Dietary Modification for the Restoration of Gut Microbiome and Management of Symptoms in Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder leading to chronic debilitating issues. A healthy diet plays an integral role in maintaining the gut microbiota equilibrium, thus promoting digestive health. The structure and function of gut microbiota are affected by genetics and environmental factors, such as altered dietary habits, gastroenteritis, stress, increased use of alcohol and drugs, and medication use. Whereas there are various management approaches cited in the literature to manage symptoms of IBS, the purpose of this article is to focus on dietary options that will restore the gut microbiome and help in managing IBS symptoms. Some of the diets that are discussed in this article include a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet, gluten-free/wheat-free diet, high-fiber diet, dietary and herbal supplements (psyllium, peppermint oil), and probiotics/prebiotics/synbiotics. The clinical practice guidelines recommended by the American College of Gastroenterology outlines evidence-based dietary recommendations for patients with IBS to manage symptoms. Recent advancements in the dietary management of IBS highlighting the use of a patient-centered, personalized nutrition approach along with lifestyle changes, pharmacological therapies, and psychosocial and behavioral interventions are also reviewed and discussed.

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Gut Microbiome and Its Role in the Pathophysiology of Irritable Bowel Syndrome

Acta gastroenterológica latinoamericana ◽

10.52787/dxfc9250 ◽

2021 ◽

Vol 51 (4) ◽

Author(s):

Giada De Palma ◽

Premysl Bercik

Keyword(s):

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Gut Microbiota ◽

Gut Microbiome ◽

Gastrointestinal Disorder ◽

Healthy Controls ◽

Fecal Microbiome ◽

Targeted Treatments ◽

Irritable Bowel ◽

And Function

Irritable bowel syndrome is the most common functional gastrointestinal disorder, affecting up to 9% individuals globally. Although the etiology of this syndrome is likely heterogenous, it presents with its hallmark symptoms of abdominal pain and altered intestinal motility. Moreover, it is considered to be a disorder of the gut-brain interaction, and the microbiome has often been implicated as a central player in its pathophysiology. Patients with irritable bowel syndrome display altered composition and function of the gut microbiota compared to healthy controls. Microbiome directed therapies, such as probiotics, antibiotics and fecal microbiome transplantation, appear to be beneficial for both gut symptoms and psychiatric comorbidities. This review aims to recapitulate the available literature on the microbiome contribution to the pathophysiology and symptoms presentation of irritable bowel syndrome, as well as the current literature on microbiome-targeted treatments for this disease.

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Diet and gut microbiome interactions of relevance for symptoms in irritable bowel syndrome

Microbiome ◽

10.1186/s40168-021-01018-9 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Julien Tap ◽

Stine Störsrud ◽

Boris Le Nevé ◽

Aurélie Cotillard ◽

Nicolas Pons ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Gut Microbiota ◽

Gut Microbiome ◽

Symptom Severity ◽

Dietary Habits ◽

Gastrointestinal Symptoms ◽

Linear Regression Models ◽

Food Diary ◽

New Associations ◽

Irritable Bowel

Abstract Background While several studies have documented associations between dietary habits and microbiota composition and function in healthy individuals, no study explored these associations in patients with irritable bowel syndrome (IBS), and especially with symptoms. Methods Here, we used a novel approach that combined data from a 4-day food diary, integrated into a food tree, together with gut microbiota (shotgun metagenomic) for individuals with IBS (N = 149) and healthy controls (N = 52). Paired microbiota and food-based trees allowed us to detect new associations between subspecies and diet. Combining co-inertia analysis and linear regression models, exhaled gas levels and symptom severity could be predicted from metagenomic and dietary data. Results We showed that individuals with severe IBS are characterized by a higher intake of poorer-quality food items during their main meals. Our analysis suggested that covariations between gut microbiota at subspecies level and diet could be explained with IBS symptom severity, exhaled gas, glycan metabolism, and meat/plant ratio. We provided evidence that IBS severity is associated with altered gut microbiota hydrogen function in correlation with microbiota enzymes involved in animal carbohydrate metabolism. Conclusions Our study provides an unprecedented resolution of diet-microbiota-symptom interactions and ultimately guides new interventional studies that aim to identify gut microbiome-based nutritional recommendations for the management of gastrointestinal symptoms. Trial registration This trial was registered on the ClinicalTrials.gov, with the registration number NCT01252550, on 3rd December 2010.

