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Abnormal colonic fermentation in irritable bowel syndrome
1Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, UK.
Lancet (London, England)
|October 20, 1998
Summary
Irritable bowel syndrome (IBS) patients exhibit increased colonic gas production, especially hydrogen. An exclusion diet significantly reduced IBS symptoms and gas excretion, suggesting fermentation plays a key role in IBS.
Area of Science:
- Gastroenterology
- Microbiology
- Human Physiology
Background:
- The etiology of Irritable Bowel Syndrome (IBS) remains largely unknown.
- Potential contributing factors include post-infectious changes, altered gut microbiota, and food intolerances.
- This study investigated the association between these factors and colonic malfermentation in IBS patients.
Purpose of the Study:
- To assess colonic malfermentation in female IBS patients compared to healthy controls.
- To evaluate the impact of a standard diet versus an exclusion diet on IBS symptoms and gas production.
- To explore the role of fermentation in the pathogenesis of IBS.
Main Methods:
- A crossover controlled trial involving six female IBS patients and six female controls.
- Participants followed both a standard diet and a macronutrient-matched exclusion diet.
- Faecal and breath gas (hydrogen, methane) excretion were measured, along with lactulose challenge tests.
Main Results:
- IBS patients demonstrated a significantly higher maximum rate of gas excretion compared to controls.
- While total gas production was similar, IBS patients showed elevated hydrogen production.
- An exclusion diet led to reduced IBS symptoms and decreased gas excretion, with lower breath hydrogen post-lactulose.
Conclusions:
- Colonic gas production, particularly hydrogen, is elevated in IBS patients.
- Dietary exclusion reduces both IBS symptoms and colonic gas production.
- These findings suggest that colonic fermentation is a significant factor in IBS pathogenesis, potentially linked to hydrogen-consuming bacteria activity.