinct bacte-
rial species, with a total mass of roughly 1.5kg. This gure may be inated; accord-
ing to other specialists, the mass of bacteria is between 100 and 200g wet weight
(Azpiroz etal. 2017). Although the majority of the species are difcult or impossi-
ble to cultivate, new analysis methods based on nucleic acids, proteomics, and
metabolomics are providing more information about the diversity, the genera
involved, their metabolic activities, and their roles and effects on host health. These
investigations are making it increasingly clear that intestinal metabolism signi-
cantly affects human physiology. Instead of being used for the storage of undigested
material or the absorption of salts and water, the numerous microbial transforma-
tions of undigested material result in a number of signicant physiological impacts.
The majority of these conversions involve the fermentation of non-digested carbo-
hydrates, which produces short-chain fatty acids (SCFA). The primary SCFAs pro-
duced by this fermentation are acetate, propionate, and butyrate. Lactate, a crucial
intermediary in the synthesis of SCFA, is also produced (Nagy etal. 2023).
The host’s health is believed to benet from these carbohydrate fermentation
products, but protein degradation and ammonia, phenols, indoles, thiols, amines,
and suldes are examples of amino acid fermentation products that are not. Thus, an
EU program called PASSCLAIM, which incorporated the opinion of numerous
experts, dened a healthy, or balanced, ora as one that is primarily saccharolytic
and contains a sizable number of lactobacilli and bidobacteria. Prebiotics are non-
digestible carbohydrates with the capacity to cause this kind of bidogenic altera-
tion in the intestinal microbiota (Qin etal. 2023a). The most researched prebiotics
are fructo-oligosaccharide (FOS), oligofructose, and inulin. Any b (2–1) linear fruc-
tans with varying degrees of polymerization are referred to be inulin. The existence
S. K. Kadiri et al.
221
of the b (2–1) connections causes variations in the degree of polymerization, which
can inuence inulin’s solubility, fermentability, and prebiotic effects.
Because inulin is not broken down by digestive enzymes in the small intestine, it
passes through undigested and is fermented in the colon to gases and SCFA through
intestinal bacteria. Chicory inulin has a degree of polymerization ranging from 2 to
60; oligofructose, or FOS, is the partial enzymatic hydrolysis product with a degree
of polymerization ranging from 2 to 10. The enzymatic transfer of fructosyl groups
from sucrose results in the production of FOS from sucrose. This product has short
fructan chains with a maximum polymerization degree of 5 (Hughes etal. 2022).
11.3 Biomarkers forGastrointestinal Health
Each person has a unique gut microbial makeup, and there are signicant interindi-
vidual differences. Based on their potential for pathogenicity, gut bacteria can be
broadly classied into three categories: (a) bacteroides and lactobacilli; (b) bacteroi-
des and other commensal bacteria that may have both benecial and harmful traits;
and (c) potentially pathogenic bacteria like some species of clostridia. It is often
believed that a gut microbiota that is dominated by lactobacilli and bidobacteria is
advantageous to health, despite the lack of conclusive data to support this assump-
tion. Unlike other groups like Bacteroides and Clostridia, which are also proteolytic
and amino acid fermenting, the genera Bidobacterium and Lactobacillus do not
contain any recognized pathogens and are primarily carbohydrate- fermenting bacte-
ria (Aravind etal. 2012). It goes without saying that stool weight, frequency of bowel
movements, and intestinal transit duration are signicant indicators of overall colonic
function. Furthermore, there is a broad spectrum of measuring methods for keeping
an eye on additional indicators of gut health, including metabolite prole variations,
various markers of colonization resistance against infections, intestinal lining integ-
rity, and immunomodulation. Furthermore, there exists a range of intermediate bio-
markers for colon cancer, such as the modication of genotoxicity in fecal water and
the activity of specic fecal enzymes. The series of physiological reactions that can
be brought about by ingesting probiotic bacteria, inulin-type fructans, or a combina-
tion of the two is known as synbiotics (Healey etal. 2018). The various stages of this
plan illustrate factors that can be used as potential biomarkers at different phases of
the physiological event cascade. For example, one theory suggests that a quicker
intestinal transit reduces the chance of potentially hazardous chemicals forming and
of them interacting with intestinal cells. It is crucial to remember that changes in a
single biomarker cannot offer conclusive evidence of improved health or a lower risk
of disease; nevertheless, the evidence does increase when data on multiple biomark-
ers—from various study types—all go in the same way. Furthermore, a variety of
biomarkers can offer hints on the underlying mechanisms. The impact of changes in
specic immune parameters should not be generalized due to the tremendous com-