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Integrative analysis of the gut microbiome and metabolome in a rat model with stress induced irritable bowel syndrome

Scientific Reports ◽

10.1038/s41598-021-97083-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yue Hu ◽

Fang Chen ◽

Haiyong Ye ◽

Bin Lu

Keyword(s):

Irritable Bowel Syndrome ◽

Gut Microbiota ◽

Rat Model ◽

Gut Microbiome ◽

16S Rrna Gene Sequencing ◽

Metabolic Phenotype ◽

Control Group ◽

Rrna Gene ◽

Microbial Dysbiosis ◽

Irritable Bowel

AbstractStress is one of the major causes of irritable bowel syndrome (IBS), which is well-known for perturbing the microbiome and exacerbating IBS-associated symptoms. However, changes in the gut microbiome and metabolome in response to colorectal distention (CRD), combined with restraint stress (RS) administration, remains unclear. In this study, CRD and RS stress were used to construct an IBS rat model. The 16S rRNA gene sequencing was used to characterize the microbiota in ileocecal contents. UHPLC-QTOF-MS/MS assay was used to characterize the metabolome of gut microbiota. As a result, significant gut microbial dysbiosis was observed in stress-induced IBS rats, with the obvious enrichment of three and depletion of 11 bacterial taxa in IBS rats, when compared with those in the control group (q < 0.05). Meanwhile, distinct changes in the fecal metabolic phenotype of stress-induced IBS rats were also found, including five increased and 19 decreased metabolites. Furthermore, phenylalanine, tyrosine and tryptophan biosynthesis were the main metabolic pathways induced by IBS stress. Moreover, the altered gut microbiota had a strong correlation with the changes in metabolism of stress-induced IBS rats. Prevotella bacteria are correlated with the metabolism of 1-Naphthol and Arg.Thr. In conclusion, the gut microbiome, metabolome and their interaction were altered. This may be critical for the development of stress-induced IBS.

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Taxonomic composition and biodiversity of the gut microbiome from patients with irritable bowel syndrome, ulcerative colitis, and asthma

Vavilov Journal of Genetics and Breeding ◽

10.18699/vj21.100 ◽

2022 ◽

Vol 25 (8) ◽

pp. 864-873

Author(s):

A. Y. Tikunov ◽

A. N. Shvalov ◽

V. V. Morozov ◽

I. V. Babkin ◽

G. V. Seledtsova ◽

...

Keyword(s):

