Temple stay diet and its impact on gut microbiome and irritable bowel syndrome: a prospective cohort study

Background/Aims: Irritable Bowel Syndrome (IBS) significantly impacts quality of life, with effective treatment challenged by its multifactorial pathogenesis. A temple stay program incorporating a vegetarian diet may benefit IBS by modulating the gut microbiota. Methods: In this prospective cohort study, 61 patients with diarrhea-predominant IBS (IBS-D) or mixed bowel habit IBS (IBS-M) participated in a 4 day temple stay program following a 1 week washout period. IBS symptom severity, psychological stress, and fecal microbiota composition were assessed before, immediately after, and two weeks post-intervention using the IBS Severity Scoring System (IBS-SSS) and 16S rRNA gene sequencing. Results: A subset of participants demonstrated improvements in IBS symptom severity, particularly those who exhibited marked compositional shifts in their gut microbiota, as defined by beta-diversity (weighted UniFrac distance). These microbiome responders tended to show increased levels of beneficial bacteria such as Faecalibacterium and reduced levels of opportunistic taxa including Klebsiella and Enterococcus. A significant correlation was observed between the degree of microbiota change and improvement in IBS-SSS scores. Responders also differed from non-responders in baseline gut microbiota features, including lower alpha diversity and reduced abundance of commensal genera. Conclusions: The temple stay program may provide clinical and microbial benefits in a subset of individuals with IBS, particularly those with baseline gut dysbiosis. These findings support the potential role of personalized, microbiome-informed dietary interventions in managing IBS.