Catheter used to take small intestine samples during synbiotics study

A new study used a unique (and highly invasive) method to gather information on how the small intestine reacts to synbiotic supplementation. The researchers inserted catheters through subjects’ noses that ran all the way to the end of their small intestines.

Hank Schultz, Senior Editor

May 16, 2024

4 Min Read

At a Glance

  • Researchers used a unique catheter method to get readings on small intestine. 
  • Study used a multi-species symbiotic formula from Winclove. 
  • Results weren’t groundbreaking but added valuable info to the overall microbiome picture. 

A new study on a synbiotic used an unusual method to sample the changes the intervention wrought in the small intestines of the subjects. The researchers used a long catheter to sample microbiota at several locations in the gut. 

The new research was published in the journal Gut Microbes. Titled “Spatio-temporal dynamics of the human small intestinal microbiome and its response to a synbiotic,” it was the work of researchers associated with several universities in the Netherlands as well as several who are employees of Winclove Probiotics, which supported the study in part via a public/private research partnership. 

The researchers were attempting to judge the reaction of study participants to a synbiotic intervention, which in this case was a combination of a multi-strain probiotic combined with a dosage of fructooligosaccharide. 

The probiotic portion of the intervention was a proprietary Winclove formula, branded as Ecologic 825. This is a combination of nine probiotic strains: Lactococcus lactis, Lacticaseibacillus paracasei, Lactobacillus acidophilus, Ligilactobacillus salivarius, Lacticaseibacillus casei, Lactiplantibacillus plantarum, Bifidobacterium bifidum, Bifidobacterium lactis and Bifidobacterium lactis, which together provided 1.5 billion CFU (colony forming units). Winclove has long been an advocate of multi-strain probiotics. 

Related:Researchers use postbiotic to ease acid reflux symptoms

The other portion of the test product is a fructooligosaccharide designated as FOS P6. It was used in a 10-gram dosage. 

The researchers’ goal was to investigate how the intervention changed the microbiota in the small intestine. They noted that most probiotics research focuses on changes in the fecal microbiota. Fecal samples are easy to take and there is good data correlating what is found in those samples to health outcomes. 

But that still means researchers must infer what changes took place in the small intestine based on microbiome changes further downstream. The present study aimed to change that and get a detailed picture on what microbial changes occurred in the small intestine, where exactly they took place, and when. 

The researchers recruited 20 healthy subjects, divided into two groups. One group ingested two daily doses of the synbiotic intervention, while the others took a placebo. They did this for two weeks, while they maintained their normal diets in the meantime. 

Unusual study design

The researchers resorted to an extraordinary method to get their data on the makeup of the microbiome in the small intestine. The subjects all came into the clinic for a baseline measurement, taken six days before the start of supplementation and after an overnight fast, when a catheter was inserted into their noses and snaked through their stomachs and into their duodenums. 

Related:How to formulate the new biotic products

At a structure called the ligature of Treitz — the boundary between the duodenum and the jejunum — the forcible snaking stopped. This is the point at which the small intestine starts to become highly folded, making it difficult, if not impossible, to continue to snake the catheter through that labyrinthine path.  

At that point, a small balloon was inflated at the end of the catheter. This used the body’s own peristaltic muscle contractions to push the balloon along, snaking the catheter behind it, until it reached the far end of the small intestine. It took several hours for the catheter to reach its final position. 

The catheter had small holes in it at intervals to let in samples of the microbiome taken at specific locations along the small intestine. 

The catheter procedure was repeated on the 14th day, and on that day, the contents of the small intestine were sampled three times. One was in the morning after the overnight fast, another was about two hours after ingesting the morning does of the symbiotic, and again about an hour after a standard lunch of noodles. Fecal samples were also taken. 

Valuable data gathered

The researchers found that the makeup of the microbiome was significantly different at each location at baseline. These differences were greatest after the morning fast, while later in the day these differences faded to insignificance. 

After the synbiotic ingestion, they noted brief (about two hours) spikes in the relative abundance of the microbes contained in the formula. 

The authors said the study provides valuable data for what’s happening in the small intestine but leaves more questions over the overall dynamics of the system. 

“We demonstrated significant differences in microbial and metabolomic composition at baseline between duodenum, jejunum, proximal ileum content and feces,” the researchers wrote. “In addition, the significant difference in microbial composition along the small intestine was most pronounced in the morning after overnight fasting, while it was not always measurable around noon or in the afternoon. Two weeks of synbiotic supplementation did not affect the overall microbiota and metabolomic composition in small intestinal fluids and feces differently from placebo. Moreover, small intestinal microbiota is highly dynamic, and ingested probiotic bacteria were shown to lead to a transient spike in the relative abundance of corresponding genera and ASVs, suggesting their passage through the entire gastrointestinal tract.” 

About the Author(s)

Hank Schultz

Senior Editor, Informa

Hank Schultz has been the senior editor of Natural Products Insider since early 2023. He can be reached at [email protected]

Prior to joining the Informa team, he was an editor at NutraIngredients-USA, a William Reed Business Media publication.

His approach to industry journalism was formed via a long career in the daily newspaper field. After graduating from the University of Wisconsin with degrees in journalism and German, Hank was an editor at the Tempe Daily News in Arizona. He followed that with a long stint working at the Rocky Mountain News, a now defunct daily newspaper in Denver, where he rose to be one of the city editors. The newspaper won two Pulitzer Prizes during his time there.

The changing landscape of the newspaper industry led him to explore other career paths. He began his career in the natural products industry more than a decade ago at New Hope Natural Media, which was then part of Penton and now is an Informa brand. Hank formed friendships and partnerships within the industry that still inform his work to this day, which helps him to bring an insider’s perspective, tempered with an objective journalist’s sensibility, to his in-depth reporting.

Harkening back to his newspaper days, Hank considers the readers to be the primary stakeholders whose needs must be met. Report the news quickly, comprehensively and above all, fairly, and readership and sponsorships will follow.

In 2015, Hank was recognized by the American Herbal Products Association with a Special Award for Journalistic Excellence.

When he’s not reporting on the supplement industry, Hank enjoys many outside pursuits. Those include long distance bicycle touring, mountain climbing, sailing, kayaking and fishing. Less strenuous pastimes include travel, reading (novels and nonfiction), studying German, noodling on a harmonica, sketching and a daily dose of word puzzles in The New York Times.

Last but far from least, Hank is a lifelong fan and part owner of the Green Bay Packers.

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