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.
BACKGROUND AND AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
背景与目的: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。 方法: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。 结果: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。 结论: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。
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