Randomised clinical trial: gut microbiome biomarkers are associated with clinical response to a low FODMAP diet in children with the irritable bowel syndrome
Open accessAbstract
BACKGROUND: A low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet can ameliorate symptoms in adult irritable bowel syndrome (IBS) within 48 h. AIM: To determine the efficacy of a low FODMAP diet in childhood IBS and whether gut microbial composition and/or metabolic capacity are associated with its efficacy. METHODS: In a double-blind, crossover trial, children with Rome III IBS completed a 1-week baseline period. They then were randomised to a low FODMAP diet or typical American childhood diet (TACD), followed by a 5-day washout period before crossing over to the other diet. GI symptoms were assessed with abdominal pain frequency being the primary outcome. Baseline gut microbial composition (16S rRNA sequencing) and metabolic capacity (PICRUSt) were determined. Metagenomic biomarker discovery (LEfSe) compared Responders (≥50% decrease in abdominal pain frequency on low FODMAP diet only) vs. Nonresponders (no improvement during either intervention). RESULTS: Thirty-three children completed the study. Less abdominal pain occurred during the low FODMAP diet vs. TACD [1.1 ± 0.2 (SEM) episodes/day vs. 1.7 ± 0.4, P < 0.05]. Compared to baseline (1.4 ± 0.2), children had fewer daily abdominal pain episodes during the low FODMAP diet (P < 0.01) but more episodes during the TACD (P < 0.01). Responders were enriched at baseline in taxa with known greater saccharolytic metabolic capacity (e.g. Bacteroides, Ruminococcaceae, Faecalibacterium prausnitzii) and three Kyoto Encyclopedia of Genes and Genomes orthologues, of which two relate to carbohydrate metabolism. CONCLUSIONS: In childhood IBS, a low FODMAP diet decreases abdominal pain frequency. Gut microbiome biomarkers may be associated with low FODMAP diet efficacy. ClinicalTrials.gov identifier: NCT01339117.
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Fecal microbial community composition might predict which children with IBS are more likely to respond to a low-FODMAP diet; in two studies, responders had distinct baseline microbiome signatures compared to non-responders.
“Fecal microbial community composition also might be used to predict which children with IBS are more likely to respond to a low-FODMAP diet: in two separate studies, responders had distinct baseline microbiome signatures compared to non-responders131, 132.”
From The gut Microbiome in adult and pediatric functional gastrointestinal disorders (2019) · cites this paper as [132]
Which microbial enzymatic repertoire is required for a dietary intervention to be successful depends on the nutrients present in the study diet.
“Which microbial enzymatic repertoire is required for a dietary intervention to be successful depends on the nutrients present in the study diet (70,494,510).”
From Diet and the Microbiota–Gut–Brain Axis: Sowing the Seeds of Good Mental Health (2021) · cites this paper as [494]
Turicibacter species was reported previously in pediatric patients with IBS who failed to respond to a low FODMAP diet.
“In addition, Turicibacter species was associated with abdominal pain in the ASD-FGID cohort and was reported previously in pediatric patients with IBS who failed to respond to a low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet.55”
From Distinct Microbiome-Neuroimmune Signatures Correlate With Functional Abdominal Pain in Children With Autism Spectrum Disorder (2017) · cites this paper as [55]
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- Authors
- Chumpitazi, B. P., Cope, J. L., Hollister, E. B., Tsai, C. M., McMeans, A. R., Luna, R. A., Versalovic, J., & Shulman, R. J.
- Affiliations
- Baylor College of Medicine (US)
- Children's Nutrition Research Center at Baylor College of Medicine (US)
- Corresponding author
- Chumpitazi, B. P.
- Venue
- Alimentary Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2015-06-24
- Volume
- 42
- Issue
- 4
- Pages
- 418-427
- ISSN
- 0269-2813 (ISSN-L)
- 1365-2036
- PMC
- PMC4514898
- OpenAlex
- W1709638636
- Cited by
- 436
- References
- 55
- Citations by year
- 2026: 28 · 2025: 30 · 2024: 24 · 2023: 29 · 2022: 38 · 2021: 34 · 2020: 91 · 2019: 38 · 2018: 41 · 2017: 39 · 2016: 33 · 2015: 11
- FWCI
- 42.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Alimentary Pharmacology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (K23 DK101688, P30 DK56338, UG3 DK083990)
- National Institute of Nursing Research (R01 NR05337)
- NASPGHAN Foundation (N/A)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Keywords
- irritable bowel syndrome, low FODMAP diet, gut microbiota, biomarkers, abdominal pain, carbohydrate metabolism, Faecalibacterium prausnitzii, Bacteroides, Ruminococcaceae
- MeSH terms
- Gastrointestinal Microbiome, Adolescent, Child, Disaccharides, Double-Blind Method, Female, Fermentation, Humans, Male, Monosaccharides, Oligosaccharides, Polymers, RNA, Ribosomal, 16S, Biomarkers, Abdominal Pain, Cross-Over Studies, Irritable Bowel Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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