What is a Fructooligosaccharide?

What is a Fructooligosaccharide?

A fructooligosaccharide (also written fructo-oligosaccharide) is a carbohydrate, which is made out of a short chain of fructose molecules. It is also classed as an oligosaccharide; oligo meaning few and saccharide, sugar. Fructooligosaccharides are also sometimes called oligofructose. Often the term is abbreviated to the letters FOS.

Together with inulin fiber, fructooligosaccharides are probably most recognized for their prebiotic qualities.

They are very similar but not identical to inulin: the difference being in their chemical structures. Fructo-oligosaccharide chains of molecules are shorter than inulin chains.

Where Can I Find FOS?

You can find FOS in certain natural foods including:

  • Bananas
  • Onions
  • Tomatoes
  • Chicory
  • Sunchokes or Jerusalem artichokes
  • Yacón
  • Barley
  • Wheat

Of these foods the sunchoke or Jerusalem artichoke and its relative, the yacón have the highest concentrations of FOS.

You will also find that fructo-oligosaccharide or oligofructose, as it is also known, is added to many processed foods, mainly as a prebiotic or fiber supplement but also as a sweetener.

This type of FOS is not natural. Most is manufactured using a chemical process, in which fungal enzymes are added to white sugar (sucrose), acting upon it and turning it into FOS. Some fructooligosaccharides are also made by the hydrolysis (breaking down) of inulin from chicory. FOS is becoming increasingly popular as a prebiotic and is now added to many types of processed foods in the US. You may already have come across this additive in the foods you buy. As a prebiotic, FOS is very similar in terms of properties to inulin. It can be considered beneficial to your health as it:

  • Is virtually undigested by the human digestive system so arrives in the colon unaltered, providing a food source forbeneficial bacteria
  • Has low calorific value.
  • Increases the population of bifidobacteria in the colon.1,2
  • Acts as a non-digestible fiber in the diet and so can help relieve constipation.

Additionally FOS has been shown to:

  • Enhance magnesium absorption.3
  • Promote calcium absorption.4

Like inulin fiber, FOS appears to be a good thing. Before you decide to try it though, you should be aware of its side-effects.

What Are the Side Effects of Taking a Fructooligosaccharide?

Before you decide that fructooligosaccharides are for you, you should be aware that they:

  • Have been shown in some scientific studies to increase the growth of “bad” bacteria such as Klebsiella Pneumonia and other less-friendly organisms such as E. Coli and many Clostridium species5,6. Klebsiella Pneumonia is associated with the auto-immune disease Ankylosing Spondylitis (AS) and also worryingly is becoming increasingly resistant to antibiotics both in the US and elsewhere.
  • Are likely to cause an increase in gas, abdominal discomfort and bloating if taken in large quantities.

Should I Take Fructooligosaccharides?

It is clear then that FOS has both advantages and disadvantages. Should you take it and if so how should you take it?

Given that fructooligosaccharides appear to be able to feed less friendly organisms in the colon, we think it is prudent to avoid high quantities of FOS if your digestive flora is very unbalanced.

Large amounts of FOS are usually found in supplements such as probiotics, stand-alone fructooligosaccharide supplements or processed foods. Natural foods contain small amounts of fructo-oligosaccharides in a less concentrated form and, depending on your situation, you may be able to manage these lesser amounts.

Gut dysbiosis, intestinal candida and food intolerance symptoms are sure signs that you have a gut flora imbalance, so if this is you, be sure to avoid foods and supplements with added FOS. If you are in this situation and are taking a

probiotic supplement to help you re-balance your digestive flora, be sure to choose one which is free from FOS and other prebiotics. Also if you have Ankylosing Spondylitis then high quantities of fructooligosaccharides are not for you.

If you are free of these ailments then FOS may be of help to you. Have a word with your physician before you begin and remember to start with small quantities only and ramp up slowly!

Where Can I Buy Fructooligosaccharides (FOS)?

You can buy FOS in supplement form as a stand-alone product or combined with probiotics.

Internet retailer iHerb.com also supplies a fantastic range of stand-alone FOS supplements as well as probiotics containing FOS. Their international shipping rates are also very reasonable. Click here to browse their store and receive $5 USD off your first purchase.

What Are Prebiotics?

What Are Prebiotics?

Prebiotics are non-digestible foods or food ingredients, which enter our colons un-altered by the digestive process, serving as an energy and growth source for the beneficial bacteria that live in our large intestine. In other words, prebiotics are food for the friendly bacteria in your intestines.

