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Thématique :
- Colo-proctologie
Originalité :
Très original
Solidité :
Intermédiaire
Doit faire évoluer notre pratique :
Pas encore
 
 
Nom du veilleur :
Professeur Frank ZERBIB
Coup de coeur :
 
 
Gut
  2018/05  
 
  2018 May;67(5):872-881.  
  doi: 10.1136/gutjnl-2016-313128.  
 
  Multivariate modelling of faecal bacterial profiles of patients with IBS predicts responsiveness to a diet low in FODMAPs.  
 
  Bennet SMP, Böhn L, Störsrud S, Liljebo T, Collin L, Lindfors P, Törnblom H, Öhman L, Simrén M  
  https://www.ncbi.nlm.nih.gov/pubmed/28416515  
 
 

Abstract

OBJECTIVE:

The effects of dietary interventions on gut bacteria are ambiguous. Following a previous intervention study, we aimed to determine how differing diets impact gut bacteria and if bacterial profiles predict intervention response.

DESIGN:

Sixty-seven patients with IBS were randomised to traditional IBS (n=34) or low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) (n=33) diets for 4 weeks. Food intake was recorded for 4 days during screening and intervention. Faecal samples and IBS Symptom Severity Score (IBS-SSS) reports were collected before (baseline) and after intervention. A faecal microbiota dysbiosis test (GA-map Dysbiosis Test) evaluated bacterial composition. Per protocol analysis was performed on 61 patients from whom microbiome data were available.

RESULTS:

Responders (reduced IBS-SSS by ≥50) to low FODMAP, but not traditional, dietary intervention were discriminated from non-responders before and after intervention based on faecal bacterial profiles. Bacterial abundance tended to be higher in non-responders to a low FODMAP diet compared with responders before and after intervention. A low FODMAP intervention was associated with an increase in Dysbiosis Index (DI) scores in 42% of patients; while decreased DI scores were recorded in 33% of patients following a traditional IBS diet. Non-responders to a low FODMAP diet, but not a traditional IBS diet had higher DI scores than responders at baseline. Finally, while a traditional IBS diet was not associated with significant reduction of investigated bacteria, a low FODMAP diet was associated with reduced Bifidobacterium and Actinobacteria in patients, correlating with lactose consumption.

CONCLUSIONS:

A low FODMAP, but not a traditional IBS diet may have significant impact on faecal bacteria. Responsiveness to a low FODMAP diet intervention may be predicted by faecal bacterial profiles.

TRIAL REGISTRATION NUMBER:

NCT02107625.

 

 
Question posée
 
Quelles sont les relations entre microbiote fécal et régime alimentaire dans le syndrome de l’intestin irritable ?
 
Question posée
 
La réponse à un régime pauvre en FODMAPS (mais pas à un régime « classique ») pourrait dépendre de la composition du microbiote fécal. 4 semaines de régime pauvre en FODMAPS induisent une dysbiose significative.
 
Commentaires

Cette étude est originale et apporte des arguments scientifiques à ce que les cliniciens suspectent depuis longtemps, à savoir les interactions microbiote - « régime FODMAPS ». Ces résultats méritent d’être confirmés mais à l’avenir il serait possible de proposer des régimes en fonction du microbiote des patients SII. Ces résultats nous alertent aussi sur l’impact de ces régimes dont les conséquences à long terme ne sont pas connues.

 
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