Human Milk Oligosaccharides May Help Ease Irritable Bowel Syndrome Symptoms

Research has shown that the gut microbiota of patients with irritable bowel syndrome (IBS) lack a healthy abundance of bifidobacteria. Human milk oligosaccharides (HMOs) may help boost bifidobacteria and may also have a beneficial impact on gut motility and visceral pain, according to a new multi-center, open-label trial in patients with IBS.

In results presented at the American College of Gastroenterology’s Annual Scientific Meeting (ACG 2019) in San Antonio, Texas, investigators report the ability of HMOs to support normal bowel habits and improve other symptoms of IBS.

The research team recruited 317 subjects from 17 sites across the United States (70.7% females; mean age 44.0 years, range 18-93 years). Participants had received a physician diagnosis of IBS plus displayed Rome IV criteria. The study product comprised 5 grams of the HMOs 2’fucosyllactose (2’FL) and lacto-N-neotetraose (LNnT), which were administered in a 4:1 mix daily by mouth for 12 weeks. Investigators logged bowel habits, IBS symptoms, and quality of life at baseline and every 4 weeks during the study period.

Of the 317 subjects who received the HMOs, 136 reported constipation predominant at baseline, 85 with diarrhea predominant, 95 with mixed, and 1 with unspecified IBS.

A total of 245 subjects were included in the intent-to-treat analyses. From baseline to 12 weeks, all participants demonstrated a significant reduction in total percentage of abnormal bowel movements (Bristol Stool Form Scale types 1, 2, 6, or 7), overall IBS Symptom Severity Score, abdominal pain and bloating severity, and an improvement in health-related quality of life.

In an interview with MD Magazine® on the floor at ACG 2019, presenting author Magnus Simrén, MD, PhD, professor of gastroenterology at University of Gothenburg in Sweden, and adjunct professor at the University of North Carolina, Chapel Hill, explained the significance of the findings.

Symptom improvement mostly occurred in the first 4 weeks of treatment, and predictors of improvement in stool consistency and abdominal pain severity included younger age.

The study product was generally well-tolerated, with mild adverse events, including abdominal discomfort, distension, and flatulence, reported.

“Our findings suggest that oral supplementation with 2’FL and LNnT can provide nutritional support that significantly reduces abnormal stool consistency, abdominal pain and bloating, and improves health-related quality of life in IBS sufferers of all subtypes,” the research team concluded.

Investigators hope to proceed with a randomized controlled trial in the future.

The study, Human Milk Oligosaccharides Improve All the Central Symptoms of Irritable Bowel Syndrome: A Multi-Center, Open Label Trial, was presented Tuesday, October 29, 2019, at the American College of Gastroenterology Annual Scientific Meeting (ACG 2019) in San Antonio, Texas.