Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
School of Pharmacy, Monash University Malaysia, Subang Jaya, Malaysia.
J Gastroenterol Hepatol. 2023 Aug;38(8):1259-1268. doi: 10.1111/jgh.16174. Epub 2023 Mar 23.
The gut microbiota in irritable bowel syndrome (IBS) is known to vary with diet. We aim to (i) analyze the gut microbiota composition of IBS patients from a multi-ethnic population and (ii) explore the impact of a low FODMAP diet on gastrointestinal symptoms and gut microbiota composition among IBS patients.
A multi-center study of multi-ethnic Asian patients with IBS was conducted in two phases: (i) an initial cross-sectional gut microbiota composition study of IBS patients and healthy controls, followed by (ii) a single-arm 6-week dietary interventional study of the IBS patients alone, exploring clinical and gut microbiota changes.
A total of 34 adult IBS patients (IBS sub-types of IBS-D 44.1%, IBS-C 32.4%, and IBS-M 23.5%) and 15 healthy controls were recruited. A greater abundance of Parabacteroides species with lower levels of bacterial fermenters and short-chain fatty acids producers were found among IBS patients compared with healthy controls. Age and ethnicity were found to be associated with gut microbiota composition. Following a low FODMAP dietary intervention, symptom and quality of life improvement were observed in 24 (70.6%) IBS patients. Symptom improvement was associated with adherence to the low FODMAP diet (46.7% poor adherence vs 92.9% good adherence, P = 0.014), and gut microbiota patterns, particularly with a greater abundance of Bifidobacterium longum, Anaerotignum propionicum, and Blautia species post-intervention.
Gut microbiota variation in multi-ethnic IBS patients may be related to dietary intake and may be helpful to identify patients who are likely to respond to a low FODMAP diet.
已知肠易激综合征（IBS）患者的肠道微生物群受饮食影响而变化。我们旨在：（i）分析来自多民族人群的 IBS 患者的肠道微生物群组成；（ii）探索低 FODMAP 饮食对 IBS 患者胃肠道症状和肠道微生物群组成的影响。
对多中心、多民族亚洲 IBS 患者进行了一项研究，分为两个阶段：（i）IBS 患者和健康对照者的初始横断面肠道微生物群组成研究，随后进行（ii）IBS 患者的单臂 6 周饮食干预研究，探索临床和肠道微生物群变化。
共纳入 34 例成年 IBS 患者（IBS-D 亚型占 44.1%、IBS-C 亚型占 32.4%、IBS-M 亚型占 23.5%）和 15 例健康对照者。与健康对照者相比，IBS 患者中 Parabacteroides 物种丰度增加，而细菌发酵物和短链脂肪酸产生菌丰度降低。年龄和种族与肠道微生物群组成有关。在接受低 FODMAP 饮食干预后，24 例（70.6%）IBS 患者的症状和生活质量得到改善。症状改善与对低 FODMAP 饮食的依从性相关（46.7%依从性差与 92.9%依从性好，P=0.014），肠道微生物群模式也与改善相关，特别是干预后双歧杆菌、产丙酸拟杆菌和布劳特氏菌丰度增加。
多民族 IBS 患者肠道微生物群的变化可能与饮食摄入有关，并有助于识别可能对低 FODMAP 饮食有反应的患者。
