Impact of bread diet on intestinal dysbiosis and irritable bowel syndrome symptoms in quiescent ulcerative colitis: A pilot study

Abstract

Gut microbiota may be involved in the presence of irritable bowel syndrome (IBS)-like symptomatology in ulcerative colitis (UC) patients in remission. Bread is an important source of dietary fiber, and a potential prebiotic. To assess the effect of a bread baked using traditional elaboration, in comparison with using modern elaboration procedures, in changing the gut microbiota and relieving IBS-like symptoms in patients with quiescent ulcerative colitis. Thirty-one UC patients in remission with IBS-like symptoms were randomly assigned to a dietary intervention with 200 g/d of either treatment or control bread for 8 weeks. Clinical symptomatology was tested using questionnaires and inflammatory parameters. Changes in fecal microbiota composition were assessed by high-throughput sequencing of the 16S rRNA gene. A decrease in IBS-like symptomatology was observed after both the treatment and control bread interventions as reductions in IBS-Symptom Severity Score values (p-value < 0.001) and presence of abdominal pain (p-value < 0.001). The treatment bread suggestively reduced the Firmicutes/Bacteroidetes ratio (p-value = 0.058). In addition, the Firmicutes/Bacteroidetes ratio seemed to be associated with improving IBS-like symptoms as suggested by a slight decrease in patient without abdominal pain (p-value = 0.059). No statistically significant differential abundances were found at any taxonomic level. The intake of a bread baked using traditional elaboration decreased the Firmicutes/Bacteroidetes ratio, which seemed to be associated with improving IBS-like symptoms in quiescent ulcerative colitis patients. These findings suggest that the traditional bread elaboration has a potential prebiotic effect improving gut health (ClinicalTrials.gov ID number of study: NCT05656391).

Sourdough Bread and Metabolic Risk Factors. A Randomized, Controlled Trial in Subjects with Metabolic Syndrome

“…Likewise, the consistency in beta diversity, which measures the differences in microbial community composition between different samples, suggests that there were no changes in microbial composition across the interventions. These results are consistent with a similar trial conducted in subjects diagnosed with ulcerative colitis, which examined the effects of a two-month intervention with two different sourdough breads (differing in percentage) [43]. Consistent with our results, the above-mentioned study with 23 subjects reported no differences microbiota diversity.…”

“…Consistent with our results, the above-mentioned study with 23 subjects reported no differences microbiota diversity. Furthermore, although the bread treatment suggestively reduced the Firmicutes/Bacteroidetes ratio, both groups experienced some relief from symptoms resembling intestinal bowel disease [43]. Likewise, a one-week clinical trial involving 20 healthy subjects that compared sourdough bread consumption to white bread found similar results, with no noticeable differences in alpha and beta diversity or relative abundances at the phylum level [44].…”