plexity of gut-associated immune function and the wide interindividual differences
in numerous immunological functions, even among the healthy. For measuring
immunomodulation in human nutrition intervention, the most effective method at the
11 Inulin andGastrointestinal Disorders
222
moment is to combine markers with high and medium appropriateness (Alexiou and
Franck 2008). Manipulating the gut-brain axis, a complex communication system
that plays a vital role in regulating energy balance could be a promising approach for
treating obesity (Fig.11.1). When we consume nutrients, they trigger the release of
gut peptides. These peptides either can function locally by signaling through nerve
pathways connected to the vagus nerve or other nerves or can enter the bloodstream
and act as hormones to signal the central nervous system. The central nervous system
then generates appropriate responses based on these signals. Research has demon-
strated that gastric and gastroesophageal junction tumors that have HER2-positive
status can be effectively treated with targeted medicines such as trastuzumab derux-
tecan. Certain medicines have demonstrated a substantial enhancement in patient
outcomes by specically targeting the HER2 protein, which is excessively expressed
in certain types of malignancies. The current study is centered toward comprehend-
ing genetic indicators that can forecast the effectiveness of these therapies. This
knowledge can be utilized to customize treatments based on the genetic characteris-
tics of each patient. Studies have emphasized the signicance of cancer-derived
Fig. 11.1 The impact of a modied gut microbiome on the connection between the gut and the
brain, which may play a role in the development of obesity. The consumption of a diet high in fat
can change the composition of the microorganisms in the digestive system of the host, which can
negatively affect the communication routes between the gut and the brain. This disruption can
result in an increase in food consumption and subsequent weight gain
S. K. Kadiri et al.
223
exosomes (CDEs) in the formation of a pre-metastatic environment that facilitates
the spread of GI malignancies. Exosomes play a role in promoting immunosuppres-
sion, angiogenesis, and modication of the extracellular matrix, which contribute to
the advancement and spread of cancer. Gaining comprehension of these systems
offers valuable understanding of possible therapeutic targets to disrupt these pro-
cesses and impede the progression of cancer.
11.4 Impact ontheMetabolic Activity andMakeup
oftheGut Microbiota
Chicory-derived fructans were tested for their bidogenic effects at daily dosages
ranging from 1.25 to 4g. In several of these investigations, in addition to an increase
in Bidobacterium spp., there was also an increase in Lactobacillus spp., and other
positive alterations in the microbiota’s composition were also observed. In infants
when oligofructose and native inulin are combined, children as young as 6months
old can benet from a bidogenic effect at a consumption rate of roughly 1.7g/day.
However, when the same mixture is applied as an enteral formula, there is no dis-
cernible effect but a trend towards an increase in bidobacteria in pediatric cancer
patients between the ages of 1 and 12. Numerous studies on the prebiotic benets of
a 9:1 combination of long-chain inulin and galacto-oligosaccharides (GOS) in for-
mula-fed infants have been reported (Carabin and Flamm 1999).
In the combination where a consumption level of 6 g/L was used, no discernible
variations in the percentage of bidobacteria were observed after 16 weeks; none-
theless, all other studies do demonstrate a bidogenic effect. In one study,
Bidobacterium increased in a dose-dependent manner in terms of infants given
4g/L or 8g/L of this mixture in the formula, but Lactobacillus altered at the same
rate at both intake levels. When inulin or oligofructose from chicory is consumed, a
wide number of studies including adult volunteers consistently demonstrate signi-
cant bidogenic alterations in the makeup of the intestinal microbiota. For inulin
and oligofructose, the lowest dosage that demonstrated a bidogenic effect was 5g/
day, while for long-chain inulin, it was 9g/day. Given that short-chain FOS derived
from sucrose also has a bidogenic effect, it appears to be unaffected by chain
length (Bonnema etal. 2010a).
It was suggested that the amount of bidobacteria in the colon before starting
prebiotic supplementation is what primarily determines the size of the bidogenic
impact, rather than the daily dose. Numerous researches involving adult volunteers
appear to support this theory. This mechanism could be the reason for some studies’
lack of bidogenic effects, including the one that used 10g/day long-chain inulin,
while a different study did demonstrate the same kind of effect at 9g/day of fructan.
Furthermore, it is important to understand that a slight rise in log numbers can indi-
cate a signicant increase in the number of bacteria: for example, an increase from
log 7 to log 8 is signicantly less than an increase from log 9.2 to log 9.6. As a
result, it is impossible to guess which kind of fructan—or prebiotic, for that matter—
is the most bidogenic.
