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Research Project: Pediatric Clinical Nutrition

Location: Children's Nutrition Research Center

Title: Relationships of microbiome markers with extraintestinal, psychological distress and gastrointestinal symptoms, and quality of life in women with irritable bowel syndrome

item HOLLISTER, EMILY - Texas Children'S Hospital
item CAIN, KEVIN - University Of Washington
item SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC)
item JARRETT, MONICA - University Of Washington
item BURR, ROBERT - University Of Washington
item KO, CYNTHIA - University Of Washington Medical School
item ZIA, JASMINE - University Of Washington Medical School
item HAN, CLAIRE - University Of Washington
item HEITKEMPER, MARGARET - University Of Washington

Submitted to: Journal of Clinical Gastroenterology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/28/2018
Publication Date: 8/1/2018
Citation: Hollister, E.B., Cain, K.C., Shulman, R.J., Jarrett, M.E., Burr, R.L., Ko, C., Zia, J., Han, C.J., Heitkemper, M.M. 2018. Relationships of microbiome markers with extraintestinal, psychological distress and gastrointestinal symptoms, and quality of life in women with irritable bowel syndrome. Journal of Clinical Gastroenterology.

Interpretive Summary: The bacteria in the intestine are recognized increasingly as being important to health and disease. This is particularly true for people with irritable bowel syndrome, a common type of functional gastrointestinal disorder that causes abdominal pain and changes in stooling. In this study women with irritable bowel syndrome had the bacteria in their stool analyzed. The women also kept a record of pain symptoms and their quality of life was evaluated. Having fewer types of bacteria was associated with having more pain symptoms and a lower quality of life. Importantly, having a greater abundance of certain bacteria was associated with fewer symptoms and a better quality of life. These results suggest that altering the type of bacteria present in the intestine (by diet or probiotics) may be a treatment option for this often debilitating condition.

Technical Abstract: Altered microbial diversity has been associated with gastrointestinal (GI) symptoms in persons with irritable bowel syndrome (IBS). Less is known about the relationship of microbiome with extraintestinal pain and psychological distress symptoms and quality of life (QOL) in persons with IBS. We aimed to evaluate the relationship of fecal microbiota to GI symptoms, stool consistency, psychological distress, extraintestinal pain, and QOL in participants meeting Rome III criteria for IBS. Seventy-six women completed a 28-day diary that included GI, stool consistency, psychological distress, and extraintestinal pain ratings. Participants completed the IBS-Specific Quality of Life questionnaire. Stool samples were collected and analyzed by 16S rRNA gene sequencing. Principal component analysis was performed and the first 2 components (PC1, PC2) were used to test relationships among bacterial families and clinical measures. Participants were categorized as IBS constipation (n=22), IBS diarrhea (n=39), IBS mixed (n=13), and IBS unsubtyped (n=2). There was a significant group effect for the Firmicutes to Bacteroidetes ratio and PC1. Lower microbial diversity and richness were associated with increased urgency and extraintestinal pain, worse QOL, and looser stools. Lower extraintestinal pain was associated with increased Rikenellaceae, Christensenellaceae, Dehalobabacteriaceae, Oscillospiraceae, Mogibacteriaceae, Ruminococcaceae, Sutterellaceae, Desulfovibrionaceae, and Erysipelotrichaceae abundances. QOL was positively associated with many of these same bacterial families. Higher Firmicutes to Bacteroidetes ratio was positively associated with loose stools. There were no statistically significant relationships between daily psychological distress or abdominal pain and bacterial families. Stool microbial diversity and composition are linked to daily extraintestinal symptoms, stool consistency, and QOL in women with IBS.