P474. Gut microbiota in patients with inflammatory bowel disease and irritable bowel syndrome before and after 6 weeks of low FODMAP diet
N. Pedersen1,2, K. Kofod Vinding3, Z. Vegh4, C. Casen5, N. Andersen6, D. Ankersen6, K. Carlsen6, A. Munk Petersen3, J. Burisch6, P. Munkholm6, 1Herlev University Hospital, Department of Gastroenterology, Copenhagen, Denmark, 2University, Gastroenterology, Copenhagen, Denmark, 3University of Copenhagen, Gastroenterology, Hvidovre, Denmark, 4University of Copenhagen, Gastroenterlogy, Herlev, Denmark, 5Genetic Analysis AS, Genetic, Oslo, Norway, 6University of Copenhagen, Gastroenterology, Herlev, Denmark
Patients with Inflammatory Bowel Disease and Irritable Bowel Syndrome (IBD–IBS) might have altered microbiota. Approximately 60–80% of IBD patients suffer from IBS. Diet low in Fermentable Oligo-Di and Mono-saccharides and Polyols (LFD) was found to be effective in IBS patients. The aim of this study was to investigate the impact of LFD on faecal microbiota.
Fecal samples were collected from IBD–IBS patients in remission having irritable bowel symptoms (ROME III criteria) and randomized (not blinded) to a LFD or a normal (Western/Danish) diet (ND) during 6 weeks. IBS severity score (IBS-SSS) was scored by patients at week 0 and week 6 on an eHealth web-application, www.ibs.constant-care.dk. Bacterial DNA analysis was performed with the GA-map IBS Dysbiosis semi-quantitative Test (Genetic Analysis AS, Oslo, Norway). This 16S rRNA based test utilizes DNA probes designed to facilitate separation between patient groups and normal subjects based on their bacterial gut composition, the most common gut bacteria are represented. A numeric representation of the deviation, a “Dysbiosis Index” (DI), is calculated and change in DI between a baseline and a follow-up sample is also investigated in this work.
A total of 50 IBD–IBS patients (median 41 years, range 20–69), 39 (78%) females: 15 (30%) CD and 35 (70%) UC were included in the study. 24 (48%) were in LFD and 26 (52%) in ND. At baseline, 35 (70%) had dysbiosis, 10 (20%) had normal biosis and 5 (10%) had inconclusive result. At week 6, 25 (50%) had dysbiosis, 10 (20%) had normal biosis and 10 (20%) uncertain. 5 (10%) patients had missing dysbiosis data.
Overall there was no significant difference in dysbiosis index (DI) changes at baseline versus week 6 (median 8.5, range 2.5–104) vs. (median 6.0, range 1.9–121), p = 0.18. In LFD/normal diet group, 18 (75%)/17 (75%) had dysbiosis, 4 (17%)/3 (12%) had normal biosis and 2 (8%)/6 (23%) had inconclusive result at baseline. There was no significant difference in DI changes at baseline comparing to week 6 in both LFD/ND group [in median (range)] [12.6 (3.1–97.2)/7.4 (2.5–105) vs. 7.3 (1.9–121)/4.6 (2.2–105), p = 0.68/0.07]. Furthermore, no significant difference in DI in the LFD group compared to the ND group (p = 0.17) after 6 weeks treatment was observed. A significant improvement in IBS-SSS total score in all patients was observed (mean 210, range 60–454) at week 0, compared to (mean 117, range 0–368) week 6, p < 0.01.
High proportions (70%) of the IBD–IBS patients were dysbiotic at baseline and 50% at week 6. There was not found significant changes in the microbiota in IBD–IBS patients after 6 weeks in LFD group compared to ND.