Dietary fibre blend improves gut health in patients with Irritable Bowel Syndrome following a low FODMAP diet: a randomised, double-blind control trial

<title>Abstract</title> <p> Purpose: A diet low in FODMAP negatively affects the gut microbiota of Irritable Bowel Syndrome (IBS) patients, despite alleviation of symptoms. This study examines whether ur gut®, a mix of dietary fibres, when given to patients with stable symptoms on an existing low FODMAP diet, can improve gut microbiota, mental health, sleep and quality of life (QOL) in IBS patients without symptom exacerbation. Methods: Adult participants (n = 26, 3 males) completed a randomised, double-blind controlled study. Participants were provided with either ur gut® (n = 13) or placebo (n = 13) for 3 weeks after a 1-week baseline. At baseline and end of intervention, blood, 24-h faecal samples and 3-day weighed-food diaries were collected. Validated questionnaires were used to evaluate mental health, sleep, QOL and gut symptoms. Participants reported daily IBS symptoms and wore a wrist-based actigraphy to capture daily sleep. Results: During the intervention, both groups maintained baseline stable gut symptoms and sleep patterns. After the intervention, the ur gut® group had lower energy (P &lt; 0.05) and protein (P &lt; 0.01) intake compared to the placebo group, and increased resistant starch intake (P &lt; 0.001) compared to baseline. Changes in overall genus-level gut microbiota composition (P &lt; 0.01), including <italic>Ruminococcus E</italic> (5.5-fold increase, P &lt; 0.01), were observed. ur gut® improved GI-specific anxiety (P = 0.01) and sexual subscale of QOL (P = 0.018). Conclusion: A specific mix of fibres can increase fibre intake, improve gut microbiota and gastrointestinal-specific anxiety without impacting sleep and symptoms of IBS patients on a low FODMAP diet as compared with placebo, despite no changes found in faecal and blood biomarkers. This provides a dietary avenue to improve gut health with no exacerbation of symptoms in IBS patients. </p>