scholarly journals Two microbiota subtypes identified in irritable bowel syndrome with distinct responses to the low FODMAP diet

Gut ◽  
2021 ◽  
pp. gutjnl-2021-325177
Author(s):  
Kevin Vervier ◽  
Stephen Moss ◽  
Nitin Kumar ◽  
Anne Adoum ◽  
Meg Barne ◽  
...  
Keyword(s):  
Clinical Response ◽  
Dietary Therapy ◽  
Metabolic Genes ◽  
Unsupervised Analysis ◽  
Irritable Bowel ◽  
Fodmap Diet ◽  
Stool Microbiota ◽  
Functional Profiles ◽  
And Control ◽  
Usual Diet

ObjectiveReducing FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) can be clinically beneficial in IBS but the mechanism is incompletely understood. We aimed to detect microbial signatures that might predict response to the low FODMAP diet and assess whether microbiota compositional and functional shifts could provide insights into its mode of action.DesignWe used metagenomics to determine high-resolution taxonomic and functional profiles of the stool microbiota from IBS cases and household controls (n=56 pairs) on their usual diet. Clinical response and microbiota changes were studied in 41 pairs after 4 weeks on a low FODMAP diet.ResultsUnsupervised analysis of baseline IBS cases pre-diet identified two distinct microbiota profiles, which we refer to as IBSP (pathogenic-like) and IBSH (health-like) subtypes. IBSP microbiomes were enriched in Firmicutes and genes for amino acid and carbohydrate metabolism, but depleted in Bacteroidetes species. IBSH microbiomes were similar to controls. On the low FODMAP diet, IBSH and control microbiota were unaffected, but the IBSP signature shifted towards a health-associated microbiome with an increase in Bacteroidetes (p=0.009), a decrease in Firmicutes species (p=0.004) and normalisation of primary metabolic genes. The clinical response to the low FODMAP diet was greater in IBSP subjects compared with IBSH (p=0.02).Conclusion50% of IBS cases manifested a ‘pathogenic’ gut microbial signature. This shifted towards the healthy profile on the low FODMAP diet; and IBSP cases showed an enhanced clinical responsiveness to the dietary therapy. The effectiveness of FODMAP reduction in IBSP may result from the alterations in gut microbiota and metabolites produced. Microbiota signatures could be useful as biomarkers to guide IBS treatment; and investigating IBSP species and metabolic pathways might yield insights regarding IBS pathogenic mechanisms.

scholarly journals Two microbiota subtypes identified in Irritable Bowel Syndrome with distinct responses to the low-FODMAP diet

2021 ◽  
Author(s):  
Kevin Vervier ◽  
Stephen Moss ◽  
Nitin Kumar ◽  
Anne Adoum ◽  
Meg Barne ◽  
...  
Keyword(s):  
Clinical Response ◽  
Dietary Therapy ◽  
Metabolic Genes ◽  
Unsupervised Analysis ◽  
Irritable Bowel ◽  
Fodmap Diet ◽  
Stool Microbiota ◽  
Functional Profiles ◽  
And Control ◽  
Usual Diet

Objective: Reducing FODMAPs can be clinically beneficial in IBS but the mechanism is poorly understood. We aimed to detect microbial signatures that might predict response to the low FODMAP diet and assess whether microbiota compositional and functional shifts could provide insights into its mode of action. Design: We used metagenomics to determine high-resolution taxonomic and functional profiles of the stool microbiota from IBS cases and household controls (n=56 pairs) on their usual diet. Clinical response and microbiota changes were studied in 41 pairs after 4 weeks on a low FODMAP diet. Results. Unsupervised analysis of baseline IBS cases pre-diet identified two distinct microbiota profiles, which we refer to as IBSP (pathogenic-like) and IBSH (health-like) subtypes. IBSP microbiomes were enriched in Firmicutes and genes for amino acid and carbohydrate metabolism, but depleted in Bacteroidetes species. IBSH microbiomes were similar to controls. On the low FODMAP diet IBSH and control microbiota were unaffected, but the IBSP signature shifted towards a health-associated microbiome with an increase in Bacteroidetes (p=0.009), a decrease in Firmicutes species (p=0.004) and normalization of primary metabolic genes. The clinical response to the low FODMAP diet was greater in IBSP subjects compared to IBSH (p = 0.02). Conclusion: 50% of IBS cases manifested a 'pathogenic' gut microbial signature. This shifted towards the healthy profile on the low FODMAP diet; and IBSP cases showed an enhanced clinical responsiveness to the dietary therapy. The effectiveness of FODMAP exclusion in IBSP may result from the alterations in gut microbiota and metabolites produced. Microbiota signatures could be useful as biomarkers to guide IBS treatment; and investigating IBSP species and metabolic pathways might yield insights regarding IBS pathogenic mechanisms.

