Subtypes and Severity of Irritable Bowel Syndrome Are Not Related to Patients’ Self-Reported Dietary Triggers: Results From an Online Survey in Dutch Adults

Rijnaarts, Iris; Witteman, Ben J.M.; Zoetendal, Erwin G.; Govers, Coen; Wit, Nicole de; Roos, N.M. de

doi:10.1016/j.jand.2021.01.007

Cited by 10 publications

(14 citation statements)

References 41 publications

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“…Associations between fatty meal consumption and IBS symptoms have also been identified in a number of studies. In fact, in many IBS patients, the symptoms were triggered after the consumption of greasy or fried food [ 45 , 46 ]. Dietary fat is also linked to an increased risk for developing IBD [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Dietary fat induced chylomicron-mediated LPS translocation in a bicameral Caco-2cell model

et al. 2023

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Background There is increasing evidence that dietary fat, especially saturated fat, promotes the translocation of lipopolysaccharide (LPS) via chylomicron production in the gut. Chylomicrons can subsequently transport LPS to other parts of the body, where they can induce low-grade chronic inflammation that is linked to various metabolic and gut-related diseases. To identify promising (food) compounds that can prevent or ameliorate LPS-related low-grade inflammation, we developed and optimized a bicameral in vitro model for dietary fat-induced LPS translocation that closely mimics the in vivo situation and facilitates high-throughput screening. Methods Caco-2 cells were cultured in monolayers and differentiated to a small intestinal phenotype in 21 days. Thereafter, optimal conditions for fat-induced chylomicron production were determined by apical exposure of Caco-2 cells to a dilution range of in vitro digested palm oil and sunflower oil, optionally preceded by a 1-week apical FBS deprivation (cultured without apical fetal bovine serum). Chylomicron production was assessed by measuring basolateral levels of the chylomicron-related marker apolipoprotein B. Next, LPS was coincubated at various concentrations with the digested oils, and fat-induced LPS translocation to the basolateral side was assessed. Results We found that dietary fat-induced LPS translocation in Caco-2 cells was optimal after apical exposure to digested oils at a 1:50 dilution in combination with 750 ng/mL LPS, preceded by 1 week of apical FBS deprivation. Coincubation with the chylomicron blocker Pluronic L81 confirmed that fat-induced LPS translocation is mediated via chylomicron production in this Caco-2 cell model. Conclusion We developed a robust Caco-2 cell model for dietary fat-induced LPS translocation that can be used for high-throughput screening of (food) compounds that can reduce LPS-related low-grade inflammation.

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Section: Discussionmentioning

confidence: 99%

Dietary fat induced chylomicron-mediated LPS translocation in a bicameral Caco-2cell model

et al. 2023

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“…The prevalence of self-reported wheat sensitivity has been reported at approximately 10% globally [12]. Wheat appears to be a key trigger for symptoms in patients with IBS, reported at between 23 and 49% of individuals [5,[13][14][15].…”

Section: Gluten-free Dietmentioning

confidence: 99%

Diet and irritable bowel syndrome: an update from a UK consensus meeting

Rej

Avery

Aziz

et al. 2022

BMC Med

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There has been a renewed interest in the role of dietary therapies to manage irritable bowel syndrome (IBS), with diet high on the agenda for patients. Currently, interest has focussed on the use of traditional dietary advice (TDA), a gluten-free diet (GFD) and the low FODMAP diet (LFD). A consensus meeting was held to assess the role of these dietary therapies in IBS, in Sheffield, United Kingdom.Evidence for TDA is from case control studies and clinical experience. Randomised controlled trials (RCT) have demonstrated the benefit of soluble fibre in IBS. No studies have assessed TDA in comparison to a habitual or sham diet. There have been a number of RCTs demonstrating the efficacy of a GFD at short-term follow-up, with a lack of long-term outcomes. Whilst gluten may lead to symptom generation in IBS, other components of wheat may also play an important role, with recent interest in the role of fructans, wheat germ agglutinins, as well as alpha amylase trypsin inhibitors. There is good evidence for the use of a LFD at short-term follow-up, with emerging evidence demonstrating its efficacy at long-term follow-up. There is overlap between the LFD and GFD with IBS patients self-initiating gluten or wheat reduction as part of their LFD. Currently, there is a lack of evidence to suggest superiority of one diet over another, although TDA is more acceptable to patients.In view of this evidence, our consensus group recommends that dietary therapies for IBS should be offered by dietitians who first assess dietary triggers and then tailor the intervention according to patient choice. Given the lack of dietetic services, novel approaches such as employing group clinics and online webinars may maximise capacity and accessibility for patients. Further research is also required to assess the comparative efficacy of dietary therapies to other management strategies available to manage IBS.

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“…In addition, there seems to be a significant overlap between NCG/WS, IBS, and functional dyspepsia ( 37 , 38 ). It has previously been demonstrated that a large proportion of individuals with IBS have sensitivity to wheat, reported at between 23% and 49% ( 1 , 39 , 40 ). A key distinguishing feature between both IBS and NCGW/S is that individuals with NCG/WS tend to identify gluten as a trigger and self-report symptoms after the consumption of gluten.…”

Section: Nonceliac Gluten/wheat Sensitivitymentioning

confidence: 99%

Evidence-Based and Emerging Diet Recommendations for Small Bowel Disorders

et al. 2022

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Diet plays a key role in the manifestation and severity of gastrointestinal symptoms, with increasing research interest on the role of diet in small bowel disorders. There are predominantly 3 small bowel conditions that have potential dietary interventions. Self-reported nonceliac gluten/wheat sensitivity is prevalent. Although gluten is believed to be a potential trigger for symptoms, other components of wheat may also be triggers, including fructans, alpha-amylase trypsin inhibitors, and wheat germ agglutinins. The diagnosis can be challenging, given the lack of validated biomarkers. A gluten-free diet that excludes the abovementioned triggers is the cornerstone of treatment; however, unlike celiac disease, there is uncertainty about the level of adherence or whether the gluten-free diet is a lifelong intervention. Several primary gastrointestinal disorders are associated with an increase in inflammatory cells including eosinophils. Diet seems to be an important driver of disease pathogenesis in eosinophilic gastroenteritis, with elimination and elemental diets showing promise in management, with further robust trials required. Small intestinal bacterial overgrowth is an example of microbial dysbiosis, with renewed interest in diet being postulated to cause an adaptive change of the microbes colonizing the small intestine. However, the diagnosis of small intestinal bacterial overgrowth is limited by a lack of sensitive and specific tests, with significant knowledge gaps in relation to therapeutic measures to manage and cure small intestinal bacterial overgrowth. Currently, antimicrobials are the established management option. There have been significant clinical advances in dietary interventions related to the small bowel, but this area is currently a novel and advancing field for both patients and clinicians.

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Subtypes and Severity of Irritable Bowel Syndrome Are Not Related to Patients’ Self-Reported Dietary Triggers: Results From an Online Survey in Dutch Adults

Cited by 10 publications

References 41 publications

Dietary fat induced chylomicron-mediated LPS translocation in a bicameral Caco-2cell model

Dietary fat induced chylomicron-mediated LPS translocation in a bicameral Caco-2cell model

Diet and irritable bowel syndrome: an update from a UK consensus meeting

Evidence-Based and Emerging Diet Recommendations for Small Bowel Disorders

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