Effects of a Cod Protein Hydrolysate Supplement on Symptoms, Gut Integrity Markers and Fecal Fermentation in Patients with Irritable Bowel Syndrome.

Dale Dale,Valeur Valeur,Hoff Hoff,Hausken Hausken,Jensen Jensen,Lied Lied

doi:10.3390/nu11071635

Abstract

Peptides from fish may beneficially affect several metabolic outcomes, including gut health and inflammation. The effect of fish peptides in subjects with irritable bowel syndrome (IBS) has not previously been investigated, hence this study aimed to evaluate the effect of a cod protein hydrolysate (CPH) supplement on symptom severity, gut integrity markers and fecal fermentation in IBS-patients. A double-blind, randomized parallel-intervention with six weeks of supplementation with 2.5 g CPH (n = 13) or placebo (n = 15) was conducted. The outcomes were evaluated at baseline and the end of the study. The primary outcomes were symptom severity evaluated by the IBS severity scoring system (IBS-SSS) and quality of life. The secondary outcomes included gut integrity markers and pro-inflammatory cytokines in serum, fecal fermentation measured by concentration of short-chain fatty acids (SCFAs) and fecal calprotectin. The groups were comparable at baseline. The total IBS-SSS-scores were reduced in both the CPH-group (298 ± 69 to 236 ± 106, p = 0.081) and the placebo-group (295 ± 107 to 202 ± 103, p = 0.005), but the end of study-scores did not differ (p = 0.395). The concentrations of serum markers and SCFAs did not change for any of the groups. The baseline measures for the whole group showed that the total SCFA concentrations were inversely correlated with the total IBS-SSS-score (r = −0.527, p = 0.004). Our study showed that a low dose of CPH taken daily by IBS-patients for six weeks did not affect symptom severity, gut integrity markers or fecal fermentation when compared to the placebo group.

Highlights

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder affecting between 10–20%
The aim of this study was to evaluate the effect of a supplement with cod protein hydrolysate (CPH)
According to the Rome IV phenotype definition, 19 patients were classified as diarrhea-predominant (IBS-D) and 9 patients as mixed bowel habits (IBS-M)

Summary

Introduction

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder affecting between 10–20%of the population [1], characterized by abdominal pain, bloating and/or distention, constipation and/orNutrients 2019, 11, 1635; doi:10.3390/nu11071635 www.mdpi.com/journal/nutrientsNutrients 2019, 11, 1635 diarrhea [2,3]. Diet is considered as an important factor in IBS, with over half of the patients reporting worsening of symptoms in relation to intake of certain foods [6]. The effects of different sources of carbohydrates have been investigated in patients with IBS. A diet low in fermentable oligo-, di-, monosaccharides and polyols (FODMAPs) is currently one recommended dietary treatment [2]. When reaching the colon fermentation of these carbohydrates by colonic bacteria, this leads to the generation of gases and short chain fatty acids (SCFAs). The levels of these metabolic end-products are altered in patients with IBS, conceivably causing symptoms [7,8].

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