| Title: |
Gut Microbiome Composition and Function, Diet and Clinical Factors in Relation to Fermentable Carbohydrate-Induced Bloating: A Double-Blind, Randomized, Crossover Trial |
| Authors: |
Farsi, Dominic N; Cotillard, Aurélie; Wilson, Bridgette; So, Daniel; Gibson, Philippa S; Slater, Rachael; Probert, Chris; Morris, Samantha; Scott, S. Mark; Quinquis, Laurent; Pichaud, Matthieu; Shetty, Sudarshan; Tap, Julien; Le Nevé, Boris; Rossi, Megan; Whelan, Kevin |
| Source: |
American Journal of Gastroenterology ; ISSN 0002-9270 1572-0241 |
| Publisher Information: |
Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: |
2026 |
| Description: |
Background: Specific foods are associated with abdominal bloating, which can significantly impact quality of life. Objective: To identify responders to fiber-induced bloating and the mechanisms underpinning clinical and microbial responses. Design: Double-blind, placebo-controlled, randomized, 2-period, 2-challenge crossover trial in 41 individuals with functional bloating. Participants were randomized to 8 g/d of fructan or α-galacto-oligosaccharides (α-GOS) for 7 days with a 21-day washout. Clinical, nutritional, microbial (shotgun sequencing, metatranscriptomics) and fermentation (short-chain fatty acids, volatile organic compounds, breath hydrogen) profiles were characterized prior to each challenge to identify factors predicting response, and after the challenge to elucidate mechanisms underpinning food-induced bloating. Results: Thirty-nine participants completed both challenges (39 fructan, 40 α-GOS). Overall, seven (7/39, 17.9%) participants were fructan responders and eight (8/40, 20%) were α-GOS responders (experienced fiber-related symptom induction). Clinical metrics indicative of bloating distinguished responders and non-responders to both challenges, including greater abdominal girth (fructan, p = 0.009; α-GOS, p = 0.030). α-GOS responders had higher breath hydrogen (H 2 ) pre-challenge than α-GOS non-responders (p = 0.011). Trends were identified within metagenomic and metatranscriptomic gut microbial analyses, with higher carbohydrate active enzyme (CAZyme) diversity in fructan responders (pre-challenge, adjusted p-value (padj) = 0.024; post-challenge, padj = 0.042), and greater increase in gene expression for gamma-aminobutyric acid (GABA) degradation in α-GOS responders (padj = 0.041). Conclusion: A higher burden of GI symptoms predicts clinical response to fermentable fibers in functional bloating, while for α-GOS, higher repeated fasting breath H 2 is also a predictor. Gut microbiome function and fermentation is associated with functional bloating; however, further investigations are required ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.14309/ajg.0000000000003997 |
| Availability: |
https://doi.org/10.14309/ajg.0000000000003997; https://journals.lww.com/10.14309/ajg.0000000000003997 |
| Rights: |
http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.6D7DF3CF |
| Database: |
BASE |