Gut microbiota influences low fermentable substrate diet efficacy in children with irritable bowel syndrome

Chumpitazi, Bruno P.; Hollister, Emily B.; Oezguen, Numan; Tsai, Cynthia M.; McMeans, Ann R.; Luna, Ruth Ann; Savidge, Tor; Versalovic, James; Shulman, Robert J.

doi:10.4161/gmic.27923

Cited by 126 publications

(182 citation statements)

References 47 publications

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“…Deep analysis of microbiota composition and structure revealed no change in α-diversity (number of operational taxonomic units (OTU), ie, number of species) in children after a 1-week low FODMAP diet in a small uncontrolled study 76. Furthermore, the previously described 3-week study that reported low FODMAP-induced metabolomic alterations in adults demonstrated no effect on α-diversity or β-diversity (differences in species composition between samples at baseline and follow-up) compared with baseline 42.…”

Section: The Low Fodmap Dietmentioning

confidence: 96%

The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS

Staudacher

Whelan

2017

Gut

283

236

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There is an intensifying interest in the interaction between diet and the functional GI symptoms experienced in IBS. Recent studies have used MRI to demonstrate that short-chain fermentable carbohydrates increase small intestinal water volume and colonic gas production that, in those with visceral hypersensitivity, induces functional GI symptoms. Dietary restriction of short-chain fermentable carbohydrates (the low fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diet) is now increasingly used in the clinical setting. Initial research evaluating the efficacy of the low FODMAP diet was limited by retrospective study design and lack of comparator groups, but more recently well-designed clinical trials have been published. There are currently at least 10 randomised controlled trials or randomised comparative trials showing the low FODMAP diet leads to clinical response in 50%-80% of patients with IBS, in particular with improvements in bloating, flatulence, diarrhoea and global symptoms. However, in conjunction with the beneficial clinical impact, recent studies have also demonstrated that the low FODMAP diet leads to profound changes in the microbiota and metabolome, the duration and clinical relevance of which are as yet unknown. This review aims to present recent advances in the understanding of the mechanisms by which the low FODMAP diet impacts on symptoms in IBS, recent evidence for its efficacy, current findings regarding the consequences of the diet on the microbiome and recommendations for areas for future research.

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Section: The Low Fodmap Dietmentioning

confidence: 96%

The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS

Staudacher

Whelan

2017

Gut

283

236

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“…Consequently, typical IBS symptoms of gas and bloating are reduced/eliminated [142]. However, more studies should be carried out on the effects of a long-term low FODMAPs diet.…”

Section: Diet Approachmentioning

confidence: 99%

Rebuilding the Gut Microbiota Ecosystem

Gagliardi

Totino

Cacciotti

et al. 2018

IJERPH

273

174

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A microbial ecosystem in which bacteria no longer live in a mutualistic association is called dysbiotic. Gut microbiota dysbiosis is a condition related with the pathogenesis of intestinal illnesses (irritable bowel syndrome, celiac disease, and inflammatory bowel disease) and extra-intestinal illnesses (obesity, metabolic disorder, cardiovascular syndrome, allergy, and asthma). Dysbiosis status has been related to various important pathologies, and many therapeutic strategies aimed at restoring the balance of the intestinal ecosystem have been implemented. These strategies include the administration of probiotics, prebiotics, and synbiotics; phage therapy; fecal transplantation; bacterial consortium transplantation; and a still poorly investigated approach based on predatory bacteria. This review discusses the various aspects of these strategies to counteract intestinal dysbiosis.

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“…94 In a small study among children with IBS, a low FODMAP diet significantly decreased abdominal pain severity and frequency. Responders appeared to differ in intestinal microbiota composition, indicating that the efficacy of dietary interventions may be influenced by the microbiota 95 and may also explain why low FODMAP diets are ineffective in some.…”

Section: Diet and Ibsmentioning

confidence: 99%

Irritable bowel syndrome, the microbiota and the gut-brain axis

Raskov¹,

et al. 2016

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Irritable bowel syndrome is a common functional gastrointestinal disorder and it is now evident that irritable bowel syndrome is a multi-factorial complex of changes in microbiota and immunology. The bidirectional neurohumoral integrated communication between the microbiota and the autonomous nervous system is called the gut-brain-axis, which integrates brain and GI functions, such as gut motility, appetite and weight. The gut-brain-axis has a central function in the perpetuation of irritable bowel syndrome and the microbiota plays a critical role. The purpose of this article is to review recent research concerning the epidemiology of irritable bowel syndrome, influence of microbiota, probiota, gut-brainaxis, and possible treatment modalities on irritable bowel syndrome. The integrated actions and communication between the microbiota and the autonomous nervous system are central players in the perpetuation of IBS symptoms. This signaling pathway is called the GutBrain Axis (GBA). The GBA is a bidirectional neurohumoral communication system that integrates brain and GI functions, such as gut motility, appetite and weightand here the microbiota plays a critical role. 2Changes in gastrointestinal or central nervous system physiology may result in an altered habitat, which again may cause changes in the composition of the microbiota.Disruption of the physiologic symbiotic relationship (eubiosis) between the human host and the microbiota is called dysbiosis and is regarded a basic factor for initiating and maintaining IBS in the majority of patients. Current evidence has suggested that the dysbiosis observed in IBS and the resulting immunological response may drive and perpetuate gastrointestinal symptoms of IBS suggesting that IBS is in fact a disorder of the microbiota and the GBA. It is unclear whether the initiating factor is brain abnormalities that drive the gut changes or if changes in the gut alter brain function through vagal and sympathetic pathways.3,4 The purpose of this article is to review recent research concerning the influence of microbiota and gut-brain-axis on IBS. IBSIt is estimated that approximately 10% of the World population and 15% of the population in the Western World suffer from IBS characterized by a mixture of recurrent abdominal pain, bloating, changing stool consistency such as diarrhea (IBS-D), constipation (IBS-C), or interchanging diarrhea and constipation (mixed-type or IBS-M), mucus secretion, and nausea. 5,6 Community-based data indicate that IBS-M is the most prevalent type followed by IBS-D and IBS-C and that switching among subtypes occurs. Bloating is the most prevalent symptom reported by 96% of patients with IBS of whatever subgroup. 7 In addition to abdominal symptoms, poor sleep, headache, CONTACT Hans Raskov raskov@mail.dk Lundevangsvej 23, DK-2900 Hellerup, Denmark. Color versions of one or more of the figures in the article can be found online at www.tandfonline.com/kgmi.

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Gut microbiota influences low fermentable substrate diet efficacy in children with irritable bowel syndrome

Cited by 126 publications

References 47 publications

The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS

The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS

Rebuilding the Gut Microbiota Ecosystem

Irritable bowel syndrome, the microbiota and the gut-brain axis

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