scholarly journals Clinical Application of Dietary Therapies in Irritable Bowel Syndrome

2018 ◽  
Vol 27 (3) ◽  
pp. 307-316 ◽  
Author(s):  
Anupam Rej ◽  
Amanda Avery ◽  
Alexander Charles Ford ◽  
Anne Holdoway ◽  
Matthew Kurien ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Randomized Trials ◽  
Individual Therapy ◽  
Dietary Therapy ◽  
Round Table Discussion ◽  
Mesh Terms ◽  
Number Of Patients ◽  
Significant Difference ◽  
Irritable Bowel ◽  
Fodmap Diet

Background & Aims: Diet appears to play a pivotal role in symptom generation in Irritable Bowel Syndrome (IBS). First line dietary therapy for IBS has focused on advice concerning healthy eating and lifestyle management. Research recently has focused on the role of a diet low in fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs), gluten free (GFD) and wheat free (WFD) diets for the relief of symptoms in IBS.Methods: A round table discussion with gastroenterologists and dietitians with a specialist interest in dietary therapies in IBS was held in Sheffield, United Kingdom in May 2017. Existing literature was reviewed. PubMed and EMBASE were searched with the MeSH terms irritable bowel syndrome/diet/diet therapy/gluten/low FODMAP in different combinations to identify relevant articles. A consensus on the application of these dietary therapies into day-to-day practice was developed. Results: Fourteen randomized trials in IBS evaluating the low FODMAP diet (n studies = 9), GFD (n = 4) and WFD (n = 1) were included in this review. The total number of patients recruited from randomized trials reviewed was: n=580 low FODMAP diet (female, n=430), n=203 GFD (female, n=139), n=276 WFD (female, n=215). There was no significant difference in the gender of patients recruited for both the low FODMAP and GFD randomized studies (p=0.12). The response rate in the literature to a low FODMAP diet ranged between 50-76%, and to GFD ranged between 34-71%. Percentage of IBS patients identified as wheat sensitive was reported as 30% in the literature. Conclusion: There are no head-to-head trials to date utilizing the low FODMAP diet, GFD and WFD for dietary treatment of IBS and still a number of concerns for diets, including nutritional inadequacy and alteration of the gut microbiota. The consensus suggests that there is evidence for the use of the low FODMAP diet, GFD and WFD as dietary therapies for IBS; the decision-making process for using each individual therapy should be directed by a detailed history by the dietitian, involving the patient in the process.

Clinical Response to the Low Fodmap Diet at 12 Months: A Prospective Evaluation of Patients with Irritable Bowel Syndrome

2017 ◽  
Vol 152 (5) ◽  
pp. S918
Author(s):  
Heidi Staudacher ◽  
Miranda Lomer ◽  
James O. Lindsay ◽  
Peter M. Irving ◽  
Lee Martin ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Clinical Response ◽  
Prospective Evaluation ◽  
Irritable Bowel ◽  
Fodmap Diet

164 Gut Microbiome Biomarkers Are Associated With Clinical Response to a Low FODMAP Diet in Children With Irritable Bowel Syndrome

