title: 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.
authors.affiliation: Department of Pediatrics; Baylor College of Medicine; Houston, TX USA; Section of Pediatric Gastroenterology, Hepatology, and Nutrition; Texas Children's Hospital; Houston, TX USA.
authors.forename: Bruno P
authors.initials: BP
authors.lastname: Chumpitazi
authors.affiliation: Department of Pathology and Immunology; Baylor College of Medicine; Houston, TX USA; Texas Children's Microbiome Center; Department of Pathology; Texas Children's Hospital; Houston, TX USA.
authors.forename: Emily B
authors.initials: EB
authors.lastname: Hollister
authors.affiliation: Department of Pathology and Immunology; Baylor College of Medicine; Houston, TX USA; Texas Children's Microbiome Center; Department of Pathology; Texas Children's Hospital; Houston, TX USA.
authors.forename: Numan
authors.initials: N
authors.lastname: Oezguen
authors.affiliation: Department of Pediatrics; Baylor College of Medicine; Houston, TX USA; Section of Pediatric Gastroenterology, Hepatology, and Nutrition; Texas Children's Hospital; Houston, TX USA.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Tsai
authors.affiliation: Children's Nutrition Research Center; Houston, TX USA.
authors.forename: Ann R
authors.initials: AR
authors.lastname: McMeans
authors.affiliation: Department of Pathology and Immunology; Baylor College of Medicine; Houston, TX USA; Texas Children's Microbiome Center; Department of Pathology; Texas Children's Hospital; Houston, TX USA.
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Luna
authors.affiliation: Department of Pathology and Immunology; Baylor College of Medicine; Houston, TX USA; Texas Children's Microbiome Center; Department of Pathology; Texas Children's Hospital; Houston, TX USA.
authors.forename: Tor C
authors.initials: TC
authors.lastname: Savidge
authors.affiliation: Department of Pediatrics; Baylor College of Medicine; Houston, TX USA; Department of Pathology and Immunology; Baylor College of Medicine; Houston, TX USA; Texas Children's Microbiome Center; Department of Pathology; Texas Children's Hospital; Houston, TX USA.
authors.forename: James
authors.initials: J
authors.lastname: Versalovic
authors.affiliation: Department of Pediatrics; Baylor College of Medicine; Houston, TX USA; Section of Pediatric Gastroenterology, Hepatology, and Nutrition; Texas Children's Hospital; Houston, TX USA; Children's Nutrition Research Center; Houston, TX USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Shulman
mesh_terms: D015746:Abdominal Pain / Q000178:diet therapy / Q000382:microbiology; D000293:Adolescent; D002648:Child; D004032:Diet; D005243:Feces / Q000382:microbiology; D005260:Female; D005285:Fermentation; D041981:Gastrointestinal Tract / Q000382:microbiology*; D006801:Humans; D006859:Hydrogen / Q000378:metabolism; D043183:Irritable Bowel Syndrome / Q000178:diet therapy* / Q000382:microbiology*; D008297:Male; D008697:Methane / Q000378:metabolism; D010865:Pilot Projects
chemical_list: D006859:Hydrogen; D008697:Methane
keywords: FODMAPs; abdominal pain; irritable bowel syndrome; metabolites; microbiome; pediatric