A low intake of Fermentable, Oligo-, Di-, Mono-saccharides and Polyols (FODMAPs) is effective in the symptom control of irritable bowel syndrome (IBS) patients but may exert negative effects on the intestinal microbiota. The microbial effects of increasing regular or non-FODMAP fibre sources are largely unknown. Furthermore, it is not known if the baseline microbiota composition is associated with individual symptom control during the consumption of different rye products in IBS patients. Our objective was to evaluate whether increased consumption of low-FODMAP rye bread or regular rye bread for 4 weeks would alter the intestinal microbiota composition of IBS patients following their habitual diet, and whether these changes associate to symptoms and/or the baseline microbiota. The study was conducted as a randomized double blind controlled cross-over study (n = 50). Microbiota was analysed by 16S rRNA gene sequencing and associated with gastrointestinal symptoms. Both microbial changes and their associations to symptoms were secondary outcomes. The consumption of the test breads did not alter microbiota diversity. Compared to baseline, consumption of the low FODMAP rye bread decreased the abundance of Bacteroides, Flavonifractor, Holdemania, Parasutterella and Klebsiella and showed a trend towards increased bifidobacteria, whereas the regular rye bread decreased the abundance of Flavonifractor. When comparing between the two test breads, Klebsiella was decreased after low-FODMAP rye bread intake. Patients whose symptoms decreased during the low-FODMAP rye bread displayed more Blautia and less Barnesiella at baseline. Consumption of low-FODMAP rye bread had modest, potentially beneficial effects on patients’ microbiota while increasing their intake of fibre substantially. The baseline microbiota composition was associated with the variable degrees of symptom relief experienced by the patients. Consumption of a low-FODMAP rye bread might be one way to increase dietary fibre intake and improve the mild dysbiosis often observed among patients with IBS. ClinicalTrials.gov: NCT02161120 . Retrospectively registered 11 June 2014.

中文翻译：

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随机临床试验：低 FODMAP 黑麦面包与普通黑麦面包对肠易激综合征患者肠道菌群的影响：与个体症状变异的关联

少量摄入可发酵、寡糖、二糖、单糖和多元醇 (FODMAP) 可有效控制肠易激综合征 (IBS) 患者的症状，但可能对肠道微生物群产生负面影响。增加常规或非 FODMAP 纤维来源的微生物效应在很大程度上是未知的。此外，尚不清楚在 IBS 患者食用不同黑麦产品期间，基线微生物群组成是否与个体症状控制相关。我们的目标是评估 4 周内增加低 FODMAP 黑麦面包或普通黑麦面包的食用量是否会改变 IBS 患者在习惯性饮食后的肠道微生物群组成，以及这些变化是否与症状和/或基线微生物群有关。该研究是作为一项随机双盲对照交叉研究（n = 50）进行的。通过 16S rRNA 基因测序分析微生物群并与胃肠道症状相关。微生物变化及其与症状的关联都是次要结果。食用测试面包并没有改变微生物群的多样性。与基线相比，食用低 FODMAP 黑麦面包减少了拟杆菌属、黄酮素、霍尔曼菌属、副杆菌属和克雷伯氏菌的丰度，并呈现出双歧杆菌增加的趋势，而普通黑麦面包降低了黄酮素的丰度。在比较两种测试面包时，在摄入低 FODMAP 黑麦面包后，克雷伯氏菌减少了。在低 FODMAP 黑麦面包期间症状减轻的患者在基线时表现出更多的 Blautia 和更少的 Barnesiella。食用低 FODMAP 黑麦面包对患者的微生物群有适度的潜在有益影响，同时大大增加了他们的纤维摄入量。基线微生物群组成与患者经历的不同程度的症状缓解相关。食用低 FODMAP 黑麦面包可能是增加膳食纤维摄入量和改善 IBS 患者经常观察到的轻度生态失调的一种方法。ClinicalTrials.gov：NCT02161120。追溯登记于 2014 年 6 月 11 日。食用低 FODMAP 黑麦面包可能是增加膳食纤维摄入量和改善 IBS 患者经常观察到的轻度生态失调的一种方法。ClinicalTrials.gov：NCT02161120。追溯登记于 2014 年 6 月 11 日。食用低 FODMAP 黑麦面包可能是增加膳食纤维摄入量和改善 IBS 患者经常观察到的轻度生态失调的一种方法。ClinicalTrials.gov：NCT02161120。追溯登记于 2014 年 6 月 11 日。