Nutrients · 10 authors, 3 centres
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This prospective cohort study of 40 IBS-D patients stratified by BMI found that overweight patients had higher small intestinal permeability at baseline compared to normal-weight patients. After a 12-week Low FODMAP Diet, overweight patients showed significant improvement in intestinal barrier function along with decreased markers of epithelial integrity and bacterial translocation.
This prospective cohort study enrolled 40 IBS-D patients categorized by BMI into normal-weight (NW) and overweight (OW) groups, assessing gastrointestinal symptoms, small intestinal permeability, markers of epithelial integrity, dysbiosis, and bacterial translocation before and after 12 weeks of a Low FODMAP Diet. At baseline, OW patients exhibited significantly higher small intestinal permeability and elevated sucrose excretion compared to NW patients, though no differences in symptom severity were found between groups. After the LFD, both groups experienced symptom improvement, but OW patients showed significantly greater improvement in small intestinal permeability (Lac/Man ratio), fecal and serum zonulin, and circulating I-FABP levels, along with reduced LPS levels indicating decreased bacterial translocation. Urinary indican levels exceeded the dysbiosis threshold in both groups at baseline regardless of BMI. Limitations include the small sample size, which constrains the ability to draw firm conclusions, and the absence of molecular analysis of bacterial populations in the gastrointestinal tract. The findings suggest that excess body weight is closely linked to intestinal barrier dysfunction in IBS-D and that the LFD may be particularly beneficial for overweight patients in restoring barrier function.
