The Potential Role of Human Milk Oligosaccharides in Irritable Bowel Syndrome

Abstract

Irritable Bowel Syndrome (IBS) is the most common gastrointestinal (GI) disorder in Western populations and therefore a major public health/economic concern. However, despite extensive research, psychological and physiological factors that contribute to the aetiology of IBS remain poorly understood. Consequently, clinical management of IBS is reduced to symptom management through various suboptimal options. Recent evidence has suggested human milk oligosaccharides (HMOs) as a potential therapeutic option for IBS. Here, we review literature concerning the role of HMOs in IBS, including data from intervention and in vitro trials. HMO supplementation shows promising results in altering the gut microbiota and improving IBS symptoms, for instance by stimulating bifidobacteria. Further research in adults is required into HMO mechanisms, to confirm the preliminary results available to date and recommendations of HMO use in IBS.

Keywords: 2′fucosyllactose; Bifidobacterium; gut microbiota; human milk oligosaccharide; irritable bowel syndrome.

Figure 1

Rome IV criteria for IBS (May 2016).

Figure 2

Treatment options for IBS are based on symptoms and may be pharmacological or non-pharmacological.

Figure 3

HMO composition blueprint. HMOs can contain 5 different monosaccharides in different number and linkages, namely glucose (green circle), galactose (blue circle), N-acetlylactosamine (green square), fucose (red triangle), and sialic acid (grey diamond).

Figure 4

Small fucosylated (left) and sialylated HMOs (right). Lactose can be fucosylated or sialylated to generate the small HMOs 2′FL and 3′FL or 3′SL and 6′-SL, respectively shown here.