Functional constipation affects approximately 10% of the Indian population and may be associated with depression and poor quality of life (QOL). It is a frustrating illness and many dietary, pharmaceutical and non-pharmaceutical interventions have been used with varying results.

Dey et al. [9] from Vadodara, India, report on a double-blind placebo control trial in patients with functional constipation, in which they compared 30-day treatment with 10G galactooligosaccharide (GOS) gummies vs. a placebo and looked at constipation symptoms, gut microbiome, depression and QOL. Real-time polymerase chain reaction was used to quantitatively study fecal gut microbes, including Bifidobacterium, Lactobacillus, Clostridium and Bacteroides and phyla Bacteroidetes and Firmicutes. GOS gummy supplementation increased Bifidobacterium and Lactobacillus by 1230% and 322%, respectively (p < 0.05) and reduced Clostridium by 63%, phylum Firmicutes by 73% and Bacteroidetes by 85% (p < 0.05). The GOS-supplemented group demonstrated a higher F/B ratio (4.2) also. Symptoms including stool frequency, type of stool, incomplete stool, straining, anorectal blockage and abdominal pain while passing stools improved significantly in the experimental group. In the treatment arm, there was a 40% reduction in depression (p < 0.05) and 22% improvement in QOL.

Prebiotics are often tried in functional bowel disorders. They are naturally occurring, undigested dietary components that promote the growth of beneficial gut bacteria, thereby reducing the colonization of pathogenic bacteria. Fructooligosaccharide and inulin are the most popular prebiotics studied in irritable bowel syndrome. Galactooligosaccharide (GOS) is a relatively less explored prebiotic and the present study has shown that a short-term course of GOS can help in improving constipation, QOL and depression, possibly through its effect on gut microbes. The study is quite interesting and though limited by sample size is quite elaborate in its scope. The authors need to be commended for that.