Does Fibre-fix provided to people with irritable bowel syndrome who are consuming a low FODMAP diet improve their gut health, gut microbiome, sleep and mental health? A double-blinded, randomised controlled trial

IntroductionA diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) is an effective way to reduce gut symptoms in people with irritable bowel syndrome (IBS). This diet reduces the intake of fermentable fibres, leading to changes of the gut microbiota and insufficient fermentation in the large bowel, resulting in reduced production of short-chain fatty acids (SCFAs), such as butyrate, which has unfavourable implications for gut health, sleep and mental health. This study will examine the effect of Fibre-fix, a supplement containing a mix of dietary fibres, on the human gut microbiome composition, fermentative capacity, sleep, quality of life (QOL) and mental health of people with IBS who consume a low FODMAP diet (LFD).Methods and analysisA randomised, double-blind, placebo-controlled, study design is proposed to examine whether Fibre-fix added to an existing LFD may help modulate gastrointestinal function, improve markers of sleep, mental health and promote QOL in patients with IBS. Participants will provide stool and blood samples, daily bowel symptoms diaries and 3-day diet records. Additionally, they will complete validated questionnaires relating to FODMAP intake, sleep, mental health and QOL before and after a 3-week intervention. Gut health will be assessed via faecal microbiome composition, faecal pH and SCFA levels. Alteration of sleep will be recorded using an actigraphy device worn by all participants over the whole study. Multivariate analysis will be used to examine the gut microbiome and repeated measures Analysis of variance (ANOVA) will be used for dependent variables from questionnaires related to bowel symptoms, stool type, sleep, mental health and QOL to assess the differences between intervention and control groups after adjustment for confounding variables.Ethics and disseminationEthics approval was obtained from the Human Research Ethics Committee of Edith Cowan University (2019-00619-YAN). Results will be disseminated in peer-review journal publications, and conference presentations. Participants will be provided with a summary of findings once the study is completed. If Fibre-fix is shown to result in favourable changes in gut microbial composition, SCFA production, sleep and mental well-being without exacerbating symptoms, this will provide additional dietary management options for those with IBS following an LFD.Trial registration numberACTRN12620000032954.

Download Full-text

Alterations in gut microbiome composition and function in irritable bowel syndrome and increased probiotic abundance with daily supplementation

10.1101/2021.09.02.458777 ◽

2021 ◽

Author(s):

Joann Phan ◽

Divya Nair ◽

Suneer Jain ◽

Thibaut Montagne ◽

Demi Valeria Flores ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Gut Microbiome ◽

The United States ◽

Supporting Evidence ◽

Metagenomic Sequencing ◽

Healthy Controls ◽

Microbiome Composition ◽

Significant Difference ◽

Stool Samples ◽

Irritable Bowel

AbstractBackgroundIrritable bowel syndrome (IBS) is characterized by abdominal discomfort and irregular bowel movements and stool consistency. Because there are different symptoms associated with IBS, it is difficult to diagnose the role of the microbiome in IBS.ObjectiveHere, we present a study that includes metagenomic sequencing of stool samples from subjects with the predominant subtypes of IBS and a healthy cohort. We collected longitudinal samples from individuals with IBS who took daily made-to-order precision probiotic and prebiotic supplementation throughout the study.Materials and MethodsThis study includes a population of 489 individuals with IBS and 122 healthy controls. All stool samples were subjected to shotgun metagenomic sequencing. Precision probiotics and prebiotics were formulated for all subjects with longitudinal timepoints.ResultsThere was significant variation explained in the microbiome between the healthy and IBS cohorts. Individuals with IBS had a lower gut microbiome diversity and reduced anti-inflammatory microbes compared to the healthy controls. Eubacterium rectale and Faecalibacterium prausnitzii were associated with healthy microbiomes while Shigella species were associated with IBS. Pathway analysis indicated a functional imbalance of short chain fatty acids, vitamins, and a microbial component of Gram-negative bacteria in IBS compared to healthy controls. In the longitudinal dataset, there was a significant difference in microbiome composition between timepoints 1 and 3. There was also a significant increase in the overall microbiome score and relative abundances of probiotic species used to target the symptoms associated with IBS.ConclusionsWe identified microbes and pathways that differentiate healthy and IBS microbiomes. In response to precision probiotic supplementation, we identified a significant improvement in the overall microbiome score in individuals with IBS. These results suggest an important role for probiotics in managing IBS symptoms and modulation of the microbiome as a potential management strategy.ImportanceAn estimated 35 million people in the United States and 11.5% of the population globally are affected by IBS. Immunity, genetics, environment, diet, small intestinal bacterial overgrowth (SIBO), and the gut microbiome are all factors that contribute to the onset or triggers of IBS. With strong supporting evidence that the gut microbiome may influence symptoms associated with IBS, elucidating the important microbes that contribute to the symptoms and severity is important to make decisions for targeted treatment. As probiotics have become more common in treating IBS symptoms, identifying effective probiotics may help inform future studies and treatment.

