Denis Guyonnet

Consumption of Fermented Milk Product With Probiotic Modulates Brain Activity

BACKGROUND & AIMSnChanges in gut microbiota have been reported to alter signaling mechanisms, emotional behavior, and visceral nociceptive reflexes in rodents. However, alteration of the intestinal microbiota with antibiotics or probiotics has not been shown to produce these changes in humans. We investigated whether consumption of a fermented milk product with probiotic (FMPP) for 4 weeks by healthy women altered brain intrinsic connectivity or responses to emotional attention tasks.nnnMETHODSnHealthy women with no gastrointestinal or psychiatric symptoms were randomly assigned to groups given FMPP (n = 12), a nonfermented milk product (n = 11, controls), or no intervention (n = 13) twice daily for 4 weeks. The FMPP contained Bifidobacterium animalis subsp Lactis, Streptococcus thermophiles, Lactobacillus bulgaricus, and Lactococcus lactis subsp Lactis. Participants underwent functional magnetic resonance imaging before and after the intervention to measure brain response to an emotional faces attention task and resting brain activity. Multivariate and region of interest analyses were performed.nnnRESULTSnFMPP intake was associated with reduced task-related response of a distributed functional network (49% cross-block covariance; P = .004) containing affective, viscerosensory, and somatosensory cortices. Alterations in intrinsic activity of resting brain indicated that ingestion of FMPP was associated with changes in midbrain connectivity, which could explain the observed differences in activity during the task.nnnCONCLUSIONSnFour-week intake of an FMPP by healthy women affected activity of brain regions that control central processing of emotion and sensation.

Clinical trial: the effects of a fermented milk product containing Bifidobacterium lactis DN‐173 010 on abdominal distension and gastrointestinal transit in irritable bowel syndrome with constipation

Backgroundu2002 A sensation of abdominal swelling (bloating) and actual increase in girth (distension) are troublesome features of irritable bowel syndrome (IBS), which is more common in patients with constipation, especially those with delayed transit.

Anal gas evacuation and colonic microbiota in patients with flatulence: effect of diet

Objective To characterise the influence of diet on abdominal symptoms, anal gas evacuation, intestinal gas distribution and colonic microbiota in patients complaining of flatulence. Design Patients complaining of flatulence (n=30) and healthy subjects (n=20) were instructed to follow their usual diet for 3u2005days (basal phase) and to consume a high-flatulogenic diet for another 3u2005days (challenge phase). Results During basal phase, patients recorded more abdominal symptoms than healthy subjects in daily questionnaires (5.8±0.3 vs 0.4±0.2 mean discomfort/pain score, respectively; p=<0.0001) and more gas evacuations by an event marker (21.9±2.8 vs 7.4±1.0 daytime evacuations, respectively; p=0.0001), without differences in the volume of gas evacuated after a standard meal (262±22 and 265±25u2005mL, respectively). On flatulogenic diet, both groups recorded more abdominal symptoms (7.9±0.3 and 2.8±0.4 discomfort/pain, respectively), number of gas evacuations (44.4±5.3 and 21.7±2.9 daytime evacuations, respectively) and had more gas production (656±52 and 673±78u2005mL, respectively; p<0.05 vs basal diet for all). When challenged with flatulogenic diet, patients’ microbiota developed instability in composition, exhibiting variations in the main phyla and reduction of microbial diversity, whereas healthy subjects’ microbiota were stable. Taxa from Bacteroides fragilis or Bilophila wadsworthia correlated with number of gas evacuations or volume of gas evacuated, respectively. Conclusions Patients complaining of flatulence have a poor tolerance of intestinal gas, which is associated with instability of the microbial ecosystem.

