Article ; Online: Detection of changes in regional colonic fermentation in response to supplementing a low FODMAP diet with dietary fibres by hydrogen concentrations, but not by luminal pH.
Alimentary pharmacology & therapeutics
2023 Volume 58, Issue 4, Page(s) 417–428
Abstract: Background: Carbohydrate fermentation plays a pivotal role in maintaining colonic health with excessive proximal and deficient distal fermentation being detrimental.: Aims: To utilise telemetric gas- and pH-sensing capsule technologies for defining ... ...
| Abstract | Background: Carbohydrate fermentation plays a pivotal role in maintaining colonic health with excessive proximal and deficient distal fermentation being detrimental. Aims: To utilise telemetric gas- and pH-sensing capsule technologies for defining patterns of regional fermentation following dietary manipulations, alongside conventional techniques of measuring fermentation. Methods: In a double-blind crossover trial, 20 patients with irritable bowel syndrome were fed low FODMAP diets that included no extra fibre (total fibre content 24 g/day), or additional poorly fermented fibre, alone (33 g/day) or with fermentable fibre (45 g/day) for 2 weeks. Plasma and faecal biochemistry, luminal profiles defined by tandem gas- and pH-sensing capsules, and faecal microbiota were assessed. Results: Plasma short-chain fatty acid (SCFA) concentrations (μmol/L) were median (IQR) 121 (100-222) with fibre combination compared with 66 (44-120) with poorly fermented fibre alone (p = 0.028) and 74 (55-125) control (p = 0.069), but no differences in faecal content were observed. Luminal hydrogen concentrations (%), but not pH, were higher in distal colon (mean 4.9 [95% CI: 2.2-7.5]) with fibre combination compared with 1.8 (0.8-2.8) with poorly fermented fibre alone (p = 0.003) and 1.9 (0.7-3.1) control (p = 0.003). Relative abundances of saccharolytic fermentative bacteria were generally higher in association with supplementation with the fibre combination. Conclusions: A modest increase in fermentable plus poorly fermented fibres had minor effects on faecal measures of fermentation, despite increases in plasma SCFA and abundance of fermentative bacteria, but the gas-sensing capsule, not pH-sensing capsule, detected the anticipated propagation of fermentation distally in the colon. The gas-sensing capsule technology provides unique insights into localisation of colonic fermentation. Trial registration: ACTRN12619000691145. |
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| MeSH term(s) | Humans ; Hydrogen/analysis ; Fermentation ; FODMAP Diet ; Colon/metabolism ; Dietary Fiber/metabolism ; Fatty Acids, Volatile ; Feces/microbiology ; Diet |
| Chemical Substances | Hydrogen (7YNJ3PO35Z) ; Dietary Fiber ; Fatty Acids, Volatile |
| Language | English |
| Publishing date | 2023-06-30 |
| Publishing country | England |
| Document type | Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 639012-2 |
| ISSN | 1365-2036 ; 0269-2813 ; 0953-0673 |
| ISSN (online) | 1365-2036 |
| ISSN | 0269-2813 ; 0953-0673 |
| DOI | 10.1111/apt.17629 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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