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Human milk oligosaccharides improve IBS symptoms

Presented by
Dr Olafur Palsson, Chapel Hill, North Carolina, USA
Conference
UEGW 2019
Compounds that are structurally identical to human milk oligosaccharides (HMOs) can significantly improve irritable bowel syndrome (IBS) symptoms within 4 weeks.

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.

  1. Palsson O et al. UEG Week 2019, Abstract OP201.




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