Download Full-text

A Comprehensive Self-Management Program With Diet Education Does Not Alter Microbiome Characteristics in Women With Irritable Bowel Syndrome

Biological Research For Nursing ◽

10.1177/1099800420984543 ◽

2021 ◽

pp. 109980042098454

Author(s):

Kendra J. Kamp ◽

Anna M. Plantinga ◽

Kevin C. Cain ◽

Robert L. Burr ◽

Pamela Barney ◽

...

Keyword(s):

Quality Of Life ◽

Irritable Bowel Syndrome ◽

Usual Care ◽

Gut Microbiome ◽

Beta Diversity ◽

Self Management ◽

Symptom Improvement ◽

Microbiome Composition ◽

Irritable Bowel

Background and Purpose: Changes in diet and lifestyle factors are frequently recommended for persons with irritable bowel syndrome (IBS). It is unknown whether these recommendations alter the gut microbiome and/or whether baseline microbiome predicts improvement in symptoms and quality of life following treatment. Therefore, the purpose of this study was to explore if baseline gut microbiome composition predicted response to a Comprehensive Self-Management (CSM) intervention and if the intervention resulted in a different gut microbiome composition compared to usual care. Methods: Individuals aged 18–70 years with IBS symptoms ≥6 months were recruited using convenience sampling. Individuals were excluded if medication use or comorbidities would influence symptoms or microbiome. Participants completed a baseline assessment and were randomized into the eight-session CSM intervention which included dietary education and cognitive behavioral therapy versus usual care. Questionnaires included demographics, quality of life, and symptom diaries. Fecal samples were collected at baseline and 3-month post-randomization for 16S rRNA-based microbiome analysis. Results: Within the CSM intervention group (n = 30), Shannon diversity, richness, and beta diversity measures at baseline did not predict benefit from the CSM intervention at 3 months, as measured by change in abdominal pain and quality of life. Based on both alpha and beta diversity, the change from baseline to follow-up microbiome bacterial taxa did not differ between CSM (n = 25) and usual care (n = 25). Conclusions and Inferences: Baseline microbiome does not predict symptom improvement with CSM intervention. We do not find evidence that the CSM intervention influences gut microbiome diversity or composition over the course of 3 months.

Download Full-text

1132 A Low FODMAP Diet Reduces Abdominal Symptoms to a Greater Degree Than Bowel Symptoms in Patients With Irritable Bowel Syndrome and Diarrhea: Results of Daily Data From a US Randomized Controlled Trial

Gastroenterology ◽

10.1016/s0016-5085(16)30841-1 ◽

2016 ◽

Vol 150 (4) ◽

pp. S229-S230

Author(s):

Shanti L. Eswaran ◽

William D. Chey ◽

Kenya Jackson ◽

Sarah Ball ◽

Theresa Han-Markey

Keyword(s):

