Dr Olafur Palsson (Chapel Hill, North Carolina, USA) presented the 12-week trial, which recruited 317 subjects from 17 sites across the United States (70.7% females; mean age 44.0 years, range 18-93 years) [1]. Participants all had a diagnosis of IBS with Rome IV criteria. Study participants orally consumed 5 g of a 4:1 powder mix of 2’fucosyllactose (2’FL) and lacto-N-neotetraose (LNnT) daily for 12 weeks. Primary outcomes were patient-logged bowel habits, IBS symptoms, and quality of life at baseline followed by every 4 weeks during the study period.
Of the 317 subjects who received the HMOs, 136 reported constipation at baseline, 85 with diarrhoea, 95 with mixed constipation/diarrhoea, and 1 with unspecified IBS. From baseline to 12 weeks, all 245 participants in the intention-to-treat analyses demonstrated a significant reduction in total percentage of abnormal bowel movements (Bristol Stool Form Scale types 1, 2, 6, or 7; 89.8% [95% CI 88.1–91.5] vs 54.9% [95% CI 51.4–58.4]). Furthermore, the secondary outcomes of the IBS-Symptom Severity Score (mean 327 vs 128), abdominal pain severity (mean 62.5 vs 25.4), bloating severity (mean 56.8 vs 23.2), and improvement in health-related quality of life (mean IBS-QoL scores 50.4 vs 74.6) were also all improved. Within 4 weeks, 77% of subjects reported significant improvement in symptom severity. At 12 weeks, 87% saw a clinically significant reduction in symptom severity, specifically:
- 59% reduction in abdominal pain severity;
- 59% decreased bloating;
- 58% reduced days with abdominal pain; and
- 37% decreased number of abnormal stools.
The authors concluded that the findings in this new study support the value of microbiota-directed therapies, such as the inclusion of prebiotic HMOs in IBS dietary planning, although randomised controlled trials are still needed.
- Palsson O et al. UEG Week 2019, Abstract OP201.
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Table of Contents: UEGW 2019
Featured articles
Interview with UEG President Prof. Paul Fockens
Upper GI Disorders
Locally active corticosteroid promising in eosinophilic oesophagitis
First-in-human radiofrequency vapor ablation in Barrett’s oesophagus
Irritable Bowel Syndrome
Faecal microbiota transplantation is effective for irritable bowel syndrome
Human milk oligosaccharides improve IBS symptoms
Inflammatory Bowel Disease
Ustekinumab is safe and effective in ulcerative colitis: 2-year data
Decreased microvilli length in CD patients
Phase 2 data shows benefit for mirikizumab in CD patients
Subcutaneous ustekinumab as maintenance therapy in UC
First evidence of long-term efficacy of ABX464 in ulcerative colitis
New treatment may reverse coeliac disease
IBD prevalence 3 times higher than estimated and expected to rise
Microbiome and Microbiota
Early stages of gastric metaplasia: molecular profiling
Plant-based foods and Mediterranean diet associated with healthy gut microbiome
Antibiotic resistance in H. pylori has doubled over last 20 years
Pancreatitis
New model predicts recurrence of acute biliary pancreatitis
Hepatology
Restrictive strategy for cholecystectomy selection does not reduce pain, but does reduce surgery
β-blockers may halt cirrhosis progression: PREDESCI trial
Obeticholic acid prevents liver fibrosis from NASH
Oncology
Metal stents are better than plastic for endoscopic biliary drainage
Ramosetron relieves low anterior resection syndrome
Immunonutrition during neoadjuvant oesophagogastric cancer therapy: no benefit
Endoscopy
EUS-guided histological specimens from the pancreatic cyst wall
Digital single-operator cholangioscopy more sensitive than endoscopic retrograde cholangiopancreatography
New single-use duodenoscope well-liked by endoscopists
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