Anal gas evacuation and colonic microbiota in patients with flatulence

Objective To characterise the influence of diet on abdominal symptoms, anal gas evacuation, intestinal gas distribution and colonic microbiota in patients complaining of flatulence. Design Patients complaining of flatulence (n=30) and healthy subjects (n=20) were instructed to follow their usual diet for 3u2005days (basal phase) and to consume a high-flatulogenic diet for another 3u2005days (challenge phase). Results During basal phase, patients recorded more abdominal symptoms than healthy subjects in daily questionnaires (5.8±0.3 vs 0.4±0.2 mean discomfort/pain score, respectively; p=<0.0001) and more gas evacuations by an event marker (21.9±2.8 vs 7.4±1.0 daytime evacuations, respectively; p=0.0001), without differences in the volume of gas evacuated after a standard meal (262±22 and 265±25u2005mL, respectively). On flatulogenic diet, both groups recorded more abdominal symptoms (7.9±0.3 and 2.8±0.4 discomfort/pain, respectively), number of gas evacuations (44.4±5.3 and 21.7±2.9 daytime evacuations, respectively) and had more gas production (656±52 and 673±78u2005mL, respectively; p<0.05 vs basal diet for all). When challenged with flatulogenic diet, patients’ microbiota developed instability in composition, exhibiting variations in the main phyla and reduction of microbial diversity, whereas healthy subjects’ microbiota were stable. Taxa from Bacteroides fragilis or Bilophila wadsworthia correlated with number of gas evacuations or volume of gas evacuated, respectively. Conclusions Patients complaining of flatulence have a poor tolerance of intestinal gas, which is associated with instability of the microbial ecosystem.

Effect of a low‐flatulogenic diet in patients with flatulence and functional digestive symptoms

Diets rich in fermentable residues increase intestinal gas production. Our aim was to demonstrate the potential effects of diet on gas‐related symptoms.

Dietary patterns, digestive symptoms and health-related quality of life in women reporting minor digestive symptoms

OBJECTIVEnDigestive symptoms are reported to result from a wide range of dietary components. Dietary pattern analysis is a useful method when considering the entire diet, rather than individual foods or nutrients, providing an opportunity to take interactions into account. The aim of the present study was to investigate, using a dietary pattern approach, the relationship between diet, digestive symptoms, and health-related quality of life (HRQoL) in women reporting minor digestive symptoms.nnnMETHODSnAnalysis was performed on dietary and digestive symptoms data collected in France. Women (Nxa0=xa0308, ages 18-60xa0y) reporting a bowel movement frequency within the normal range (3-21 stools/wk) but with minor digestive symptoms in the previous month were studied. Dietary data was collected using three 24-h recalls. K-means was used to divide the dietary data into clusters. The frequency of digestive symptoms (abdominal discomfort or pain, bloating, flatulence, borborygmi) and bowel movements were evaluated over a 2-wk period. HRQoL was also assessed.nnnRESULTSnFour dietary clusters were identified and characterized as unhealthy, balance, healthy, and convenience. No differences were found in the frequency of digestive symptoms according to dietary cluster, except for flatulence (Pxa0=xa00.030), which was more prevalent in the unhealthy and convenience clusters. No significant differences were observed in HRQoL according to dietary clusters.nnnCONCLUSIONSnResults from the present study demonstrated that even within a relatively homogeneous sample of French women, distinct dietary patterns can be identified but without significant differences in digestive symptoms (except for flatulence) or HRQoL.

The Intestinal Gas Questionnaire: development of a new instrument for measuring gas-related symptoms and their impact on daily life.

Although gas‐related symptoms (GRS) are common and intrusive, there are no questionnaires to quantitate this problem. This study aimed to develop an instrument to rectify this gap in our knowledge.

Tu2074 Assessment of Digestive Symptoms and Health-Related Quality of Life in Healthy People and Subjects With Irritable Bowel Syndrome: Validation of Symptom Frequency Questionnaire

Objectives: Digestive symptoms (DS) are widely observed in the general population with different degrees of frequency and severity from healthy subjects and to patients with Irritable Bowel Syndrome (IBS). A DS questionnaire assessing the frequency of 4 DS was previously used in a non-IBS population with mild gastrointestinal discomfort to test the efficacy of a probiotic dairy food. Aim: The present study was designed to determine the ability of this DS frequency questionnaire to discriminate IBS patients from healthy subjects and compare this questionnaire with other validated questionnaires measuring similar concept. Methods: We compared 100 IBS patients according to Rome III (mean age 32 (18-59), and 100 matched (sex and age) healthy subjects. Frequency of individual DS (abdominal pain/ discomfort, bloating, flatulence, borborygmi) was assessed using a 5-point Likert scale (from none to every day of the week) and IBS severity with the IBS-SSS questionnaire. Two HealthRelated Quality of life (HRQoL) questionnaires were filled out: the Food and Benefits Assessment questionnaire (FBA) and Functional Digestive Disorders Quality of Life (FDDQL). The digestive (dis)comfort dimension of the 2 questionnaires was considered as the main dimension for the analysis. Correlations were tested using the Spearman non parametric test. Results: The DS frequency questionnaire discriminated IBS from healthy subjects with a significant difference (p,0.001) between groups (estimated mean difference = 5.58, 95%CI [4.91; 6.28]). Based on the ROC curve (AUC = 0.9479), a cut off value of 5 gives a sensitivity of 92% and a specificity of 84% with a positive likelihood ratio of 5.75. Composite score of DS correlated strongly (p,0.0001) with digestive discomfort measured by FDDQL (0.816), digestive comfort measured by FBA (-0.789) and the IBS-SSS score (0.762). Conclusions: Measurement of digestive symptom frequency by means of an original questionnaire can discriminate IBS patients from healthy subjects and provides a relevant evaluation of the impact of the disease.

