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

Abstract

We sought to determine whether a low fermentable substrate diet (LFSD) decreases abdominal pain frequency in children with irritable bowel syndrome (IBS) and to identify potential microbial factors related to diet efficacy. Pain symptoms, stooling characteristics, breath hydrogen and methane, whole intestinal transit time, stool microbiome, and metabolite composition were collected and/or documented in eight children with IBS at baseline and during one week of an LFSD intervention. Pain frequency (P < 0.05), pain severity (P < 0.05), and pain-related interference with activities (P < 0.05) decreased in the subjects while on the LFSD. Responders vs. non-responders: four children (50%) were identified as responders (>50% decrease in abdominal pain frequency while on the LFSD). There were no differences between responders and non-responders with respect to hydrogen production, methane production, stooling characteristics, or gut transit time. Responders were characterized by increased pre-LFSD abundance of bacterial taxa belonging to the genera Sporobacter (P < 0.05) and Subdoligranulum (P < 0.02) and decreased abundance of taxa belonging to Bacteroides (P < 0.05) relative to non-responders. In parallel, stool metabolites differed between responders and non-responders and were associated with differences in microbiome composition. These pilot study results suggest that an LFSD may be effective in decreasing GI symptoms in children with IBS. Microbial factors such as gut microbiome composition and stool metabolites while on the diet may relate to LFSD efficacy.

Keywords: :

• FODMAPs
• abdominal pain
• irritable bowel syndrome
• metabolites
• microbiome
• pediatric

10.4161/gmic.27923

Disclosure of Potential Conflicts of Interest

No potential conflict of interest was disclosed.

Acknowledgments

Funding was provided by the NASPGHAN Foundation/Nestle Young Investigator Development Award to B.P.C. This study also was supported in part by R01 NR05337 (R.J.S.) and UH3 DK083990 (J.V.) from the National Institutes of Health (R.J.S.), the Daffy’s Foundation (R.J.S.), American College of Gastroenterology Clinical Research Award (B.P.C.), the USDA/ARS under Cooperative Agreement No. 6250-51000-043 (R.J.S.), and P30 DK56338 which funds the Texas Medical Center Digestive Disease Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This work is a publication of the University of Washington and the USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, and Texas Children's Hospital. The contents do not necessarily reflect the views or policies of the USDA, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government. We thank Jane Muir, Jacqueline Barett, and Dr Peter Gibson for their guidance with the dietary intervention, Yoni Samocha, Sonia Singh, and Linda Cao for their research assistance, and Yue Shang and Jessica Runge from the Texas Children’s Microbiome Center for their assistance in sample processing and sequencing.