4. Discussion
IBS-C, visceral pain, flatulence, anxiety, abdominal pain, IBS, gastritis, constipation, pain, dysbiosis, depression
MUCOSAL INFLAMMATION, INFLAMMATION, DISEASE, GASTRITIS
There is still no standard for the treatment of IBS, which means that when new therapies are tested, they are usually compared to the placebo. However, placebo response rates in this disease are high: 30% to 40% of patients experience relief or resolution of symptoms, as shown by Ford et al. [Agave fructans, as an ingredient in functional foods in the diet, also serve as a support for the gut microbiota, which in turn favorably influences the production of fermentation products with beneficial metabolic effects, such as short-chain fatty acids [In the present study, we did not observe significant weight changes caused by the jelly functional food treatment. This is in contrast to what was reported by Silva-Adame et al. [Many clinical trials have evaluated how a low-FODMAP diet (LFD) affects IBS symptoms. These studies indicate that a low-FODMAP diet helps to relieve symptoms. However, fewer protocols have been evaluated, suggesting that a low-FODMAP diet could affect the microbiota and lead to a state of dysbiosis. Therefore, the low-FODMAP diet remains a controversial topic. According to Martínez Vázquez [Additionally, it is well-known that microbial changes can worsen intestinal symptoms associated with IBS-C, such as visceral pain, low-grade inflammation, and changes in stool frequency. Substantial evidence indicates that the microbiota is one of the primary factors affecting IBS in certain patients. This process is unclear but may be due to the transient alteration of the microbiota composition postinfection and ongoing dysbiosis in the presence of low-grade mucosal inflammation [On the other hand, the fact that most of the symptoms evaluated do not present significant differences, except for those mentioned above (constipation, flatulence, and gastritis), indicates that, contrary to what several authors asserted regarding the effect of the low-FODMAP diet on IBS due to the presence of some undesirable symptoms, the implementation of agave fructans as a prebiotic using the GelyfunDi Rosa et al. [In addition, in this protocol, the group treated with agave fructans presented a significant difference over the 30 days of treatment compared to the placebo in terms of initial abdominal pain and stress condition factors which were subsequently related to the evaluation of quality of life. Andrae et al. [Once the reclassification was performed, it was possible to establish a significant difference between the study group and the placebo group in terms of the effect of fructans as a useful treatment in conditions such as IBS with a predominance of constipation, where constipation is the main factor associated with the symptoms of these patients (abdominal pain and inflammation, pain when defecating, and flatulence with an unpleasant smell). The use of FODMAPs (prebiotics), according to Staudacher et al. [Therefore, it is possible to consider that the improvement in the symptoms associated with IBS-C was due to (a) the type of prebiotic used (Mx/a/2015/016512); (b) the supplemented dose between 5 and 15 g; (c) the duration of the treatment of at least 15 days; and (d) the method of administration of the agave fructans, which was through the GelyfunRegarding the type of prebiotic, according to McRorie, [Linear and branched fructans like agave fructans can normalize gut functionality by producing products of fermentation such as SCFA in specific high concentrations of butyrate [According to the dose and duration of treatment, it is important to highlight that according to McRorie [On the other hand, Silva-Adame et al. [Finally, regarding the method of administration, this study used a functional food, i.e., a functional hydrated fiber (GelyfunThe effects of functional foods with fructans on improving symptoms and quality of life in IBS-C have been studied previously in humans. The present study is the first clinical trial to date that uses agave fructans as an ingredient in functional food for IBS-C treatment.Previous clinical studies of constipation and IBS-C have used functional foods as modes of treatment, for example, dairy products [For this reason, this study suggests that the definition of the term “functional” can differ from that provided by the Panel on the Definition of Dietary Fiber Staff from the Institute of Medicine [On the other hand, when using this type of treatment, in most cases, improvements in the frequency and consistency of bowel movements have been obtained, and in very few cases, the possibility of significantly improving the symptoms of the condition has been seen, as well as a limited or insignificant improvement in quality of life, as well as nonsignificant changes in the anxiety and depression scores evaluated using the HADS instrument.The results of the present investigation showed significant improvements in the quality of life of IBS-C patients using a functional prebiotic jelly as a continuous 4-week treatment. These results differ from those in a recent meta-analysis by Willson Rossi et al. [Generally, females are more prone to worse mental health than males, and the effective treatment of the psychological aspects of the disease including anxiety and depression can improve the QOL of patients with IBS. So, the treatment of a functional prebiotic fiber (GelyfunAccording to Freijy et al. [