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Abnormal fibre usage in UC in remission.

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Colonic fermentation of fiber and starch is reduced in ulcerative colitis (UC) patients, even in remission. Increasing resistant starch and wheat bran intake did not correct this diminished fermentation, suggesting a role for gut microbiota dysfunction.

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Area of Science:

  • Gastroenterology
  • Microbiome research
  • Dietary science

Background:

  • Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
  • Gut microbiota and fermentation play crucial roles in digestive health.
  • Understanding fermentation in UC patients is important for management.

Purpose of the Study:

  • To compare colonic fermentation in UC patients in remission with healthy controls.
  • To investigate the effects of increased dietary fiber and resistant starch intake on fermentation in both groups.
  • To assess whole gut transit time (WGTT) and microbiota composition.

Main Methods:

  • A randomized, single-blind, cross-over study involving UC patients and healthy controls.
  • Assessment of fiber intake, fecal non-starch polysaccharide (NSP) and starch excretion, fermentation products, and WGTT.
  • Dietary intervention involved increasing intake of wheat bran (WB) and resistant starch (RS).

Main Results:

  • UC patients showed higher fecal NSP and starch concentrations despite lower habitual fiber intake.
  • Increased RS/WB intake normalized gut transit in UC patients but did not enhance NSP fermentation.
  • UC patients had lower Akkermansia muciniphila and altered Clostridium cluster XIVa diversity compared to controls.

Conclusions:

  • Gut fermentation of NSP and starch is diminished in UC patients.
  • This diminished fermentation is not explained by abnormal gut transit.
  • Abnormal gut microbiota functioning may underlie the impaired fermentation in UC.