Ulcerative Colitis ◽

Irritable Bowel Syndrome ◽

Gut Microbiota ◽

Gut Microbiome ◽

Taxonomic Composition ◽

16S Rrna Genes ◽

Rrna Genes ◽

Taxonomic Structure ◽

Opportunistic Bacteria ◽

Irritable Bowel

To date, the association of an imbalance of the intestinal microbiota with various human diseases, including both diseases of the gastrointestinal tract and disorders of the immune system, has been shown. However, despite the huge amount of accumulated data, many key questions still remain unanswered. Given limited data on the composition of the gut microbiota in patients with ulcerative colitis (UC) and irritable bowel syndrome (IBS) from different parts of Siberia, as well as the lack of data on the gut microbiota of patients with bronchial asthma (BA), the aim of the study was to assess the biodiversity of the gut microbiota of patients with IBS, UC and BA in comparison with those of healthy volunteers (HV). In this study, a comparative assessment of the biodiversity and taxonomic structure of gut microbiome was conducted based on the sequencing of 16S rRNA genes obtained from fecal samples of patients with IBS, UC, BA and volunteers. Sequences of the Firmicutes and Bacteroidetes types dominated in all samples studied. The third most common in all samples were sequences of the Proteobacteria type, which contains pathogenic and opportunistic bacteria. Sequences of the Actinobacteria type were, on average, the fourth most common. The results showed the presence of dysbiosis in the samples from patients compared to the sample from HVs. The ratio of Firmicutes/Bacteroidetes was lower in the IBS and UC samples than in HV and higher the BA samples. In the samples from patients with intestinal diseases (IBS and UC), an increase in the proportion of sequences of the Bacteroidetes type and a decrease in the proportion of sequences of the Clostridia class, as well as the Ruminococcaceae, but not Erysipelotrichaceae family, were found. The IBS, UC, and BA samples had signif icantly more Proteobacteria sequences, including Methylobacterium, Sphingomonas, Parasutterella, Halomonas, Vibrio, as well as Escherichia spp. and Shigella spp. In the gut microbiota of adults with BA, a decrease in the proportion of Roseburia, Lachnospira, Veillonella sequences was detected, but the share of Faecalibacterium and Lactobacillus sequences was the same as in healthy individuals. A signif icant increase in the proportion of Halomonas and Vibrio sequences in the gut microbiota in patients with BA has been described for the f irst time.

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Probiotics in Irritable Bowel Syndrome: An Up-to-Date Systematic Review

Nutrients ◽

10.3390/nu11092048 ◽

2019 ◽

Vol 11 (9) ◽

pp. 2048 ◽

Cited By ~ 7

Author(s):

Hanna Fjeldheim Dale ◽

Stella Hellgren Rasmussen ◽

Özgün Ömer Asiller ◽

Gülen Arslan Lied

Keyword(s):

Systematic Review ◽

Irritable Bowel Syndrome ◽

Gut Microbiota ◽

Gastrointestinal Disorder ◽

Inclusion Criteria ◽

Probiotic Supplementation ◽

Beneficial Effects ◽

Randomized Controlled ◽

Irritable Bowel ◽

Gut Microbiota Composition

Irritable bowel syndrome (IBS) is a frequent functional gastrointestinal disorder, and alterations in the gut microbiota composition contributes to symptom generation. The exact mechanisms of probiotics in the human body are not fully understood, but probiotic supplements are thought to improve IBS symptoms through manipulation of the gut microbiota. The aim of this systematic review was to assess the latest randomized controlled trials (RCTs) evaluating the effect of probiotic supplementation on symptoms in IBS patients. A literature search was conducted in Medline (PubMed) until March 2019. RCTs published within the last five years evaluating effects of probiotic supplements on IBS symptoms were eligible. The search identified in total 35 studies, of which 11 met the inclusion criteria and were included in the systematic review. Seven studies (63.6%) reported that supplementation with probiotics in IBS patients significantly improved symptoms compared to placebo, whereas the remaining four studies (36.4%) did not report any significant improvement in symptoms after probiotic supplementation. Of note, three studies evaluated the effect of a mono-strain supplement, whereas the remaining eight trials used a multi-strain probiotic. Overall, the beneficial effects were more distinct in the trials using multi-strain supplements with an intervention of 8 weeks or more, suggesting that multi-strain probiotics supplemented over a period of time have the potential to improve IBS symptoms.

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Mechanism of action and therapeutic benefit of rifaximin in patients with irritable bowel syndrome: a narrative review

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284819897531 ◽

2020 ◽

Vol 13 ◽

pp. 175628481989753 ◽

Cited By ~ 2

Author(s):

William D. Chey ◽

Eric D. Shah ◽

Herbert L. DuPont

Keyword(s):

