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β-Galactooligosaccharide in Conjunction With Low FODMAP Diet Improves Irritable Bowel Syndrome Symptoms but Reduces Fecal Bifidobacteria.
- Source :
-
The American journal of gastroenterology [Am J Gastroenterol] 2020 Jun; Vol. 115 (6), pp. 906-915. - Publication Year :
- 2020
-
Abstract
- Introduction: The low FODMAP diet (LFD) reduces symptoms and bifidobacteria in irritable bowel syndrome (IBS). β-galactooligosaccharides (B-GOS) may reduce the symptoms and increase bifidobacteria in IBS. We investigated whether B-GOS supplementation alongside the LFD improves IBS symptoms while preventing the decline in bifidobacteria.<br />Methods: We performed a randomized, placebo-controlled, 3-arm trial of 69 Rome III adult patients with IBS from secondary care in the United Kingdom. Patients were randomized to a sham diet with placebo supplement (control) or LFD supplemented with either placebo (LFD) or 1.4 g/d B-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 (H NMR) were analyzed.<br />Results: At 4 weeks, adequate symptom relief was higher in the LFD/B-GOS group (16/24, 67%) than in the control group (7/23, 30%) (odds ratio 4.6, 95% confidence interval: 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 in the control (9.77 [0.41], P = 0.018). A proportion of Actinobacteria was lower in LFD (1.9%, P = 0.003) and LFD/B-GOS (1.8%, P < 0.001) groups than in the control group (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 in the control group (609.2).<br />Discussion: The LFD combined with B-GOS prebiotic produced a greater symptom response than the sham diet plus placebo, but addition of 1.4 g/d B-GOS did not prevent the reduction of bifidobacteria. The LFD reduces fecal Actinobacteria and butyrate thus strict long-term use should not be advised.
- Subjects :
- Adult
Combined Modality Therapy
Diet Therapy methods
Feces chemistry
Female
Fermentation
Humans
In Situ Hybridization, Fluorescence
Irritable Bowel Syndrome metabolism
Irritable Bowel Syndrome microbiology
Irritable Bowel Syndrome physiopathology
Male
Middle Aged
RNA, Ribosomal, 16S
Treatment Outcome
Urine chemistry
Young Adult
Bifidobacterium genetics
Diet, Carbohydrate-Restricted methods
Galactose therapeutic use
Gastrointestinal Microbiome genetics
Irritable Bowel Syndrome therapy
Oligosaccharides therapeutic use
Prebiotics
Subjects
Details
- Language :
- English
- ISSN :
- 1572-0241
- Volume :
- 115
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The American journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 32433273
- Full Text :
- https://doi.org/10.14309/ajg.0000000000000641