Multivariate modelling of faecal bacterial profiles of patients with IBS predicts responsiveness to a diet low in FODMAPs

• Published in: Gut Vol. 67; no. 5; pp. 872 - 881
• Main Authors: Bennet, Sean M P, Böhn, Lena, Störsrud, Stine, Liljebo, Therese, Collin, Lena, Lindfors, Perjohan, Törnblom, Hans, Öhman, Lena, Simrén, Magnus
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.05.2018
• Subjects: Bacteria; Bacterial infections; Diet; Disaccharides; Dysbacteriosis; Food intake; Gastroenterologi; Gastroenterology; Gastroenterology and Hepatology; Intervention; Irritable bowel syndrome; Lactose; Medicin och hälsovetenskap; Microbiology in the medical area; Microbiomes; Microbiota; Mikrobiologi inom det medicinska området; Monosaccharides; Multivariate analysis; Nutrient deficiency; Oligosaccharides; Polyols; Translational Medicine TRIM; Translationell medicin TRIM; Sweden; DIET; IRRITABLE BOWEL SYNDROME; INTESTINAL BACTERIA
• ISSN: 0017-5749; 1468-3288; 1468-3288
• DOI: 10.1136/gutjnl-2016-313128

ObjectiveThe effects of dietary interventions on gut bacteria are ambiguous. Following a previous intervention study, we aimed to determine how differing diets impact gut bacteria and if bacterial profiles predict intervention response.DesignSixty-seven patients with IBS were randomised to traditional IBS (n=34) or low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) (n=33) diets for 4 weeks. Food intake was recorded for 4 days during screening and intervention. Faecal samples and IBS Symptom Severity Score (IBS-SSS) reports were collected before (baseline) and after intervention. A faecal microbiota dysbiosis test (GA-map Dysbiosis Test) evaluated bacterial composition. Per protocol analysis was performed on 61 patients from whom microbiome data were available.ResultsResponders (reduced IBS-SSS by ≥50) to low FODMAP, but not traditional, dietary intervention were discriminated from non-responders before and after intervention based on faecal bacterial profiles. Bacterial abundance tended to be higher in non-responders to a low FODMAP diet compared with responders before and after intervention. A low FODMAP intervention was associated with an increase in Dysbiosis Index (DI) scores in 42% of patients; while decreased DI scores were recorded in 33% of patients following a traditional IBS diet. Non-responders to a low FODMAP diet, but not a traditional IBS diet had higher DI scores than responders at baseline. Finally, while a traditional IBS diet was not associated with significant reduction of investigated bacteria, a low FODMAP diet was associated with reduced Bifidobacterium and Actinobacteria in patients, correlating with lactose consumption.ConclusionsA low FODMAP, but not a traditional IBS diet may have significant impact on faecal bacteria. Responsiveness to a low FODMAP diet intervention may be predicted by faecal bacterial profiles.Trial registration numberNCT02107625.