Fibre and IBD: The Good, The Bad, and The Inflammatory

Inflammatory bowel disease (IBD) can be a challenging condition to manage, and dietary choices can have a significant impact on symptoms and disease progression. While many sources tout the benefits of fibre consumption for gut health, recent research suggests that not all fibres are created equal, and some may in fact have negative effects on individuals with IBD.

According to a recent study published in Gastroenterology, unfermented dietary beta-fructan fibres can induce pro-inflammatory cytokines in a subset of individuals with IBD due to the absence or impairment of fermentative gut microbes and increased interactions between immune cells and gut contents. This means that for some individuals, fibre consumption can actually exacerbate symptoms and lead to inflammation. Additionally, the study found that gut microbial function, rather than composition, predicts pro-inflammatory response to fiber consumption. While fibre avoidance may improve symptoms, it may also deprive patients of the benefits of fibres, which are important in IBD. Therefore it's key for people with IBD to work out what fibres they tolerate and aim to include a variety of these daily.

So, what can individuals with IBD do to manage their fibre intake and avoid negative effects? Here are some practical ideas and actions based on the research:

1. Understand Your Microbial Diversity

The study found that the pro-inflammatory response to fibre consumption in individuals with IBD is linked to the absence or impairment of fermentative gut microbes. This means that individuals with low microbial diversity or impairment of certain gut bacteria may be more sensitive to certain fibres than others. Understanding your own microbial diversity can help you make informed choices about which fibres to consume and which to avoid. You can get your gut microbiota profile checked by certain companies like microba.

2. Experiment with Fermentable Fibres

While unfermented beta-fructan fibres may be detrimental in some individuals with IBD, fermentable fibres such as those found in inulin (e.g. asparagus, banana) and beta-glucan (e.g. oats, mushrooms) can have beneficial effects on gut health and reduce inflammation when fermented by gut microbes. This is likely due the metabolites released after fermentation of these fibres. Experimenting with different types of fermentable fibres can help you find ones that work for your individual gut microbiome.

3. Monitor Symptoms and Make Adjustments

It's important to pay attention to your body and monitor symptoms when consuming fibre. If you notice negative effects after consuming certain fibres, it may be best to avoid them. On the other hand, if you find that certain fibres improve symptoms and reduce inflammation, you may want to increase your intake. A food-symptom diary is very useful in this instance. Keeping a diary for a few weeks then getting your Dietitian to assess it will help you identify your individual trigger foods, including your intolerances and tolerances.

4. Consult with a Dietitian

If you're unsure about how to manage your fibre intake or have questions about which fibres are safe for you, consulting with a Dietitian that specialises in gut health can provide valuable guidance. An Accredited Practising Dietitian can help you develop a personalised dietary plan that takes into account your individual needs.

In summary...

While fibre consumption can have many beneficial effects on gut health, it's important for individuals with IBD to be mindful of which fibres they consume and how they affect symptoms. Understanding your own microbial diversity, experimenting with fermentable fibres, monitoring symptoms, and consulting with a Dietitian can all help you manage your fibre intake and avoid negative effects.

Reference: https://doi.org/10.1053/j.gastro.2022.09.034