Irritable Bowel Syndrome (IBS) is a complex and confusing disorder. If the pain and discomfort are universally present in people who suffer from it, the symptoms, by their diversity and intensity, are expressed individually and make each patient a unique case. Without any universal treatment, patients often go through a period of wandering and therapeutic groping.
Because in IBS what relieves Pierre can sometimes be ineffective for Jacques and we better understands the urge of these patients to test different therapeutic approaches, even if it is difficult to predict which one may work. In this respect, in the existing therapeutic arsenal, dietary approaches such as a diet low in FODMAPs or probiotics intake are effective in the IBS treatment, but the response to these treatments varies from patient to patient.
What if there was a simple way to predict the response of each IBS patient to this or that dietary approach? This is what a UK study has just concluded, conducted by Prof. Kevin Whelan, on 93 IBS patients separated into two groups.1
For 4 weeks, one group was on a diet low in FODMAPs and the other on a placebo diet. In addition to this real or imaginary diet, a subgroup of patients in each group received a probiotic (Vivomixx) or placebo.
At the end of these 4 weeks, the analysis on the fecal samples by gas chromatography made it possible to identify a specific VOC profile (volatile organic compounds), correlated with the patients’ response to the FODMAPs diet and the probiotics.
The VOC analysis is about to revolutionize the diagnostic approach, as done by this Israeli team of researchers who has recently identified the volatile imprint of 17 diseases, based on the study of 1400 patients. For the IBS patients, this method could improve management care allowing to identify quickly, for each patient, the most suitable therapeutic approach. If a diet low in FODMAPs has real benefits for some IBS patients, it also causes a bifidobacteria depletion in the intestinal flora that must be compensated by probiotic intake, as confirmed by another study of Pr. Whelan, recently published in Gastroenterology.2
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1. Volatile Organic Compounds in Feces Associate With Response to Dietary Intervention in Patients With Irritable Bowel Syndrome – Megan Rossi, Raphael Aggio, Heidi M. Staudacher, Miranda C. Lomer, James O. Lindsay, Peter Irving, Chris Probert and Kevin Whelan https://doi.org/10.1016/j.cgh.2017.09.055
2. A Diet Low in FODMAPs Reduces Symptoms in Patients With Irritable Bowel Syndrome and A Probiotic Restores Bifidobacterium Species: A Randomized Controlled Trial Heidi Maria Staudacher, Miranda C. E. Lomer, Freda M. Farquharson, Petra Louis, Francesca Fava, Elena Franciosi, Matthias Scholz, Kieran M. Tuohy, James O. Lindsay, Peter M. Irving, and Kevin Whelan https://doi.org/10.1053/j.gastro.2017.06.010
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