Aim: to evaluate the fecal content of short-chain fatty acids (SCFAs) in patients with irritable bowel syndrome (IBS) across different body weight categories and to formulate recommendations for the personalized patient management with IBS. Patients and Methods: an open cross-sectional study was conducted with 175 patients aged 18 to 44 years. Participants were divided into the following groups: group 1: 100 patients diagnosed with IBS, further divided into: subgroup 1A: 50 overweight or obese patients; subgroup 1B: 50 patients with normal weight; group 2: 75 patients without IBS, further divided into: subgroup 2A: 50 overweight or obese patients; subgroup 2B: 25 conditionally healthy patients with normal weight. The severity and presence of IBS symptoms were evaluated using a 10-point scale. Parameters studied included eating habits, quality of life, and specific anxiety, assessed through validated questionnaires. Absolute and relative concentrations of SCFAs and zonulin in fecal samples were measured. Additionally, serum concentrations of leptin and adiponectin were assessed. Results: overweight and obese individuals exhibited a higher fecal SCFA content, independent of IBS presence. Within the IBS cohort, distinct SCFA profiles were noted based on IBS subtype. IBS with diarrhea predominance (IBS-D) was characterized by the highest absolute concentrations of acetate, propionate, and butyrate, increased relative proportions of propionate and butyrate, a significant shift in the anaerobic index into a markedly negative range. IBS with constipation predominance (IBS-C) showed the lowest absolute concentrations of acetate, propionate, and butyrate, elevated relative levels of acetate and isoacids and a milder shift in the anaerobic index toward a slightly negative range. SCFA levels were associated with IBS symptom severity, dietary patterns, intestinal epithelial barrier permeability, and concentrations of adipose tissue-related hormones such as leptin and adiponectin. Conclusion: the results suggest a potential role of the gut microbiota and its metabolites in shaping the clinical phenotype of IBS, particularly in overweight and obese patients. These results highlight the need for further research into personalized treatment approaches for IBS based on SCFA profiles and microbiota-associated mechanisms. Future studies may allow for the optimization of existing IBS treatment tactics, incorporating targeted dietary, lifestyle, and therapeutic modifications tailored to individual microbiota patterns. Keywords: irritable bowel syndrome, short-chain fatty acids, acetate, propionate, butyrate, obesity. For citation: Fedorin M.M., Livzan M.A., Gaus O.V., Druk I.V. Content of short-chain fatty acids in feces and the potential for correction of the intestinal microbiota in patients with irritable bowel syndrome with different body weight. RMJ. 2024;10:2–8. DOI: 10.32364/2225- 2282-2024-10-1
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