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In a recent article in GUT,1 we showed that, among 194 patients with diarrhoea-predominant irritable bowel syndrome (IBS-D), 43 had altered bile acid (BA) metabolism (ABAM) (serum 7αC4>52 ng/mL). Patients with ABAM, had faster colonic transit (CT), lower α diversity and a different microbial compositional profile based on β diversity compared with IBS-D without ABAM. There were no significant differences in the stool short-chain fatty acid (SCFA) concentrations between the two groups.1 There is evidence that transit impacts gut microbiome composition and diversity.2
We wish to extend the previous analysis to compare the microbiome composition and SCFA in the same cohort of patients with IBS-D (total 181) with and without rapid CT, before and after adjusting for presence of ABAM. Patient selection, CT measurement, microbiome and SCFA analysis have been previously described.1
CT was measured as geometric centre (GC) by scintigraphy (range 1–5, where 1=ascending colon, 5=stool). Patients with colonic GC at 24 hours >3.45 (90th percentile of normal3) were considered …
Twitter @JBousaba, @JohnnyTingZheng
JB and TZ contributed equally.
Contributors JB: interpretation of results, drafting and revising manuscript, joint first author. TZ: interpretation of results, revising manuscript, joint first author. SD: data analysis, revising manuscript, coauthorship. SJ and JC: analysis of microbiome data, coauthorship. MC: principal investigator, regulatory affairs (IRB), senior author.
Funding This work was supported by grant R01-DK115950 from National Institutes of Health (MC).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.