P847 A pilot trial on the effect of a fibre-enriched nutritional supplement on the gut microbiota of stricturing Crohn’s disease patients
C.M. Herrera De Guise1, E. Varela2, A. Ibarz1, R. Burgos3, G. Cardenas3, M. Luis Fernando1, V. Robles1, N. Borruel1, F. Guarner Aguilar1, F. Casellas1
1Hospital Universitari Vall d’Hebron, Gastroenterology, Barcelona, Spain, 2Institut de Recerca Vall d’Hebron, Gastroenterology, Barcelona, Spain, 3Unitat de Suport Nutricional, Nutrition, Barcelona, Spain
Background
Diet is a potential factor that could influence the pathogenesis and activity of Inflammatory Bowel Disease(IBD). Soluble fibre is the best way to generate short-chain fatty acids such as butyrate, which has anti-inflammatory effects. Around 1/3 of Crohn’s disease (CD) patients will present with stricturing disease, most frequently in the terminal ileum. These patients often follow a very low-residue diet. CD patients present significant changes in the structure of their microbiota with a decreased prevalence of butyrate-producing bacteria such as
Methods
We performed a single arm, pilot trial in CD patients with ileal stricturing disease who followed a very low-residue diet as assessed by a dietician. The fibre-enriched nutritional supplement (reg#26.06141/BA-72556) consisted of a 200ml vanilla-flavoured shake that included 3.4 gr of soluble fibre, omega-3 and oleic fatty acids. Patients received 2 supplements per day for 6 weeks, and were followed for 6 months. We obtained frozen faecal samples at time-points 0, 3, 6, 12 and 24 weeks. Total bacteria and
Results
Ten patients were included in the study with a median age of 38 [36–50] years, 60% were male, median BMI 25.2 [24.3–28.4] and 40% were current smokers. Six patients completed the 6 weeks of the supplement. Two patients did not receive the supplement because they underwent ileocecal resection, 1 patient was lost to follow-up and 1 patient dropped-out early because of poor palatability of the supplement. At baseline, all patients had
Conclusion
CD patients with structuring disease and who follow a very low-residue diet have a markedly reduced abundance of