14 Sep 2017

Enzyme finding is good news for vegetarians with bowel disorder

Legumes, soy milk and nuts may be back on the menu for those
suffering from IBS, thanks to Monash University research.
by Anne Crawford

 A digestive enzyme supplement may hold the key to improving the symptoms suffered by patients with irritable bowel syndrome (IBS) when they eat a carbohydrate commonly found in legumes, soy milk and nuts, according to Monash University research.

Researchers in the Central Clinical School’s Department of Gastroenterology have found that oral α-galactosidase co-ingested with foods high in galacto-oligosaccharides (GOS) helps reduce symptoms. IBS is a common functional gastrointestinal disorder affecting one in seven Australian adults, characterised by chronic and relapsing symptoms including lower abdominal pain and discomfort, bloating, wind, distension and altered bowel habits.


The study, which appeared in the ‘American Journal of Gastroenterology’, is part of a large body of work by the researchers into carbohydrates called FODMAPs. The results are particularly important to patients who are vegetarian and vegan, whose sources of protein have previously been limited when following the low FODMAP diet. The diet was developed by researchers at Monash University led by Professor Peter Gibson and Dr Jane Muir; galacto-oligosaccharides are one of the five sub-groups considered in it.

Using a randomised, double-blind, placebo-controlled, cross-over trial the researchers found that approximately two-thirds of patients with IBS had symptoms when consuming foods high in GOS and low in other FODMAPs. They then found that an enzyme supplement containing α-galactosidase was able to improve symptoms associated with eating these foods.

“Foods that commonly contain GOS are also important sources of nutrients, including protein and pre-biotic fibre,” said first author Dr Caroline Tuck. “We hope that if we can improve tolerance to GOS in patients with irritable bowel syndrome, it will improve their nutritional adequacy. This is especially important in vegetarians and vegans as GOS containing foods are key sources of protein,” Dr Tuck said.

The findings can be applied directly to clinical practice to improve intake of high GOS containing foods in IBS patients as an adjunct therapy to the low FODMAP diet, she said.

The Monash FODMAP team is constantly testing new foods for their FODMAP content, including testing foods from around the world. It also tests foods as part of the food and recipe certification programs now recognised world-wide.

“This study was looking at the low FODMAP diet from a slightly different angle, trying to improve tolerance to FODMAPs in irritable bowel syndrome patients,” Dr Tuck said.

Dr Tuck is now a post-doctoral research fellow at Queen’s University in Canada, where she is working in the Gastrointestinal Diseases Research Unit.

“My PhD supervisors had strongly encouraged me to pursue research positions internationally and I was lucky to be able to take up the opportunity to do so. Coming from the world-renowned team at Monash University I am sure had a big hand in assisting me to be successful in finding a post-doctoral position.”

Her PhD investigated a number of strategies to enhance tolerance to various FODMAP subgroups. Dr Tuck is currently working with the the team to publish further manuscripts from the findings in her thesis.

“I feel incredibly fortunate to have been a part of the team for my PhD,” she said. “The MonashFODMAP team are a fantastic group of knowledgeable people.”

Dr Tuck became interested in specialising in an area with a focus on research during her honours research project and during her first job after graduating as a dietitian in hospital in Stawell, country Victoria.  

“I find that working in research and clinically hugely complement each other, so in an ideal world I would balance them both,” she said.

The research was supported by a NHMRC project grant obtained by lead researcher on the paper Dr Jane Muir.

Reference

Tuck CJ, Taylor KM, Gibson PR, Barrett JS, Muir JG. Increasing Symptoms in Irritable Bowel Symptoms With Ingestion of Galacto-Oligosaccharides Are Mitigated by α-Galactosidase Treatment. Am J Gastroenterol. 2017 Aug 15. doi: 10.1038/ajg.2017.245. [Epub ahead of print]

https://www.monash.edu/medicine/ccs/gastroenterology/fodmap

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