Fiber and Prebiotic Interventions in Pediatric Inflammatory Bowel Disease: What Role Does the Gut Microbiome Play?

Abstract

The etiology of inflammatory bowel disease (IBD) is complex but is thought to be linked to an intricate interaction between the host’s immune system, resident gut microbiome and environment, i.e., diet. One dietary component that has a major impact on IBD risk and disease management is fiber. Fiber intakes in pediatric IBD patients are suboptimal and often lower than in children without IBD. Fiber also has a significant impact on beneficially shaping gut microbiota composition and functional capacity. The impact is likely to be particularly important in IBD patients, where various studies have demonstrated that an imbalance in the gut microbiome, referred to as dysbiosis, occurs. Microbiome-targeted therapeutics, such as fiber and prebiotics, have the potential to restore the balance in the gut microbiome and enhance host gut health and clinical outcomes. Indeed, studies in adult IBD patients demonstrate that fiber and prebiotics positively alter the microbiome and improve disease course. To date, no studies have been conducted to evaluate the therapeutic potential of fiber and prebiotics in pediatric IBD patients. Consequently, pediatric IBD specific studies that focus on the benefits of fiber and prebiotics on gut microbiome composition and functional capacity and disease outcomes are required.

A Comparative Study on the Ameliorative Effects of Aqueous Extract of Two Varieties of Hibiscus on the Intestinal Epithelial Barrier in Bowel Inflammation

“…Prebiotics has been previously proved to ameliorate intestinal inflammation. In vitro and in vivo studies provided using prebiotics as a therapy for IBD via their anti-inflammatory activities (Valcheva et al, 2015, Healey, 2020, Le et al 2020. The role of prebiotic fibers in reducing intestinal inflammation is associated with the stimulation of the growth of gut probiotics.…”

Variations on gut health and energy metabolism in pigs and humans by intake of different dietary fibers

“…and a decrease populations of total anaerobes or Clostridia in the feces were observed when the pigs were fed diets containing 0.5% fructo-oligosaccharide in combination with Bifidobacterium longum (Clarke et al, 2017). Small intestine is mainly responsible for food digestion and absorption, while large intestine is important for microbial fermentation of substances (Healey et al, 2020). Hindgut of pigs and humans contain a larger proportion of Firmicutes than small intestine, indicating that large intestine might undertake a crucial role in microbial fermentation of dietary fiber (Flint et al, 2008).…”

“…Greater populations of Escherichia-Shigella and Streptococcus are always considered as pathogenic bacteria related to host infection and enteric diseases, such as diarrhea symptoms. Thus, occurrences of enteropathies are primarily associated with microbial composition in the upper gut (Healey et al, 2020).…”

An Inulin-Type Fructan Enriched Exclusive Enteral Nutrition Formula Suppresses Colitis Through Gut Microbiome Modulation and Promoting Expansion of Anti-Inflammatory T Cell Subsets

“…Previous studies have demonstrated that prebiotics and fiber beneficially modulate the gut microbiome and reduce inflammation in IBD [19][20][21] . Inulin-type fructans (IN) appear to be particularly promising in enhancing clinical outcomes in adult IBD patients, suppressing inflammation as well as modulating the composition and function of the gut microbiome 22,23 .…”