Low FODMAP diet can decrease abdominal pain in children with IBS

Previous research has shown that adults with irritable bowel syndrome (IBS) who adopt a low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet show an improvement in symptoms within 2 days. Would the low FODMAP diet have the same effect in childhood IBS? Does the gut microbiota predict the success of the diet in children who respond to this dietary intervention?

33 children with IBS participated in this study. Gut microbial composition and metabolic capacity were assessed at baseline, and then the children were randomised to either a low FODMAP diet or a typical American childhood diet (TACD) for 48 hours. Foods in each dietary condition were prepared and delivered to the children’s homes. They completed a 5-day washout period and then adopted the other diet.

Results showed that the children overall had less abdominal pain during the low FODMAP diet than the TACD. Compared with baseline (i.e. their habitual diets), children had more abdominal pain episodes during the TACD condition and fewer episodes during the low FODMAP diet condition.

Those who had at least a 50% decrease in abdominal pain frequency on the low FODMAP diet were classified as ‘responders’ and those who showed no improvement during either intervention were ‘nonresponders’. Metagenomic biomarker discovery (LEfSe) showed that the responders, at baseline, were enriched in bacterial taxa with greater saccharolytic metabolic capacity (e.g. Bacteroides, Ruminococcaceae, Faecalibacterium prausnitzii), as well as bacteria related to carbohydrate metabolism.

This research shows that a low FODMAP diet can be an effective intervention for decreasing abdominal pain in childhood IBS. Gut microbial biomarkers at baseline may predict children’s response to the intervention.

Reference:

Chumpitazi BP, et al. (2015) Randomised clinical trial: gut microbiome biomarkers are associated with clinical response to a low FODMAP diet in children with the irritable bowel syndrome. Alimentary Pharmacology & Therapeutics DOI: 10.1111/apt.13286

James Versalovic
James Versalovic
Dr. James Versalovic received his M.D. with Honors at Baylor College of Medicine (BCM) in 1995 and his Ph.D. in Cellular and Molecular Biology at BCM in 1994. He pursued clinical pathology/medical microbiology residency training at the Massachusetts General Hospital and Harvard Medical School. He also received postdoctoral research training in the Division of Comparative Medicine at the Massachusetts Institute of Technology (MIT). Dr. Versalovic joined the medical staff as a clinical pathologist at the Massachusetts General Hospital and served as Assistant Professor of Pathology at Harvard Medical School from 1999-2001. He is board-certified in clinical pathology, molecular genetic pathology, and molecular diagnostics. Dr. Versalovic currently serves as Pathologist-In-Chief, Head of the Department of Pathology, and as member of the Board of Directors at Texas Children’s Hospital. He also serves as Vice Chair of Molecular Pathology and Omics at BCM, and Director of the Texas Children’s Microbiome Center. He holds the Milton J. Finegold endowed chair as Professor of Pathology & Immunology, and Professor of Pediatrics, Molecular and Human Genetics, and Molecular Virology & Microbiology at Baylor College of Medicine. He is Co-Director of the Medical Scientist (MD/PhD) Training Program at Baylor. He served as Editor-in-Chief of the Manual of Clinical Microbiology and Editor of Therapeutic Microbiology: Probiotics and Related Strategies. As a Principal Investigator, his primary research interests include the human microbiome, probiotics, medical and molecular microbiology, innate immunity, digestive diseases, and gastrointestinal physiology. His research program has been supported by the U.S. National Institutes of Health, Department of Defense, and Crohn’s and Colitis Foundation of America. Dr. Versalovic has authored 131 primary manuscripts, 34 book chapters, and 2 patents. He received the Lansky Award as a national leader in pathology under the age of 45 from the College of American Pathologists Foundation. He also received the BioGaia Ivan Casas Probiotics Research Award and the BCM Graduate School of Biomedical Sciences Distinguished Alumnus Award.