2015 ◽  
Vol 148 (4) ◽  
pp. S-44 ◽  
Author(s):  
Bruno P. Chumpitazi ◽  
Emily B. Hollister ◽  
Julia L. Cope ◽  
Ruth A. Luna ◽  
James Versalovic ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Clinical Response ◽  
Gut Microbiome ◽  
Irritable Bowel ◽  
Fodmap Diet

scholarly journals Diarrhea Predominant-Irritable Bowel Syndrome (IBS-D): Effects of Different Nutritional Patterns on Intestinal Dysbiosis and Symptoms

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1506
Author(s):  
Annamaria Altomare ◽  
Claudia Di Rosa ◽  
Elena Imperia ◽  
Sara Emerenziani ◽  
Michele Cicala ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Intestinal Microbiota ◽  
Gastrointestinal Disorder ◽  
Additional Energy ◽  
Nutritional Advice ◽  
Intestinal Dysbiosis ◽  
Gi Symptoms ◽  
Mutualistic Relationship ◽  
Irritable Bowel ◽  
Fodmap Diet

Irritable Bowel Syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by abdominal pain associated with defecation or a change in bowel habits. Gut microbiota, which acts as a real organ with well-defined functions, is in a mutualistic relationship with the host, harvesting additional energy and nutrients from the diet and protecting the host from pathogens; specific alterations in its composition seem to play a crucial role in IBS pathophysiology. It is well known that diet can significantly modulate the intestinal microbiota profile but it is less known how different nutritional approach effective in IBS patients, such as the low-FODMAP diet, could be responsible of intestinal microbiota changes, thus influencing the presence of gastrointestinal (GI) symptoms. The aim of this review was to explore the effects of different nutritional protocols (e.g., traditional nutritional advice, low-FODMAP diet, gluten-free diet, etc.) on IBS-D symptoms and on intestinal microbiota variations in both IBS-D patients and healthy subjects. To date, an ideal nutritional protocol does not exist for IBS-D patients but it seems crucial to consider the effect of the different nutritional approaches on the intestinal microbiota composition to better define an efficient strategy to manage this functional disorder.

scholarly journals Low-FODMAP diet reduces irritable bowel symptoms in patients with inflammatory bowel disease

2017 ◽  
Vol 23 (18) ◽  
pp. 3356 ◽  
Author(s):  
Natalia Pedersen ◽  
Dorit Vedel Ankersen ◽  
Maria Felding ◽  
Henrik Wachmann ◽  
Zsuzsanna Végh ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Bowel Symptoms ◽  
Inflammatory Bowel ◽  
Irritable Bowel ◽  
Fodmap Diet

scholarly journals Irritable bowel syndrome: new insights into symptom mechanisms and advances in treatment

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 780 ◽  
Author(s):  
Robin Spiller
Keyword(s):  
Irritable Bowel Syndrome ◽  
New Agents ◽  
Enteric Nerves ◽  
Inflammatory Bowel ◽  
Magnetic Resonance Imaging Mri ◽  
Irritable Bowel ◽  
Fodmap Diet ◽  
And Function ◽  
The Impact

Despite being one of the most common conditions leading to gastroenterological referral, irritable bowel syndrome (IBS) is poorly understood. However, recent years have seen major advances. These include new understanding of the role of both inflammation and altered microbiota as well as the impact of dietary intolerances as illuminated by magnetic resonance imaging (MRI), which has thrown new light on IBS. This article will review new data on how excessive bile acid secretion mediates diarrhea and evidence from post infectious IBS which has shown how gut inflammation can alter gut microbiota and function. Studies of patients with inflammatory bowel disease (IBD) have also shown that even when inflammation is in remission, the altered enteric nerves and abnormal microbiota can generate IBS-like symptoms. The efficacy of the low FODMAP diet as a treatment for bloating, flatulence, and abdominal discomfort has been demonstrated by randomized controlled trials. MRI studies, which can quantify intestinal volumes, have provided new insights into how FODMAPs cause symptoms. This article will focus on these areas together with recent trials of new agents, which this author believes will alter clinical practice within the foreseeable future.

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