Effects of Malted Rice Amazake on Constipation Symptoms and Gut Microbiota in Children and Adults with Severe Motor and Intellectual Disabilities: A Pilot Study.

Suzumi Kageyama,A Yasmin Syauki,Tomo Suka,Jun Kunisawa,Yoshihiro Kurohashi,Kenji Mizuguchi,Kazuaki Teramoto,Haruka Sakaue,Koji Hosomi,Yasuyuki Irie,Hitomi Yumioka,Jonguk Park,Rikako Inoue,Miki Doi

doi:10.3390/nu13124466

Abstract

Constipation is a frequent complication in patients with severe motor and intellectual disabilities (SMID). The aim of this study was to investigate changes in constipation symptoms and gut microbiota associated with the intake of malted rice amazake, a fermented food in Japan, in patients with SMID. Ten patients consumed the test food for six weeks, and their physical condition, dietary and medication status, and constipation assessment scale (CAS) were investigated. Comprehensive fecal microbiome analysis using the 16S rRNA sequence method was performed. The results showed a significant decrease in CAS, and a significant increase in Lactobacillales and decrease in Escherichia-Shigella after consuming malted rice amazake. To investigate the difference in the effects of malted rice amazake consumption, based on the characteristics of the original gut microbiota, the patients were grouped according to the similarity of their gut microbiota before the intervention; Firmicutes-rich Group 1 (n = 5), Actinobacteria-rich Group 2 (n = 4), and Proteobacteria-rich Group 3 (n = 1). The CAS decreased in Groups 1 and 2. The relative abundance of Bifidobacterium showed an increasing tendency both overall and in Group 1, but it was originally higher in Group 2. Our results suggest that malted rice amazake consumption reduces constipation symptoms and simultaneously changes the gut microbiota, but the changes may vary depending on the original composition of the gut microbiota.

Highlights

Patients with severe motor and intellectual disabilities (SMID) have multiple health problems that require constant medical care
The purpose of this study was to investigate the changes in constipation symptoms The purpose of this study was to investigate the changes in constipation symptoms and gut microbiota, associated with the intake of malted rice amazake for six weeks, in and gut microbiota, associated with the intake of malted rice amazake for six weeks, in patients with SMID
By by focusing on the gut microbiota of patients with SMID, and analyzing each group acfocusing on the gut microbiota of patients with SMID, and analyzing each group according cording to the similarity of their gut microbiota before the intervention, we examined the to the similarity of their gut microbiota before the intervention, we examined the different different of consuming malted rice amazake on the characteristics of the origeffects of effects consuming malted rice amazake based onbased the characteristics of the original gut inal gut microbiota

Summary

Introduction

Patients with severe motor and intellectual disabilities (SMID) have multiple health problems that require constant medical care. According to a recent systematic review, as many as 35 symptoms, including epilepsy, pulmonary and respiratory diseases, hearing impairment, gastroesophageal reflux disease, and visual impairment, have been reported [1]. Among these symptoms, constipation has been reported to occur in 57% of the children with severe cerebral palsy [2] and 94% of the children with SMID [3], making constipation a frequent complication in patients with SMID. Causes of constipation include skeletal deformity due to underlying diseases such as cerebral palsy, excessive muscle tone, decreased intestinal peristalsis, resulting in difficulty in defecation, lifestyle factors such as inadequate water intake, lack of fiber in the diet, and lack of exercise, as well as the effects of therapeutic drugs, such as anticonvulsants [2,7,8].

Objectives

Methods

Results

Discussion

Conclusion