Unraveling the role of the gut microbiota in obesity; cause or effect?

No abstract available

The Impact of ‘Crohn’s Disease-TReatment-with-EATing’ Diet (CD-TREAT Diet) and Exclusive Enteral Nutrition on Healthy Gut Bacteria Metabolism

No abstract available

Multidisciplinary Perinatal Care in IBD

BACKGROUND AND AIMS: Patients with inflammatory bowel disease [IBD] are often affected during their reproductive years and may have many perinatal queries that require the comprehensive perspectives of a multidisciplinary team [MDT]. The purpose of this topical review is to assess the scientific evidence and provide expert opinion related to nutritional, psychological, and supportive care of women and their infants throughout the prenatal, antenatal, and infant periods.METHODS: A consensus expert panel of a paediatrician, gastroenterologists, nurses, and dietitians was convened by the European Crohn's and Colitis Organisation. This panel critically reviewed literature related to the non-medical management of patients with IBD during preconception, pregnancy, the postnatal period, and the first years of the infant's life. Statements were developed using an e-Delphi process over two rounds and were confirmed when ≥80% of experts agreed with the statements.RESULTS: A total of 19 current practice positions were developed that cover the preconception period, pregnancy and lactation, and early life exposures associated with risk of IBD. Development of the infant microbiome and its role in the immune system and topics including nutritional optimization, psychological support, and education relating to early life were reviewed.CONCLUSIONS: Patients with IBD have unique nutritional and psychosocial needs that may affect fertility and pregnancy outcomes. The early life environment of infants born to parents with IBD may be associated with subsequent development of IBD in offspring. A MDT is the optimal setting to support and counsel patients throughout the perinatal period.</p

The pathophysiology of bile acid diarrhoea: differences in the colonic microbiome, metabolome and bile acids

Bile acid diarrhoea (BAD) is a common disorder resulting from increased loss of bile acids (BAs), overlapping irritable bowel syndrome with diarrhoea (IBS-D). The gut microbiota metabolises primary BAs to secondary BAs, with differing impacts on metabolism and homeostasis. The aim of this study was to profile the microbiome, metabolic products and bile acids in BAD. Patients with BAD diagnosed by SeHCAT testing, were compared with other IBS-D patients, and healthy controls. Faecal 16S ribosomal RNA gene analysis was undertaken. Faecal short chain fatty acid (SCFA) and urinary volatile organic compounds (VOCs) were measured. BAs were quantified in serum and faeces. Faecal bacterial diversity was significantly reduced in patients with BAD. Several taxa were enriched compared to IBS-D. SCFA amounts differed in BAD, controls and IBS-D, with significantly more propionate in BAD. Separation of VOC profiles was evident, but the greatest discrimination was between IBS-D and controls. Unconjugated and primary BA in serum and faeces were significantly higher in BAD. The faecal percentage primary BA was inversely related to SeHCAT. BAD produces dysbiosis, with metabolite differences, including VOC, SCFA and primary BAs when compared to IBS-D. These findings provide new mechanistic insights into the pathophysiology of BAD

AODTH-007 Dietary manipulation of the healthy human and colitic rat gut microbiome by cd-treat diet and exclusive enteral nutrition; a proof of concept study

