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Altered Colonic Bacterial Fermentation as a Potential Pathophysiological Factor in Irritable Bowel Syndrome
Tamar Ringel-Kulka1, Chang Hwan Choi2,3, Daniel Temas2
1Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
Irritable bowel syndrome (IBS) patients show lower colonic pH, indicating increased fermentation. Fecal short-chain fatty acids (SCFAs) are not reliable indicators of this altered intestinal fermentation in IBS.
Area of Science:
- Gastroenterology
- Microbiome research
- Human physiology
Background:
- Irritable bowel syndrome (IBS) is often linked to dysbiosis and abnormal intestinal fermentation.
- Investigating the precise location and extent of altered fermentation is crucial for understanding IBS pathophysiology.
Purpose of the Study:
- To determine the location and magnitude of altered intestinal bacterial fermentation in IBS patients.
- To compare fermentation markers between IBS subtypes and healthy controls (HC).
Main Methods:
- Wireless motility capsule (SmartPill) used to measure intraluminal pH and transit times in the small and large bowel.
- Fecal short-chain fatty acids (SCFAs) analyzed via capillary gas chromatography.
- Correlations assessed between pH, SCFAs, transit times, and IBS symptom severity.
Main Results:
- Colonic intraluminal pH was significantly lower in IBS patients (6.8) compared to HC (7.3).
- No significant pH differences were observed in the small bowel.
- Total fecal SCFA levels varied by IBS subtype but were similar to HC overall; colonic pH correlated with transit time and symptom severity.
Conclusions:
- Decreased colonic intraluminal pH in IBS suggests heightened colonic fermentation.
- Fecal SCFAs appear to be insensitive markers for assessing intraluminal bacterial fermentation in IBS.
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