11 Inulin andGastrointestinal Disorders
224
It is not unexpected that inulin produced from Jerusalem artichokes and chicory
has bidogenic properties. A decline in potentially harmful species, like Clostridium
spp., was also seen in certain investigations (Holscher etal. 2014).
11.5 The Relationship Between Inulin andConstipation
Because of its ber content and prebiotic qualities, inulin can help relieve
constipation.
Enhanced Stool Bulk: A soluble ber called inulin holds onto water in the diges-
tive tract as it goes through undigested, giving the stool more volume. Constipation
may be alleviated by this greater mass, which can encourage bowel motions and
make stools softer and easier to pass.
Encouragement of Bowel Regularity: Inulin is a prebiotic that feeds the good
bacteria in the gut. Short-chain fatty acids (SCFAs) are created when these bacteria
ferment inulin, and they have the ability to increase bowel regularity and peristalsis,
the wave-like movements of the intestines. Constipation can be avoided and bowel
motions can be regulated using this (Holownia etal. 2010; Havenaar etal. 1999).
Better Gut Microbiota Balance: Bidobacteria and lactobacilli, two types of
good bacteria linked to better gut health and regular bowel movements, are encour-
aged to develop when inulin is consumed. Inulin supports a balanced composition
of gut ora, which benets digestive health in general and may help avoid constipa-
tion (Bouchaud etal. 2016). Inulin can retain water in the digestive system, which
helps make feces softer and easier to pass through the intestines. Constipation may
be lessened by this increased water retention, which facilitates the passage of feces.
Decreased Transit Time: Inulin may contribute to a reduction in transit time, or
the amount of time food takes to pass through the digestive system. Inulin can aid in
preventing the excessive reabsorption of water from the stool by encouraging a
faster transit time (Veereman 2007).
In Western countries, constipation is one of the most prevalent health problems.
The prevalence varies between 5% and 30% based on the diagnostic criteria applied.
An epidemiology survey that examined the frequency and duration of constipation
in 13,879 participants found that 12% of persons globally self-identify as consti-
pated. Constipation is a common condition that can be difcult to diagnose and
treat, which drives up expenses for healthcare systems annually. There is currently
no adequate natural remedy for functional constipation. Many bulking medications
are not always effective and well accepted by many people, and commonly used
laxatives frequently have negative effects. Therefore, the task of devising efcient
and user-friendly methods to combat constipation arises. Among the natural food
ingredients that include inulin-type fructans are leek, onions, wheat, garlic, chicory,
and artichokes. Polymers and oligomers made up of fructosyl units connected by β
(2 → 1) glycosidic linkages make up inulin (Bui et al. 2021). Because of its
β-conguration, inulin is not easily broken down by the digestive enzymes found in
humans. Due to its indigestibility, inulin arrives in the large intestine mostly intact,
where colonic bacteria ferment it in a targeted manner. So, dietary bers with proven
S. K. Kadiri et al.
225
prebiotic properties are inulin-type fructans. The particular modications to the gut
microora’s activity and/or composition are benecial to human health (Simakachorn
etal. 2011).
Numerous human intervention studies have conrmed the health benets of
chicory-derived inulin-type fructans, including the favorable adjustment of gut
microbiota, the modulation of immunological response, effects on satiety and body
weight, mineral absorption, and bone health. Similar to what other study groups
have reported, chicory inulin has been shown to have favorable effects on bowel
function. This was recently supported by a meta-analysis and a positive scientic
opinion issued by the European Food Safety Authority (EFSA) in response to a
request for information about health claims. The current investigation, which fol-
lowed more recent guidelines for suitable study designs to examine gut function,
should reinforce these ndings even more (Harmsen etal. 2002).
The goal of the current randomized, double-blind, placebo-controlled interven-
tion trial was to ascertain how Orafti Inulin consumption affected the frequency of
stools in constipated but otherwise healthy volunteers. Investigating the impact on
gastrointestinal traits, quality of life and stool consistency were secondary goals. In
accordance with contemporary guidelines for suitable study designs to examine
digestive function, this randomized, double-blind, placebo-controlled experiment
was created to look at the impact of the dietary ber inulin, which is produced from
chicory, on intestinal function. Stool frequency, the main end measure, increased
signicantly when 12g/day of Orafti Inulin was consumed in comparison to malto-
dextrin, the placebo product (p = 0.038). These ndings support the notion that
chicory inulin enhances gut health and facilitates better bowel function (Falony
etal. 2009; Roller etal. 2004; Velasco etal. 2010; Dehghan etal. 2013).
