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Lenhart A, Dong T, Joshi S, et al. Effect of Exclusion Diets on Symptom Severity and the Gut Microbiota in Patients With Irritable Bowel Syndrome. Clin Gastroenterol Hepatol. 2021;doi: 10.1016/j.cgh.2021.05.027.
Lenhart, A., Dong, T., Joshi, S., Jaffe, N., Choo, C., Liu, C., Jacobs, J. P., Lagishetty, V., Shih, W., Labus, J. S., Gupta, A., Tillisch, K., Mayer, E. A., & Chang, L. (2021). Effect of Exclusion Diets on Symptom Severity and the Gut Microbiota in Patients With Irritable Bowel Syndrome. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, . https://doi.org/10.1016/j.cgh.2021.05.027
Lenhart, Adrienne, et al. "Effect of Exclusion Diets on Symptom Severity and the Gut Microbiota in Patients With Irritable Bowel Syndrome." Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association vol. (2021). doi: https://doi.org/10.1016/j.cgh.2021.05.027
Lenhart A, Dong T, Joshi S, Jaffe N, Choo C, Liu C, Jacobs JP, Lagishetty V, Shih W, Labus JS, Gupta A, Tillisch K, Mayer EA, Chang L. Effect of Exclusion Diets on Symptom Severity and the Gut Microbiota in Patients With Irritable Bowel Syndrome. Clin Gastroenterol Hepatol. 2021 May 20; doi: 10.1016/j.cgh.2021.05.027. Epub 2021 May 20. PMID: 34022450.
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Clin Gastroenterol Hepatol. 2021 May 20; doi: 10.1016/j.cgh.2021.05.027. Epub 2021 May 20.

Effect of Exclusion Diets on Symptom Severity and the Gut Microbiota in Patients With Irritable Bowel Syndrome.

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

Adrienne Lenhart, Tien Dong, Swapna Joshi, Nancee Jaffe, Charlene Choo, Cathy Liu, Jonathan P Jacobs, Venu Lagishetty, Wendy Shih, Jennifer S Labus, Arpana Gupta, Kirsten Tillisch, Emeran A Mayer, Lin Chang

Affiliations

  1. Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, California.
  2. Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, California; G Oppenheimer Center for Neurobiology of Stress and Resilience, Los Angeles, California.
  3. David Geffen School of Medicine, University of California, Los Angeles, California.
  4. Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, California; Division of Gastroenterology, Hepatology and Parenteral Nutrition, Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, California.
  5. Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California.
  6. Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, California; G Oppenheimer Center for Neurobiology of Stress and Resilience, Los Angeles, California. Electronic address: [email protected].

PMID: 34022450 DOI: 10.1016/j.cgh.2021.05.027

Abstract

BACKGROUND & AIMS: Altered fecal microbiota have been reported in irritable bowel syndrome (IBS), although studies vary, which could be owing to dietary effects. Many IBS patients may eliminate certain foods because of their symptoms, which in turn may alter fecal microbiota diversity and composition. This study aimed to determine if dietary patterns were associated with IBS, symptoms, and fecal microbiota differences reported in IBS.

METHODS: A total of 346 IBS participants and 170 healthy controls (HCs) completed a Diet Checklist reflecting the diet(s) consumed most frequently. An exclusion diet was defined as a diet that eliminated food components by choice. Within this group, a gluten-free, dairy-free, or low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet was further defined as restrictive because they often are implicated in reducing symptoms. Stool samples were obtained from 171 IBS patients and 98 HCs for 16S ribosomal RNA gene sequencing and microbial composition analysis.

RESULTS: Having IBS symptoms was associated with consuming a restrictive diet (27.17% of IBS patients vs 7.65% of HCs; odds ratio, 3.25; 95% CI, 1.66-6.75; P value = .006). IBS participants on an exclusion or restrictive diet reported more severe IBS symptoms (P = .042 and .029, respectively). The composition of the microbiota in IBS patients varied depending on the diet consumed. IBS participants on an exclusion diet had a greater abundance of Lachnospira and a lower abundance of Eubacterium (q value, <.05), and those on a restrictive diet had a lower abundance of Lactobacillus (q value, <.05).

CONCLUSIONS: Restrictive diets likely are consumed more by IBS patients than HCs to reduce GI symptom severity. Dietary patterns influence the composition of the fecal microbiota and may explain some of the differences between IBS and HCs.

Copyright © 2021 by the AGA Institute. Published by Elsevier Inc. Published by Elsevier Inc. All rights reserved.

Keywords: Diet; Fecal Microbiome; Irritable Bowel Syndrome

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