Searching the microbiome for clues to managing inflammatory bowel disease

Sometimes the best medicine is the most basic. Just ask any of the patients with inflammatory bowel disease who are following a new diet designed to reduce the debilitating symptoms of the illness, developed by Barbara Olendzki, RD, MPH, director of the UMass Medical School Center for Applied Nutrition, and colleagues.

Last year, the results of a small, retrospective case study of the IBD Anti-inflammatory Diet (IBD-AID) created by Olendzki, assistant professor of medicine in the Division of Preventive and Behavioral Medicine, and colleagues was published in Nutrition Journal. All of the patients who adhered to the diet for at least four weeks experienced significant reduction in their symptoms, and all were all able to discontinue at least one of their IBD medications.

Based on the success of this pilot study, Olendzki has applied for funding for a larger study to further test the effectiveness of the diet.

"What surprised us was the patients' response to the diet. The patients have my heart . . . they have to, whether they want to or not, modify their diets so they are not injured on the inside. The beauty of this diet is that it offers them something that is nutritionally complete and balanced," said Olendzki. "The nice part about it is that the debilitating symptoms that patients are currently experiencing have dropped off. Some of my patients are able to reduce their medications."

She is also collaborating with colleagues in the UMass Center for Microbiome Research to uncover how exactly this diet affects gut bacteria.

By sampling the gut microbiome of patients before and after they begin IBD-AID, the researchers hope to identify the specific effects the diet has on the gut bacteria, and to develop better guidelines for treating IBD with diet.

"We're collaborating with the Center for Microbiome Research so that we can determine the components of the diet that match with the changes in the microbiome that we're expecting are the cause of why this diet is working," said Olendzki. "If we can do that, we can come up with guidelines, which currently don't exist. There are no guidelines for people with inflammatory bowel disease the way there are for people with cardiovascular disease. I know that diet can absolutely affect your risk for inflammatory bowel disease."

What is a microbiome?

Collectively, the microorganisms and their genes inhabiting a particular environment are called a microbiome. The microorganisms that live in and on an individual are referred to as the human microbiome. The human gut contains trillions of bacteria that have profound influences on immune development, health and disease.