Irritable Bowel Syndrome ◽

Gut Microbiota ◽

Mechanism Of Action ◽

Bacterial Overgrowth ◽

Gastrointestinal Disorder ◽

Small Intestinal Bacterial Overgrowth ◽

The United States ◽

Clinical Effects ◽

Healthy Individuals ◽

Irritable Bowel

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder with a multifactorial pathophysiology. The gut microbiota differs between patients with IBS and healthy individuals. After a bout of acute gastroenteritis, postinfection IBS may result in up to approximately 10% of those affected. Small intestinal bacterial overgrowth (SIBO) is more common in patients with IBS than in healthy individuals, and eradication of SIBO with systemic antibiotics has decreased symptoms of IBS in some patients with IBS and SIBO. The nonsystemic (i.e. low oral bioavailability) antibiotic rifaximin is indicated in the United States and Canada for the treatment of adults with IBS with diarrhea (IBS-D). The efficacy and safety of 2-week single and repeat courses of rifaximin have been demonstrated in randomized, placebo-controlled studies of adults with IBS. Rifaximin is widely thought to exert its beneficial clinical effects in IBS-D through manipulation of the gut microbiota. However, current studies indicate that rifaximin induces only modest effects on the gut microbiota of patients with IBS-D, suggesting that the efficacy of rifaximin may involve other mechanisms. Indeed, preclinical data reveal a potential role for rifaximin in the modulation of inflammatory cytokines and intestinal permeability, but these two findings have not yet been examined in the context of clinical studies. The mechanism of action of rifaximin in IBS is likely multifactorial, and further study is needed.

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Determining the association between fibromyalgia, the gut microbiome and its biomarkers: A systematic review

10.21203/rs.2.21278/v1 ◽

2020 ◽

Author(s):

Sharon Erdrich ◽

Jason A Hawrelak ◽

Stephen P Myers ◽

Joanna E Harnett

Keyword(s):

Systematic Review ◽

Irritable Bowel Syndrome ◽

Gut Microbiota ◽

Gut Microbiome ◽

Original Research ◽

Gastrointestinal Microbiota ◽

Research Reporting ◽

Gut Dysfunction ◽

Irritable Bowel ◽

The Relationship

Abstract Background The association between fibromyalgia and irritable bowel syndrome is well-established. Alterations in the composition and diversity of the gut microbiome in irritable bowel syndrome have been reported, however, this association is poorly understood in fibromyalgia. Our aim was to summarise the research reporting on the gastrointestinal microbiome and its biomarkers in people with fibromyalgia.Methods A systematic review of published original research reporting on the gastrointestinal microbiota and its biomarkers in adults with a diagnosis of fibromyalgia was undertaken.Results From 4771 studies, 11 met our inclusion criteria and were separated into four main groups: papers reporting Helicobacter pylori ; other gut bacterial markers; metabolomics and other biomarkers, which included intestinal permeability and small intestinal bacterial overgrowth.Conclusion The results suggest there is a paucity of quality research in this area, with indications that the gut microbiota may play a role in fibromyalgia within the emerging field of the gut-musculoskeletal axis. Further investigations into the relationship between the gut microbiota, gut dysfunction and fibromyalgia are warranted.

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Irritable bowel syndrome

Romanian Journal of Medical Practice ◽

10.37897/rjmp.2016.1.6 ◽

2016 ◽

Vol 11 (1) ◽

pp. 33-36

Author(s):

Vasile Valeriu LUPU ◽

◽

Andrada DRUICĂ ◽

Ancuţa IGNAT ◽

Irina Manuela MUCENICA ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Gastrointestinal Disorder ◽

Recurrent Abdominal Pain ◽

Lifestyle Changes ◽

Limited Information ◽

Number Of Children ◽

Bowel Diseases ◽

Environmental Causes ◽

Irritable Bowel ◽

As Stress

Irritable bowel syndrome (IBS) is not a disease. It is a group of symptoms that occur together, symptoms as: chronic or recurrent abdominal pain, altered bowel habits, and bloating, with the absence of structural or biochemical abnormalities. Irritable bowel syndrome is a functional gastrointestinal disorder. The causes of IBS are poorly understood. Limited information is available about the number of children with IBS. IBS affects boys and girls equally, but affects each person differently. IBS can be very difficult to diagnose. IBS is diagnosed by exclusion. To diagnose IBS, a health care provider will conduct a physical exam and take a complete medical history. The main objective of treatment for IBS is to restore normal daily function. Diet and lifestyle changes are important in decreasing the frequency and severity of IBS symptoms. Irritable bowel syndrome is a long-term disease and symptoms usually recur. This may be influenced by factors such as stress, diet or other environmental causes. Avoiding triggers is the best way to prevent symptoms of IBS. However, based on the symptoms, this disease can be confused with other organic bowel diseases.

