title: Abnormal fibre usage in UC in remission.
abstract: OBJECTIVE
  Colonic fermentation in patients with UC in remission was compared with that in matched healthy subjects on habitual diets and when dietary fibre was increased.
  
  
  METHODS
  Fibre intake, faecal output of fibre (measured as non-starch polysaccharide (NSP)), starch, microbiota and fermentation products, and whole gut transit time (WGTT) were assessed in association with habitual diet and when dietary intake of wheat bran (WB)-associated fibre and high amylose-associated resistant starch (RS) was increased in an 8-week, randomised, single-blind, cross-over study.
  
  
  RESULTS
  Despite a tendency to lower habitual fibre intake in UC patients, faecal NSP and starch concentrations were threefold higher than in controls, whereas concentrations of phenols and short-chain fatty acids, pH and WGTT were similar. Increasing RS/WB intake was well tolerated. In controls (n=10), it more than doubled faecal NSP and starch excretion (p=0.002 for both), had no effect on NSP usage and reduced WGTT (p=0.024). In UC patients (n=19), high intake of RS/WB tended to normalise gut transit, but did not increase the proportion of NSP fermented. Increasing intake of RS/WB had little effect on faecal fermentation patterns or the structure of the microbiota. However, faeces from the UC cohort had lower proportions of Akkermansia muciniphila and increased diversity within Clostridium cluster XIVa compared to controls.
  
  
  CONCLUSIONS
  Gut fermentation of NSP and starch is diminished in patients with UC. This cannot be explained by abnormal gut transit and was not corrected by increasing RS/WB intake, and may be due to abnormal functioning of the gut microbiota.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry: ACTRN12614000271606.
authors.affiliation: Eastern Health Clinical School, Monash University, Box Hill Hospital, Box Hill, Victoria, Australia.
authors.forename: Sally L
authors.initials: SL
authors.lastname: James
authors.affiliation: Commonwealth Scientific & Industrial Research Organisation (CSIRO) Food Futures Flagship and CSIRO Animal, Food and Health Sciences, Adelaide, Australia.
authors.forename: Claus T
authors.initials: CT
authors.lastname: Christophersen
authors.affiliation: Commonwealth Scientific & Industrial Research Organisation (CSIRO) Food Futures Flagship and CSIRO Animal, Food and Health Sciences, Adelaide, Australia.
authors.forename: Anthony R
authors.initials: AR
authors.lastname: Bird
authors.affiliation: Commonwealth Scientific & Industrial Research Organisation (CSIRO) Food Futures Flagship and CSIRO Animal, Food and Health Sciences, Adelaide, Australia.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Conlon
authors.affiliation: Eastern Health Clinical School, Monash University, Box Hill Hospital, Box Hill, Victoria, Australia Department of Gastroenterology, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
authors.forename: Ourania
authors.initials: O
authors.lastname: Rosella
authors.affiliation: Eastern Health Clinical School, Monash University, Box Hill Hospital, Box Hill, Victoria, Australia Department of Gastroenterology, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Gibson
authors.affiliation: Eastern Health Clinical School, Monash University, Box Hill Hospital, Box Hill, Victoria, Australia Department of Gastroenterology, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
authors.forename: Jane G
authors.initials: JG
authors.lastname: Muir
mesh_terms: D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000378:metabolism*; D018592:Cross-Over Studies; D004043:Dietary Fiber / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides / Q000378:metabolism; D012074:Remission Induction; D016037:Single-Blind Method; D013213:Starch / Q000378:metabolism
chemical_list: D004043:Dietary Fiber; D011134:Polysaccharides; D013213:Starch
keywords: Chronic Ulcerative Colitis; Colonic Microflora; Diet; Dietary Fibre; Intestinal Bacteria