Texas Children’s researchers have embarked on a five-year crossover dietary intervention study that could determine why certain children with Irritable Bowel Syndrome (IBS) develop symptoms when eating wheat.
IBS is a common gastrointestinal (GI) disorder that can develop in children at any age. Since IBS patients have extremely sensitive digestive tracts, they may experience frequent abdominal pain, bloating, flatulence and changes in bowel habits that include diarrhea and/or constipation.
A group of sugars called FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols) are known to exacerbate IBS symptoms. Since these sugars are poorly digested in the small intestine, trillions of bacteria in the colon ferment the sugars, which can produce excessive gas in IBS sufferers. One of these hard-to-digest sugars is fructans.
In collaboration with researchers at Baylor College of Medicine and funding from the National Institutes of Health (NIH), Texas Children’s Gastroenterologist Dr. Bruno Chumpitazi and his team are conducting a double-blind, randomized, placebo-controlled study to examine the effects of fructans – a natural sugar found in wheat – in 80 children with IBS.
“Certain IBS children experience unpleasant GI symptoms when challenged with fructans,” said Chumpitazi, director of Texas Children’s Neurogastroenterology and Motility program. “We hypothesize these symptoms are due to the composition of bacteria in their gut, or gut microbiome, and what these bacteria do with the fructans.”
All 80 children will receive the same low FODMAP diet with varying drinks prepared by the Children’s Nutrition Research Center at Baylor. Based on randomization, one drink will contain fructans while the other will contain maltodextrin, a starch that our bodies can easily absorb without the help of gut bacteria.
“The children will consume the assigned diet over a period of 72 hours,” said Chumpitazi. “They will return to their normal diet for at least seven days before starting the low FODMAP diet with a different drink combination.”
With the help of Texas Children’s Microbiome Center led by Dr. James Versalovic and the Texas Children’s Center for Pediatric Abdominal Pain Research led by Dr. Robert J. Shulman, researchers will track the children’s symptoms daily and collect stool samples before and after the dietary interventions to monitor changes in their gut microbiome’s bacterial composition and bacterial byproducts. The byproducts produced by the bacteria will also be measured through breath testing.
The objective of the NIH-funded study is to identify whether bacteria in the gut and/or other factors are responsible for IBS symptoms in patients when fructans are consumed.
“If we understand why IBS children in the trial respond differently to the fructan challenge, it could help scientists develop targeted therapies to enhance the quality of life for patients with this GI disorder,” said Chumpitazi.
Other Baylor College of Medicine scientists collaborating in this study include Dr. Joe Petrosino and Dr. Aleksander Milosavljevic.