Randomized Controlled Trial ◽

Irritable Bowel Syndrome ◽

Controlled Trial ◽

Randomized Controlled ◽

Bowel Symptoms ◽

Abdominal Symptoms ◽

Daily Data ◽

Irritable Bowel ◽

Fodmap Diet

Download Full-text

Faculty Opinions recommendation of Randomised clinical trial: gut microbiome biomarkers are associated with clinical response to a low FODMAP diet in children with the irritable bowel syndrome.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725585464.793547363 ◽

2018 ◽

Author(s):

William Chey

Keyword(s):

Clinical Trial ◽

Irritable Bowel Syndrome ◽

Clinical Response ◽

Gut Microbiome ◽

Randomised Clinical Trial ◽

Irritable Bowel ◽

Fodmap Diet

Download Full-text

Melatonin improves bowel symptoms in female patients with irritable bowel syndrome: a double-blind placebo-controlled study

Alimentary Pharmacology & Therapeutics ◽

10.1111/j.1365-2036.2005.02673.x ◽

2005 ◽

Vol 22 (10) ◽

pp. 927-934 ◽

Cited By ~ 83

Author(s):

W. Z. LU ◽

K. A. GWEE ◽

S. MOOCHHALLA ◽

K. Y. HO

Keyword(s):

Irritable Bowel Syndrome ◽

Controlled Study ◽

Double Blind ◽

Double Blind Placebo ◽

Female Patients ◽

Bowel Symptoms ◽

Irritable Bowel

Download Full-text

Randomised clinical trial: gut microbiome biomarkers are associated with clinical response to a low FODMAP diet in children with the irritable bowel syndrome

Alimentary Pharmacology & Therapeutics ◽

10.1111/apt.13286 ◽

2015 ◽

Vol 42 (4) ◽

pp. 418-427 ◽

Cited By ~ 174

Author(s):

B. P. Chumpitazi ◽

J. L. Cope ◽

E. B. Hollister ◽

C. M. Tsai ◽

A. R. McMeans ◽

...

Keyword(s):

Clinical Trial ◽

Irritable Bowel Syndrome ◽

Clinical Response ◽

Gut Microbiome ◽

Randomised Clinical Trial ◽

Irritable Bowel ◽

Fodmap Diet

Download Full-text

Diet-induced modifications to human microbiome reshape colonic homeostasis in irritable bowel syndrome

10.1101/2021.08.15.456374 ◽

2021 ◽

Author(s):

Ayelet Pearl ◽

Hadar Bootz ◽

Ehud Melzer ◽

Efrat Sharon ◽

Shlomi Abuchatzera ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Human Microbiome ◽

Bifidobacterium Adolescentis ◽

Microbiome Composition ◽

Beneficial Effects ◽

Gene Sets ◽

Pathway Discovery ◽

Irritable Bowel ◽

Fodmap Diet ◽

Host Tissues

Changes in microbiome composition have been associated with a wide array of human diseases, turning the human microbiota into an attractive target for therapeutic intervention. Yet clinical translation of these findings requires the establishment of causative connections between specific microbial taxa and their functional impact on host tissues. Here, we colonized gut organ cultures with longitudinal microbiota samples collected from newly-diagnosed and therapy-naive irritable bowel syndrome (IBS) patients under low-FODMAP (fermentable Oligo-, Di-, Mono-saccharides and Polyols) diet. We show that post-diet microbiota regulates intestinal expression of inflammatory and neuro-muscular gene-sets. Specifically, we identify Bifidobacterium adolescentis as a diet-sensitive pathobiont that alters tight junction integrity and disrupts gut barrier functions. Collectively, we present a unique pathway discovery approach for mechanistic dissection and identification of functional diet-host-microbiota modules. Our data support the hypothesis that the gut microbiota mediates the beneficial effects of low-FODMAP diet, and reinforce the potential feasibility of microbiome based-therapies in IBS.

Download Full-text