Multivariate modelling of faecal bacterial profiles of patients with IBS predicts responsiveness to a diet low in FODMAPs

Gut - Tập 67 Số 5 - Trang 872-881 - 2018
Sean Bennet1,2, Lena Böhn3,1, Stine Störsrud3,1, Therese Liljebo4, Lena Collin5, Perjohan Lindfors5,1,6, Hans Törnblom3,1, Lena Öhman1,2,7, Magnus Simrén8
1Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
2Department of Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
3Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
4Department of Nutrition, Karolinska University Hospital, Stockholm, Sweden
5Department of Gastroenterology, Sabbatsbergs Hospital, Stockholm, Sweden
6Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
7School of health and education, University of Skövde, Skövde, Sweden
8Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg 405 30, Sweden

Tóm tắt

ObjectiveThe effects of dietary interventions on gut bacteria are ambiguous. Following a previous intervention study, we aimed to determine how differing diets impact gut bacteria and if bacterial profiles predict intervention response.DesignSixty-seven patients with IBS were randomised to traditional IBS (n=34) or low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) (n=33) diets for 4 weeks. Food intake was recorded for 4 days during screening and intervention. Faecal samples and IBS Symptom Severity Score (IBS-SSS) reports were collected before (baseline) and after intervention. A faecal microbiota dysbiosis test (GA-map Dysbiosis Test) evaluated bacterial composition. Per protocol analysis was performed on 61 patients from whom microbiome data were available.ResultsResponders (reduced IBS-SSS by ≥50) to low FODMAP, but not traditional, dietary intervention were discriminated from non-responders before and after intervention based on faecal bacterial profiles. Bacterial abundance tended to be higher in non-responders to a low FODMAP diet compared with responders before and after intervention. A low FODMAP intervention was associated with an increase in Dysbiosis Index (DI) scores in 42% of patients; while decreased DI scores were recorded in 33% of patients following a traditional IBS diet. Non-responders to a low FODMAP diet, but not a traditional IBS diet had higher DI scores than responders at baseline. Finally, while a traditional IBS diet was not associated with significant reduction of investigated bacteria, a low FODMAP diet was associated with reducedBifidobacteriumand Actinobacteria in patients, correlating with lactose consumption.ConclusionsA low FODMAP, but not a traditional IBS diet may have significant impact on faecal bacteria. Responsiveness to a low FODMAP diet intervention may be predicted by faecal bacterial profiles.Trial registration numberNCT02107625.

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Gut

Tập 67 Số 5

872-881

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