β-galacto-oligosaccharide in conjunction with low FODMAP diet improves irritable bowel syndrome symptoms but reduces fecal bifidobacteria

TY - JOUR

T1 - β-galacto-oligosaccharide in conjunction with low FODMAP diet improves irritable bowel syndrome symptoms but reduces fecal bifidobacteria

AU - Wilson, Bridgette

AU - Rossi, Megan

AU - Kanno, Tokuwa

AU - Parkes, Gareth

AU - Anderson, Simon

AU - Mason, James

AU - Irving, Peter M.

AU - Lomer, Miranda

AU - Whelan, Kevin

PY - 2020/3/30

Y1 - 2020/3/30

N2 - Introduction: The low FODMAP diet (LFD) reduces symptoms and bifidobacteria in irritable bowel syndrome (IBS). Β-galacto-oligosaccharides (β-GOS) may reduce symptoms and increase bifidobacteria in IBS. We investigated whether β-GOS supplementation alongside the LFD improves IBS symptoms whilst preventing the decline in bifidobacteria. Methods: We performed a randomized, placebo-controlled, 3-arm, trial of 69 Rome III, adult, IBS patients from secondary care in the United Kingdom. Patients were randomized to; sham diet with placebo supplement (control) or LFD supplemented with either placebo (LFD) or 1.4 g/d β-GOS (LFD/B-GOS), for 4-weeks. Gastrointestinal symptoms, fecal microbiota (fluorescent in-situ hybridization and 16S rRNA sequencing), fecal short-chain fatty acids (gas-liquid chromatography) and pH (probe), and urine metabolites (1H NMR) were analyzed. Results: At 4-weeks, adequate symptom relief was higher in the LFD/B-GOS group (16/24, 67%) than control (7/23, 30%) (OR 4.6, 95%CI: 1.3-15.6; p=0.015), Bifidobacterium concentrations (log10 cells/g dry weight) were not different between LFD and LFD/B-GOS but were lower in the LFD/B-GOS (9.49 (0.73)) than control (9.77 (0.41), p=0.018). Proportion of Actinobacteria was lower in LFD (1.9%, p=0.003) and LFD/B-GOS (1.8%, p<0.001) groups than control (4.2%). Fecal butyrate was lower in the LFD (387.3, p=0.028) and LFD/B-GOS (346.0, p=0.007) groups than control (609.2). Conclusion: The LFD combined with β-GOS prebiotic produced a greater symptom response than the sham diet plus placebo but addition of 1.4 g/d β-GOS did not prevent the reduction of bifidobacteria. The LFD reduces fecal Actinobacteria, and butyrate thus strict long-term use should not be advised.

AB - Introduction: The low FODMAP diet (LFD) reduces symptoms and bifidobacteria in irritable bowel syndrome (IBS). Β-galacto-oligosaccharides (β-GOS) may reduce symptoms and increase bifidobacteria in IBS. We investigated whether β-GOS supplementation alongside the LFD improves IBS symptoms whilst preventing the decline in bifidobacteria. Methods: We performed a randomized, placebo-controlled, 3-arm, trial of 69 Rome III, adult, IBS patients from secondary care in the United Kingdom. Patients were randomized to; sham diet with placebo supplement (control) or LFD supplemented with either placebo (LFD) or 1.4 g/d β-GOS (LFD/B-GOS), for 4-weeks. Gastrointestinal symptoms, fecal microbiota (fluorescent in-situ hybridization and 16S rRNA sequencing), fecal short-chain fatty acids (gas-liquid chromatography) and pH (probe), and urine metabolites (1H NMR) were analyzed. Results: At 4-weeks, adequate symptom relief was higher in the LFD/B-GOS group (16/24, 67%) than control (7/23, 30%) (OR 4.6, 95%CI: 1.3-15.6; p=0.015), Bifidobacterium concentrations (log10 cells/g dry weight) were not different between LFD and LFD/B-GOS but were lower in the LFD/B-GOS (9.49 (0.73)) than control (9.77 (0.41), p=0.018). Proportion of Actinobacteria was lower in LFD (1.9%, p=0.003) and LFD/B-GOS (1.8%, p<0.001) groups than control (4.2%). Fecal butyrate was lower in the LFD (387.3, p=0.028) and LFD/B-GOS (346.0, p=0.007) groups than control (609.2). Conclusion: The LFD combined with β-GOS prebiotic produced a greater symptom response than the sham diet plus placebo but addition of 1.4 g/d β-GOS did not prevent the reduction of bifidobacteria. The LFD reduces fecal Actinobacteria, and butyrate thus strict long-term use should not be advised.

M3 - Article

SN - 1572-0241

JO - The American Journal of Gastroenterology

JF - The American Journal of Gastroenterology

ER -