Treatment efficacy of a low FODMAP diet compared to a low lactose diet in IBS patients: A randomized, cross-over designed study

Krieger-Grübel, Claudia; Hutter, Senta; Hiestand, Mirjam; Brenner, Isabella; Güsewell, Sabine; Borovicka, Jan

doi:10.1016/j.clnesp.2020.09.020

Cited by 31 publications

(24 citation statements)

References 30 publications

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“…Although the health and diet questionnaire included questions regarding gut symptoms and chronic conditions, a formal diagnosis was not verified. For potential life-style modifications in addition to probiotic supplementation, diet changes may also be an important factor in alleviating symptoms or changing the microbiome (92)(93)(94). Low FODMAP diet (LFD) and low lactose diet (LLD) reduced the IBS-SSS score.…”

Section: Discussionmentioning

confidence: 99%

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

Phan

Nair

Jain

et al. 2021

Preprint

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Background. Irritable 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. Objective. Here, 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 Methods. This 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. Results. There 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. Conclusions. We 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.

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Section: Discussionmentioning

confidence: 99%

“…IBS subjects on LFD had significantly less abdominal pain, bloating, and gas production (93). These diet interventions were not accessed in this study.…”

Section: Discussionmentioning

confidence: 99%

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

Phan

Nair

Jain

et al. 2021

Preprint

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“… 98 In most but not all studies, lactose restriction does not lead to relief of symptoms even in patients with demonstrated malabsorption. 92 , 99–101 The effects of lactose malabsorption may be more complex and persist after restriction as lactose malabsorption is associated with increased colonic lymphocytes, eosinophils, and mast cells as well as visceral hypersensitivity, which may represent secondary therapeutic targets if symptoms persist after lactose elimination. 102–105 …”

Section: Treatmentmentioning

confidence: 99%

An Update on the Assessment and Management of Pediatric Abdominal Pain

Friesen¹,

Colombo²,

Deacy³

et al. 2021

PHMT

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Chronic abdominal pain is very common in children and adolescent and results in high personal and social costs. Most youth with chronic abdominal pain fulfill criteria for a functional abdominal pain disorder (FAPD) as defined by Rome criteria. These are complex conditions with a wide array of biological, psychological, and social factors contributing to the experience of pain. The purpose of the current review is to provide an overview of the pathophysiology of FAPDs and an up-to-date summary of the literature related to FAPDs in children and adolescents, with additional focus on several areas (eg, diet and probiotics) where patients and families frequently have questions or implement self-directed care. We also provide an approach to the assessment and treatment of pediatric FAPDs focusing on the robust literature regarding psychological interventions and much sparser literature regarding medication treatment.

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“…It is also likely that lactose-containing foods may be better tolerated when eaten as part of a meal rather than in isolation [ 96 ]. A recent cross-over RCT of 29 IBS patients found that both a low FODMAP diet and a low-lactose diet significantly improved symptoms [ 99 ]. A thorough dietary review would guide such a decision.…”

Section: Dietary Management Of Chronic Diarrhoeamentioning

confidence: 99%

What Are the Pearls and Pitfalls of the Dietary Management for Chronic Diarrhoea?

et al. 2021

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Chronic diarrhoea affects up to 14% of adults, it impacts on quality of life and its cause can be variable. Patients with chronic diarrhoea are presented with a plethora of dietary recommendations, often sought from the internet or provided by those who are untrained or inexperienced. In this review, we summarise the possible causes of chronic diarrhoea that can be managed by diet, the symptom improvement and quality of life benefits but also the potential risks of such dietary treatments. Clinicians need to consider both the benefits and risks of dietary treatments before making dietary recommendations to manage chronic diarrhoea. The pivotal role that dietitians have in ensuring optimal symptom improvement without jeopardising nutritional and overall health is discussed.

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Treatment efficacy of a low FODMAP diet compared to a low lactose diet in IBS patients: A randomized, cross-over designed study

Cited by 31 publications

References 30 publications

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

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

An Update on the Assessment and Management of Pediatric Abdominal Pain

What Are the Pearls and Pitfalls of the Dietary Management for Chronic Diarrhoea?

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