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Improved gastrointestinal health for irritable bowel syndrome with metagenome-guided interventions

Precision Clinical Medicine ◽

10.1093/pcmedi/pbaa013 ◽

2020 ◽

Vol 3 (2) ◽

pp. 136-146

Author(s):

Cem Meydan ◽

Ebrahim Afshinnekoo ◽

Nate Rickard ◽

Guy Daniels ◽

Laura Kunces ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Symptom Score ◽

Gut Microbiome ◽

Gastrointestinal Disorder ◽

Complex Nature ◽

Post Intervention ◽

Targeted Interventions ◽

Average Decrease ◽

Symptom Scores ◽

Irritable Bowel

Abstract Irritable bowel syndrome (IBS) is the most prevalent functional gastrointestinal disorder worldwide, and the most common reason for referral to gastroenterology clinics. However, the pathophysiology is still not fully understood and consequently current management guidelines are very symptom-specific, leading to mixed results. Here we present a study of 88 individuals with IBS who had baseline sequencing of their gut microbiome (stool samples), received targeted interventions that included dietary, supplement, prebiotic/probiotic, and lifestyle recommendations for a 30-day period, and a follow-up sequencing of their gut microbiome. The study's objectives were to demonstrate unique metagenomic signatures across the IBS phenotypes and to validate whether metagenomic-guided interventions could lead to improvement of symptom scores in individuals with IBS. Enrolled subjects also completed a baseline and post-intervention questionnaire that assessed their symptom scores. The average symptom score of an individual with IBS at baseline was 160 and at the endpoint of the study the average symptom score of the cohort was 100.9. The mixed IBS subtype showed the most significant reduction in symptom scores across the different subtypes (average decrease by 102 points, P = 0.005). The metagenomics analysis reveals shifts in the microbiome post-intervention that have been cross-validated with the literature as being associated with improvement of IBS symptoms. Given the complex nature of IBS, further studies with larger sample sizes, more targeted analyses, and a broader population cohort are needed to explore these results further.

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Dietary Fibre Intervention for Gut Microbiota, Sleep and Mental Health in Adults with Irritable Bowel Syndrome: A Scoping Review

Nutrients ◽

10.3390/nu13072159 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2159

Author(s):

Ran Yan ◽

Lesley Andrew ◽

Evania Marlow ◽

Kanita Kunaratnam ◽

Amanda Devine ◽

...

Keyword(s):

Mental Health ◽

Irritable Bowel Syndrome ◽

Gut Microbiota ◽

Scoping Review ◽

Dietary Intervention ◽

Gastrointestinal Disorder ◽

Short Chain Fatty Acids ◽

Irritable Bowel ◽

Type Studies ◽

Global Population

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder affecting 4–5% of the global population. This disorder is associated with gut microbiota, diet, sleep, and mental health. This scoping review therefore aims to map existing research that has administrated fibre-related dietary intervention to IBS individuals and reported outcomes on at least two of the three following themes: gut microbiota, sleep, and mental health. Five digital databases were searched to identify and select papers as per the inclusion and exclusion criteria. Five articles were included in the assessment, where none reported on all three themes or the combination of gut microbiota and sleep. Two studies identified alterations in gut microbiota and mental health with fibre supplementation. The other three studies reported on mental health and sleep outcomes using subjective questionnaires. IBS-related research lacks system biology-type studies targeting gut microbiota, sleep, and mental health in patients undergoing diet intervention. Further IBS research is required to explore how human gut microbiota functions (such as short-chain fatty acids) in sleep and mental health, following the implementation of dietary pattern alteration or component supplementation. Additionally, the application of objective sleep assessments is required in order to detect sleep change with more accuracy and less bias.

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