CO.29 Effets d’un lait fermenté avec le probiotique Bifidobacterium lactis DN-173 010 sur la distension abdominale, le temps de transit gastrointestinal et les symptômes digestifs chez des sujets atteints du syndrome de l’intestin irritable avec constipation

Objectif Une sensation de ballonnement intestinal et d’augmentation de la distension abdominale sont des genes caracteristiques rencontrees chez les sujets ayant un syndrome de l’intestin irritable (SII) et tout particulierement ceux avec predominance de constipation (SII-C) avec un temps de transit lent. L’objectif de cette etude est d’evaluer chez des personnes atteintes de SII-C, si la consommation d’un lait fermente contenant le probiotique Bifidobacterium lactis DN-173 010 etait capable de reduire la distension abdominale (en association avec l’acceleration du temps de transit gastro-intestinal) et d’ameliorer les symptomes digestifs du SII. Patients et Methodes Cette etude d’intervention randomisee, parallele et controlee a ete conduite en double aveugle sur des femmes atteintes de SII-C (critere Rome III). Elles ont consomme quotidiennement pendant 28 jours, soit 2 pots d’un lait fermente (groupe produit) contenant Bifidobacterium lactis DN-173 010 (1,2xa0×xa01010 cfu par pot de 125xa0g) et les 2 ferments traditionnels du yaourt, soit 2 pots d’un produit laitier non fermente (groupe controle). La distension abdominale des sujets, critere principal de l’etude, a ete mesuree objectivement par une technique validee ( Abdominal Inductance Plethysmography ) avant et a la fin de la periode de consommation. Les temps de transit dans l’intestin grele et le colon ont egalement ete mesures avant et a la fin de la periode de consommation. Les symptomes lies au SII-C (douleurs abdominales, ballonnements, flatulences) ont ete evalues quotidiennement tout au long de l’etude. L’analyse des resultats a ete faite en intention de traiter (ITT) sur une population de 34 sujets. Resultats Suite a l’intervention, une baisse significative de la distension abdominale maximale a ete observee dans le groupe produit versus le groupe controle [difference mediane -39 %, IC 95 % (-78 ; -5) ; pxa0=xa00,02]. La distension abdominale moyenne tend egalement a diminuer dans le groupe produit comparativement au groupe controle [-1,52xa0cm, (-3,33 ; 0,39) ; pxa0=xa00,096]. Une acceleration significative du temps de transit de l’intestin grele [-1,2 h (-2,3 ; 0) ; p = 0,049] ainsi que du temps de transit colique [-12,2 h (-22,8 ; -1,6) ; pxa0=xa00,026] a ete montree dans le groupe produit vs groupe controle. Enfin, la consommation du lait fermente teste ameliore significativement la severite des symptomes totaux lies au SII-C [-0,5 (-1,0 ; -0,05) ; pxa0=xa00,032]. Conclusion Cette etude est la premiere utilisant une methode objective qui montre l’effet positif d’un probiotique sur la distension abdominale. Elle demontre l’effet du lait fermente avec Bifidobacterium lactis DN-173 010 sur l’amelioration des symptomes de sujets SII-C en association avec une acceleration des temps de transit dans l’intestin grele et le colon. Du fait de son action globale sur les parametres intestinaux, ce lait fermente pourrait etre interessant dans la gestion des symptomes lies au SII-C.