Types of Prebiotics

There are numerous different prebiotics currently on the market. In the US, the most common ones in use include:

  • Inulin, sometimes also known as inulin fiber
  • Fructo-oligosaccharides (FOS)
  • Galacto-oligosaccharides (GOS)
  • Lactulose

These substances have been the subject of numerous studies. Most of this research focuses on inulin, FOS and GOS and these substances, with their relatively long history of safe use, are now generally regarded as safe1,2.

More recently new prebiotics have become available from Japan. These include:

  • Isomalto-oligosaccharides (ISO)
  • Soy-oligosaccharides (SOS)
  • Xylo-oligosaccharides (XOS)
  • Lactosucrose (LS)
  • Pectic-oligosaccharides

These newer compounds have been studied to varying degrees in laboratory test tubes (in vitro), mainly in animal feeding studies. These novel prebiotic substances are not widely available.

What Are The Advantages of Prebiotics?

Garlic and Onions are Good Sources of Prebiotics
Garlic & Onions: Good
Sources of Prebiotics

Prebiotics feed the friendly bacteria in our large intestine and so help good bacteria to survive and thrive. The general consensus is that prebiotics help to improve the intestinal probiotic balance in our intestines by feeding the probiotic bacteria. In this way prebiotics are thought to be indirectly beneficial to our health.

Prebiotics not only serve as nourishment, strengthening our all important probiotic intestinal flora, they also slow down the activity, growth and metabolism of the “unhelpful” microbes, with which they have to compete for survival.

Prebiotics are also:

  • Easy to store. Most do not require refrigeration
  • Readily available in natural forms in your local grocery store
  • Excellent value for money
  • Easy to include in your normal diet – in fact you may already unknowingly be eating several excellent sources of prebiotics!

What Are The Disadvantages of Prebiotics?

In terms of disadvantages, a side effect of prebiotics is that you may experience temporary gastro-intestinal problems such as increased gas and/or bloating when you begin taking them or if your intake of these substances is particularly high. One way to avoid such a scenario is to begin by taking only a small amount of prebiotic and then gradually to increase your intake over a number of weeks.

In theory prebiotics are supposed to feed only friendly bacteria. However, in cases where the digestive flora has become unbalanced, they also appear to support the growth of unhelpful bacteria. If you know your digestive flora is unbalanced or are experiencing symptoms of food intolerance, intestinal dysbiosis or an overgrowth of Candida Albicans, be advised that prebiotics may exacerbate your symptoms, worsening your overall situation. Indeed, Gastroenterologist, Professor John Hunter, of the Gastroenterology Research Unit, Addenbrookes Hospital, UK, advises his food intolerant patients to avoid prebiotics3.

Where Can I Find Prebiotics?

If you are keen to try prebiotics, you can find them in:

Natural Foods

Many natural foods are rich in prebiotics AND are very easy to find at your local grocery store! These include:


  • Tomatoes
  • Sunchokes or Jerusalem artichokes
  • Onions
  • Chicory
  • Greens (especially dandelion greens but also spinach, collard greens, chard, kale, mustard greens, and others)
  • Asparagus
  • Garlic
  • Leeks


  • Berries
  • Bananas

Whole Grains:

  • Wheat
  • Oatmeal
  • Barley
  • Flaxseed


  • Lentils
  • Kidney beans
  • Chickpeas
  • Navy beans
  • White beans
  • Black beans

And breast milk!

Including natural prebiotic-rich foods in your diet is the most cost effective way of adding prebiotics to your diet. Naturally-occurring prebiotics in food are also stable and they survive the cooking process. This makes them really easy and convenient to include in your diet.

Processed Foods

Increasingly prebiotics are being added to many types of processed foods such as commercial yogurt and dairy drinks, nutrition and meal replacement bars, “green foods”, functional wafers, cereals and cereal bars as well as infant foods and formulas. You can buy many of these foods at your local grocery store.

Be aware, however, that many of these foods may be high in sugar and/or salt and so may not always be as healthy as they first appear.

Also many processed foods such as canned beans contain prebiotics but may not be labeled as such.

Buying specific prebiotic processed foods can be an expensive way of getting prebiotics into your diet.

Nutritional Supplements

Prebiotics can also be purchased as a supplement, either as a stand-alone product such as a pure fructooligosaccharide (FOS) supplement or as an enhancement to a probiotic supplement. Probiotics with added prebiotics are easy to find. Examples include Culturelle and HMF probiotics as well as the high potency probiotics Therbiotic Complete (Klaire Laboratories) and Maximum Support Probiotic Formula (Brain Child Nutritionals).

