A Comprehensive Self-Management Program With Diet Education Does Not Alter Microbiome Characteristics in Women With Irritable Bowel Syndrome

Overview

Journal Biol Res Nurs

Specialties Biology
Nursing

Date 2021 Jan 8

PMID 33412896

Citations 3

Authors

Kendra J Kamp

Anna M Plantinga

Kevin C Cain

Robert L Burr

Pamela Barney

Monica Jarrett

Ruth Ann Luna

Tor Savidge

Robert Shulman

Margaret M Heitkemper

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: Changes in diet and lifestyle factors are frequently recommended for persons with irritable bowel syndrome (IBS). It is unknown whether these recommendations alter the gut microbiome and/or whether baseline microbiome predicts improvement in symptoms and quality of life following treatment. Therefore, the purpose of this study was to explore if baseline gut microbiome composition predicted response to a Comprehensive Self-Management (CSM) intervention and if the intervention resulted in a different gut microbiome composition compared to usual care.

Methods: Individuals aged 18-70 years with IBS symptoms ≥6 months were recruited using convenience sampling. Individuals were excluded if medication use or comorbidities would influence symptoms or microbiome. Participants completed a baseline assessment and were randomized into the eight-session CSM intervention which included dietary education and cognitive behavioral therapy versus usual care. Questionnaires included demographics, quality of life, and symptom diaries. Fecal samples were collected at baseline and 3-month post-randomization for 16S rRNA-based microbiome analysis.

Results: Within the CSM intervention group (n = 30), Shannon diversity, richness, and beta diversity measures at baseline did not predict benefit from the CSM intervention at 3 months, as measured by change in abdominal pain and quality of life. Based on both alpha and beta diversity, the change from baseline to follow-up microbiome bacterial taxa did not differ between CSM (n = 25) and usual care (n = 25).

Conclusions And Inferences: Baseline microbiome does not predict symptom improvement with CSM intervention. We do not find evidence that the CSM intervention influences gut microbiome diversity or composition over the course of 3 months.

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References

Hsueh H, Jarrett M, Cain K, Burr R, Deechakawan W, Heitkemper M . Does a self-management program change dietary intake in adults with irritable bowel syndrome?. Gastroenterol Nurs. 2011; 34(2):108-16. PMC: 3091481. DOI: 10.1097/SGA.0b013e31821092e8. View

Huo R, Zeng B, Zeng L, Cheng K, Li B, Luo Y . Microbiota Modulate Anxiety-Like Behavior and Endocrine Abnormalities in Hypothalamic-Pituitary-Adrenal Axis. Front Cell Infect Microbiol. 2017; 7:489. PMC: 5715198. DOI: 10.3389/fcimb.2017.00489. View

Chong P, Chin V, Looi C, Wong W, Madhavan P, Yong V . The Microbiome and Irritable Bowel Syndrome - A Review on the Pathophysiology, Current Research and Future Therapy. Front Microbiol. 2019; 10:1136. PMC: 6579922. DOI: 10.3389/fmicb.2019.01136. View

Bijkerk C, de Wit N, Muris J, Whorwell P, Knottnerus J, Hoes A . Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial. BMJ. 2009; 339:b3154. PMC: 3272664. DOI: 10.1136/bmj.b3154. View

Lackner J, Jaccard J, Keefer L, Brenner D, Firth R, Gudleski G . Improvement in Gastrointestinal Symptoms After Cognitive Behavior Therapy for Refractory Irritable Bowel Syndrome. Gastroenterology. 2018; 155(1):47-57. PMC: 6035059. DOI: 10.1053/j.gastro.2018.03.063. View

Luna R, Oezguen N, Balderas M, Venkatachalam A, Runge J, Versalovic J . Distinct Microbiome-Neuroimmune Signatures Correlate With Functional Abdominal Pain in Children With Autism Spectrum Disorder. Cell Mol Gastroenterol Hepatol. 2017; 3(2):218-230. PMC: 5331780. DOI: 10.1016/j.jcmgh.2016.11.008. View

Allen A, Hutch W, Borre Y, Kennedy P, Temko A, Boylan G . Bifidobacterium longum 1714 as a translational psychobiotic: modulation of stress, electrophysiology and neurocognition in healthy volunteers. Transl Psychiatry. 2016; 6(11):e939. PMC: 5314114. DOI: 10.1038/tp.2016.191. View

