Human milk oligosaccharides improve IBS symptoms

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.

Posted on 23 October, 201918 March, 2021