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.
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