Remember that prebiotics work in conjunction with probiotics so to get best benefit take a probiotic too. And last of all, a final word about prebiotics… there are no official guidelines as to the optimum daily dose of prebiotics so if you do decide to try prebiotics, be sure to consult your physician before beginning to ensure your intake is sensible for your situation.

What Is Pouchitis?

What Is Pouchitis?

Pouchitis affects those, typically with ulcerative colitis, who have undergone ileal pouch-anal anastomosis (also known as j-pouch surgery), to create a surgical alternative to the colon. Pouchitis occurs when this surgically created pouch, known as an ileal-anal pouch or J-pouch, becomes inflamed. This condition affects approximately thirty-two percent of patients with an ileoanal pouch. The longer the time since the pouch was created, the greater the likelihood of the pouch becoming inflamed. The symptoms include:

  • Bloody diarrhea
  • More frequent bowel movements
  • Discomfort in passing stools
  • Cramping abdominal pain
  • Fever

Pouchitis Treatment

The condition is usually treated with antibiotics. Immunosuppressant drugs may also be used.

That antibiotics prove useful in treating this condition indicates that bacteria are likely to play a role in pouchitis.

Evidence from clinical experience also supports this theory, concluding that the disorder “appears to be associated with high concentrations of bacteria”1.

Additionally, sufferers have been shown to have decreased levels of the beneficial bacteria lactobacilli and bifidobacteria in their colons, more of the less helpful bacteria Clostridium perfringens, as well as species such as fungi that were not found in controls2. As a result, the possible role of probiotics to restore bacterial balance and treat this disorder is receiving increased interest in the scientific community.

Evidence for Probiotics in the Treatment of Pouchitis

Although it must be said that research is in its early days, initial evidence for the use of probiotics in the treatment of ileal-anal pouch inflammation is promising. Numerous different probiotic formulations have been used in these studies. The probiotic supplement VSL3 and Lactobacillus rhamnosus GG, which is also marketed under the name Culturelle probiotic products, have proved to be useful in helping pouchitis patients.

The probiotic supplement VSL3 has been shown to be of benefit to pouchitis patients in two double-blind placebo controlled trials. In the first trial of thirty-six patients with recurrent or refractory pouchitis (i.e. that which does not respond to antibiotic treatment), sixteen received the probiotic supplement VSL3, whilst the remaining twenty took a placebo. Of the patients who took the probiotic supplement, 85% of sufferers had not experienced a relapse after one year of therapy compared to only 6% of those taking the placebo3.

In the second trial of twenty-three patients with mild, active pouchitis, 69% of those who took VSL3 for a four week period achieved remission4.

Several other research projects have used different probiotic species with pouchitis patients.

A trial using Lactobacillus rhamnosus GG (often marketed as Culturelle) indicated that this probiotic was useful if given immediately following initial j-pouch or ileal-anal pouch surgery. This trial concluded that therapy with between ten and twenty billion CFUs of Lactobacillus rhamnosus GG could delay the first onset of pouchitis for up to three years5.

Likewise a different scientific project using Lactobacillus acidophilus with Bifidobacterium lactis concluded that patients who consumed Cultura, a product containing these probiotics, over a four-week period, did show a decrease in their Pouchitis Disease Activity Index (PDAI) scores. These changed from a level considered to be diagnostic for pouchitis to one which is considered not active for pouchitis. The probiotic therapy however did not change either the mucosal inflammation of the pouch or the pouch blood flow6.

However a research trial using Lactobacillus rhamnosus GG for acute, active pouchitis did not show any therapeutic benefit from using probiotics, though the researchers did concede that the use of this probiotic had indeed positively influenced the pouch bacterial flora7.

Should I Try Probiotics for Pouchitis?

The study of probiotics for pouchitis is very new, but it does seem that probiotics may be useful in:

  • Achieving remission after treatment with antibiotics.
  • Delaying the onset of the initial bout of pouchitis.

There is, however, to date not enough evidence to suggest that probiotics are of use in treating acute, severe pouchitis – more research is needed into this aspect and indeed into the clinical use of probiotics for pouchitis in general. Future evidence, the existing data in this area as well as the growing body of evidence supporting the use of probiotics in ulcerative colitis, may indeed lead to more mainstream use of probiotics for pouchitis in the future.

In the meantime though, if you think from reading this page that probiotics could be of use in your situation, be sure to consult your physician before you begin. Ensure too that you take the same strains and quantities that have been proven to be of use for pouchitis.