The indigestibility of chicory in the small intestine of humans and the following
fermentation that occurs in the colon are the mechanisms by which the dietary ber
inulin from the plant increases the frequency of stools. Lactate, short-chain fatty
acids (SCFA), and gases are produced when chicory inulin is fermented by bacteria.
This is accompanied by a rise in digesta’s water content and bacterial cell mass.
Higher gastrointestinal motility results from peristalsis being stimulated by the
increased stool material (Welters etal. 2002). Moreover, stools soften and become
more easily expelled. Since SCFA has been demonstrated to be able to elicit a peri-
staltic response akin to that brought on by mechanical stimulation, fermentation
itself has been found to have signicant impacts on bowel function. As long as it
does not cause diarrhea, an increase in stool frequency is regarded as a positive
physiological effect. According to this criterion, there was a minor softening of the
feces after consuming chicory inulin, as determined by the validated Bristol Stool
Form Scale (Casellas etal. 2007). When Orafti Inulin was consumed compared to a
placebo, there was a decrease in the proportion of patients with a median stool con-
sistency of <3, which indicates rmer stools that are more difcult to evacuate
(22.7% versus 36.4%). Inulin consumption was also linked to a softening of stool
consistency in constipated subjects, according to a prior study. Constipated subjects
frequently experience straining. Despite the fact that the current study participants
generally assessed the sensation of straining as quite low, chicory inulin
11 Inulin andGastrointestinal Disorders
226
signicantly improved the sensation when compared to a placebo. This could be
explained by softer stools that show a reduction in discomfort and help in the defe-
cation process (Wan etal. 2020).
Chicory inulin was found to have a positive impact on bowel function, namely,
increasing the frequency of stools, even at a dosage of 12g/day without causing any
discomfort to the gastrointestinal tract. Consequences of colonic fermentation, such
as the passage of gas, are physiologically linked to the amount of dietary ber con-
sumed. Orafti Inulin demonstrated excellent tolerability overall during the trial (Qin
etal. 2023b). In this experiment, Orafti Inulin consumption was associated with
higher pleasure when compared to placebo (p=0.059). This was assessed using the
appropriate sub-score from the PAC-QoL questionnaire, a validated tool for evaluat-
ing the quality of life of patients who are constipated. The improvement in stool
frequency during the intervention phase may account for the subjects’ better satis-
faction with chicory inulin. This suggests that regular emptying is a ritualistic part
of health and quality of life and that constipation is a real hindrance to day-to-day
functioning that could be alleviated by consuming Orafti Inulin. The study partici-
pants did not alter their dietary or lifestyle choices (Tawck etal. 2022).
The average estimated ber uptake using 3-day eating protocols was only about
23g/day, and 80% of subjects did not meet the German recommendation of 30g of
dietary ber per day. The results of the German National Nutrient Intake Survey II
are corroborated by these data. According to this poll, around 75% of women and
68% of men in Germany do not consume the required amounts of dietary ber
(Rubel etal. 2021). The same is true for the USA, where the median dietary ber
intake is only half of the recommended intake amount, at roughly 15g/day. After
accounting for the 12 g of fermentable ber chicory inulin that were given as a
supplement in this trial, the participants were able to meet the required daily allow-
ance of ber. Chicory root bers can simply be added to consumer products to boost
ber intake and enhance digestive function at the same time.
The results of this trial showed that individuals with persistent constipation
responded well to Orafti
®
Inulin. There has been a noticeable increase in the fre-
quency of stools, which has been linked to a softening in stool consistency. These
changes have improved people’s quality of life, chiey by raising contentment
(Anjuomo etal. 2021).
11.6 Inulin andIts Relationship withIrritable Bowel
Syndrome (IBS)
The symptoms of irritable bowel syndrome (IBS) include gas, bloating, atulence,
and abnormal bowel movements. Research indicates that restricting fermentable
oligo-, di-, and monosaccharides and polyols (FODMAPS) may be benecial for
those with irritable bowel syndrome (IBS). Certain FODMAPs, such as fructans
and galacto-oligosaccharide (GOS), are thought to have prebiotic effects; a low-
FODMAP diet limits the intake of prebiotic bers, which promotes an imbalance in
the gut microbiota (Zhu etal. 2019a).
S. K. Kadiri et al.