Doshi J, Cai Q, Buono J, Spalding W, Sarocco P, Tan H . Economic burden of irritable bowel syndrome with constipation: a retrospective analysis of health care costs in a commercially insured population. J Manag Care Spec Pharm. 2014; 20(4):382-90. PMC: 10437385. DOI: 10.18553/jmcp.2014.20.4.382. View

Biesiekierski J, Jalanka J, Staudacher H . Can Gut Microbiota Composition Predict Response to Dietary Treatments?. Nutrients. 2019; 11(5). PMC: 6566829. DOI: 10.3390/nu11051134. View

10.

Vodicka M, Ergang P, Hrncir T, Mikulecka A, Kvapilova P, Vagnerova K . Microbiota affects the expression of genes involved in HPA axis regulation and local metabolism of glucocorticoids in chronic psychosocial stress. Brain Behav Immun. 2018; 73:615-624. DOI: 10.1016/j.bbi.2018.07.007. View

11.

Bennet S, Bohn L, Storsrud S, Liljebo T, Collin L, Lindfors P . Multivariate modelling of faecal bacterial profiles of patients with IBS predicts responsiveness to a diet low in FODMAPs. Gut. 2017; 67(5):872-881. DOI: 10.1136/gutjnl-2016-313128. View

12.

Jarrett M, Cain K, Barney P, Burr R, Naliboff B, Shulman R . Balance of Autonomic Nervous System Predicts Who Benefits from a Self-management Intervention Program for Irritable Bowel Syndrome. J Neurogastroenterol Motil. 2015; 22(1):102-11. PMC: 4699727. DOI: 10.5056/jnm15067. View

13.

Tillisch K, Mayer E, Gupta A, Gill Z, Brazeilles R, Le Neve B . Brain Structure and Response to Emotional Stimuli as Related to Gut Microbial Profiles in Healthy Women. Psychosom Med. 2017; 79(8):905-913. PMC: 6089374. DOI: 10.1097/PSY.0000000000000493. View

14.

Jarrett M, Cain K, Burr R, Hertig V, Rosen S, Heitkemper M . Comprehensive self-management for irritable bowel syndrome: randomized trial of in-person vs. combined in-person and telephone sessions. Am J Gastroenterol. 2009; 104(12):3004-14. PMC: 2804069. DOI: 10.1038/ajg.2009.479. View

15.

Ringstrom G, Storsrud S, Simren M . A comparison of a short nurse-based and a long multidisciplinary version of structured patient education in irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2012; 24(8):950-7. DOI: 10.1097/MEG.0b013e328354f41f. View

16.

Bonnert M, Olen O, Lalouni M, Benninga M, Bottai M, Engelbrektsson J . Internet-Delivered Cognitive Behavior Therapy for Adolescents With Irritable Bowel Syndrome: A Randomized Controlled Trial. Am J Gastroenterol. 2016; 112(1):152-162. DOI: 10.1038/ajg.2016.503. View

17.

Chumpitazi B, Cope J, Hollister E, Tsai C, McMeans A, Luna R . Randomised clinical trial: gut microbiome biomarkers are associated with clinical response to a low FODMAP diet in children with the irritable bowel syndrome. Aliment Pharmacol Ther. 2015; 42(4):418-27. PMC: 4514898. DOI: 10.1111/apt.13286. View

18.

Wang L, Alammar N, Singh R, Nanavati J, Song Y, Chaudhary R . Gut Microbial Dysbiosis in the Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Case-Control Studies. J Acad Nutr Diet. 2019; 120(4):565-586. DOI: 10.1016/j.jand.2019.05.015. View

19.

Schnorr S, Bachner H . Integrative Therapies in Anxiety Treatment with Special Emphasis on the Gut Microbiome. Yale J Biol Med. 2016; 89(3):397-422. PMC: 5045149. View

20.

Simpson C, Mu A, Haslam N, Schwartz O, Simmons J . Feeling down? A systematic review of the gut microbiota in anxiety/depression and irritable bowel syndrome. J Affect Disord. 2020; 266:429-446. DOI: 10.1016/j.jad.2020.01.124. View