Introduction The extensive modulation of the gut microbiome in Crohn’s disease (CD) children treated with exclusive enteral nutrition (EEN) offers clues about EEN’s potential mode of action; but also on the development of novel therapies through dietary manipulation of the gut microbiota. This proof of concept study compared the effect of a novel ‘ordinary’ food diet (CD-TREAT diet) and EEN on A)healthy human and B)colitic rat gut microbiota.Method A)Healthy adults followed two experimental diets for 7 days with a 15 day wash out period in between; EEN and CD-TREAT, an ”ordinary” food diet with similar nutrient and food ingredient composition to EEN. Faecal and urine samples were collected before and after each intervention and 16srRNA sequencing, untargeted faecal and urine metabolomics were performed; B)10-month-old HLA-B27 and HLA-B7 trangenic rats received EEN, CD-TREAT or regular rat chow for 4 weeks. Faeces were collected before, during and post treatment and gut contents/tissue at sacrifice. Disease activity was quantified by blinded histological scores. Gut bacterial metabolic activity was measured by faecal short chain fatty acids (SCFA) quantification.Results A)100 faecal and urine samples were collected from 25 healthy adults. Gut bacterial community structure significantly changed after both EEN (R2=0.15,p=0.001) and CD-TREAT (R2=0.05,p=0.003) and shifted towards the same direction. EEN’s and CD-TREAT’s impact on 3%OTU community structures was strongly correlated (R2=0.38,p&lt;2.2e-16). Untargeted faecal metabolomics also revealed a strong correlation between the EEN and CD-TREAT changes (R=0.31,p&lt;10-14); B)100 faecal samples were collected from 12 HLA-B27 and 8 HLA-B7 transgenic adult rats. Both dietary interventions increased the body weight of the HLA-B27 rats (Median%change,EEN:+9,CD-TREAT:+16,Control:-2) and decreased the weight of caecum and colon contents. Faecal concentration of total SCFA, acetic and propionate decreased while isobutyric and isocaproic increased during both diets. Histopathology scores revealed that both diets benefited moderately ileal but not colonic inflammation.Conclusion We have developed an ”EEN composition-like” food diet which induces similar gut microbiome changes with EEN. These proof of concept data support a subsequent pilot trial in patients with active CD.Disclosure of Interest None DeclaredAbstract AODTU-007 Figure

AODTH-007 Dietary manipulation of the healthy human and colitic rat gut microbiome by cd-treat diet and exclusive enteral nutrition; a proof of concept study

Introduction The extensive modulation of the gut microbiome in Crohn’s disease (CD) children treated with exclusive enteral nutrition (EEN) offers clues about EEN’s potential mode of action; but also on the development of novel therapies through dietary manipulation of the gut microbiota. This proof of concept study compared the effect of a novel ‘ordinary’ food diet (CD-TREAT diet) and EEN on A)healthy human and B)colitic rat gut microbiota.Method A)Healthy adults followed two experimental diets for 7 days with a 15 day wash out period in between; EEN and CD-TREAT, an ”ordinary” food diet with similar nutrient and food ingredient composition to EEN. Faecal and urine samples were collected before and after each intervention and 16srRNA sequencing, untargeted faecal and urine metabolomics were performed; B)10-month-old HLA-B27 and HLA-B7 trangenic rats received EEN, CD-TREAT or regular rat chow for 4 weeks. Faeces were collected before, during and post treatment and gut contents/tissue at sacrifice. Disease activity was quantified by blinded histological scores. Gut bacterial metabolic activity was measured by faecal short chain fatty acids (SCFA) quantification.Results A)100 faecal and urine samples were collected from 25 healthy adults. Gut bacterial community structure significantly changed after both EEN (R2=0.15,p=0.001) and CD-TREAT (R2=0.05,p=0.003) and shifted towards the same direction. EEN’s and CD-TREAT’s impact on 3%OTU community structures was strongly correlated (R2=0.38,p&lt;2.2e-16). Untargeted faecal metabolomics also revealed a strong correlation between the EEN and CD-TREAT changes (R=0.31,p&lt;10-14); B)100 faecal samples were collected from 12 HLA-B27 and 8 HLA-B7 transgenic adult rats. Both dietary interventions increased the body weight of the HLA-B27 rats (Median%change,EEN:+9,CD-TREAT:+16,Control:-2) and decreased the weight of caecum and colon contents. Faecal concentration of total SCFA, acetic and propionate decreased while isobutyric and isocaproic increased during both diets. Histopathology scores revealed that both diets benefited moderately ileal but not colonic inflammation.Conclusion We have developed an ”EEN composition-like” food diet which induces similar gut microbiome changes with EEN. These proof of concept data support a subsequent pilot trial in patients with active CD.Disclosure of Interest None DeclaredAbstract AODTU-007 Figure