Microbiome test may lead to personalized treatment for irritable bowel syndrome

A new, improved diagnostic classification technique enables stratification of pediatric patients with irritable bowel syndrome (IBS) with greater precision so they can receive optimal treatment, according to a new study published in the Journal of Molecular Diagnostics.

To improve the treatment of children with IBS, investigators have developed a sophisticated way to analyze the microbial and metabolic contents of the gut. In the report, researchers describe how a new battery of tests enables researchers to distinguish patients with IBS from healthy children and identifies correlations between certain microbes and metabolites with abdominal pain. With this information, practitioners could begin tailoring nutritional and targeted therapies that address a child's specific gastrointestinal problems.

For the study, researchers obtained samples from 23 preadolescent children with IBS and 22 healthy controls. Participants were asked to maintain daily pain and stool diaries for two weeks and to provide fecal samples.

Investigators found that there are differences in bacterial composition, bacterial genes, and fecal metabolites in children with IBS compared to healthy controls. In addition to identifying correlations of these factors with abdominal pain, the researchers generated a highly accurate classifier using metagenomic and metabolic markers that distinguishes children with IBS from healthy controls with 80 percent or greater accuracy. This classifier assesses specific metabolites, types of bacteria, functional pathways, and other factors.

This microbiome-based classifier can potentially help identify subpopulations of children with IBS that are more likely to benefit from microbiome-related therapies, including diet modification, while guiding others to alternative appropriate treatment plans. The investigators also provide insights into how specific microbiome-related findings may be related to abdominal pain, thus opening potential novel treatment approaches.

A chronic disease that is evaluated clinically can be stratified in the future based on differences in the composition and function of the intestinal microbiome. Researchers say they hope that these findings will begin to usher in an era of metagenomics-based, data-driven precision diagnostics for IBS and other functional gastrointestinal disorders.

IBS is a disruptive gastrointestinal condition characterized by bloating, changes in bowel habits, and pain that affects up to 20 percent of the world's population, both children and adults. Increasing evidence indicates that the onset and symptoms of IBS are related to the gut microbiome. Deficiencies or excesses of specific gut microbes or metabolites may contribute to the disease process of IBS.