{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T05:07:45Z","timestamp":1779944865127,"version":"3.53.1"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by mucosal inflammation, in which gut dysbiosis and immune imbalance play pivotal roles. Dietary and microbiota-targeted interventions, particularly the low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet and probiotics, have individually shown benefits in symptom control and inflammation modulation. However, evidence on their combined impact remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 80 adults with mild-to-moderate UC managed at a tertiary inflammatory bowel disease center between 2022 and 2025. Patients were stratified into four exposure groups: low-FODMAP + probiotic, low-FODMAP only, probiotic only, and standard care. Clinical and biochemical outcomes were assessed over approximately 8 weeks. Primary endpoints included change in Mayo score and clinical remission. Secondary outcomes included changes in C-reactive protein (CRP) and fecal calprotectin (FCal).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The combined low-FODMAP + probiotic group showed the greatest reduction in Mayo score (\u22122.4 \u00b1 0.8;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) and CRP (\u22123.5 \u00b1 1.8 mg\/L), with 60% achieving clinical remission. A significant improvement in FCal (\u2212180 \u00b1 70 \u03bcg\/g) was also observed in this group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A combined low-FODMAP diet and probiotic regimen was associated with the most favorable clinical and inflammatory outcomes in this cohort of adults with mild-to-moderate UC. Because a formal statistical interaction test was not performed, these findings should not be interpreted as proof of synergy, but rather as evidence of an observed combined benefit in this retrospective study. This integrated nutritional\u2013microbial strategy represents a promising adjunctive approach for personalized UC management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1801783","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T04:57:13Z","timestamp":1779944233000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Synergistic effects of probiotics and low-FODMAP diet on clinical and inflammatory outcomes in ulcerative colitis: a retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Shan","family":"Jia","sequence":"first","affiliation":[{"name":"Twelve Wards of Zhejiang Hospital Sandun Campus","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"XiaoLong","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Zhejiang Hospital","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BaoSheng","family":"Bao","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Zhejiang Hospital","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BinBin","family":"Liu","sequence":"additional","affiliation":[{"name":"Twelve Wards of Zhejiang Hospital Sandun Campus","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3390\/nu14122469","article-title":"Nutrition and Supplementation in Ulcerative Colitis","author":"Radziszewska","year":"2022","journal-title":"Nutrients"},{"key":"B2","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1186\/s13063-020-4108-7","article-title":"A randomized controlled trial investigating the effect of a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols on the intestinal microbiome and inflammation in patients with ulcerative colitis: study protocol for a randomized controlled trial","volume":"21","author":"Milajerdi","year":"2020","journal-title":"Trials"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.09.024","article-title":"Effects of low-FODMAP diet on symptoms, fecal microbiome, and markers of inflammation in patients with quiescent inflammatory bowel disease in a randomized trial","author":"Cox","year":"2020","journal-title":"Gastroenterology."},{"key":"B4","doi-asserted-by":"publisher","first-page":"544","DOI":"10.3390\/nu17030544","article-title":"Low-FODMAP Diet for Irritable Bowel Syndrome: Insights from Microbiome","volume":"17","author":"Zhang","year":"2025","journal-title":"Nutrients"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1638","DOI":"10.3390\/microorganisms8111638","article-title":"Effects of Low and High FODMAP Diets on Human Gastrointestinal Microbiota Composition in Adults with Intestinal Diseases: A Systematic Review","volume":"8","author":"Vandeputte","year":"2020","journal-title":"Microorganisms"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1780","DOI":"10.3390\/nu13061780","article-title":"The Microbiome as a Therapy in Pouchitis and Ulcerative Colitis","volume":"13","author":"LeBlanc","year":"2021","journal-title":"Nutrients"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e0165122","DOI":"10.1128\/spectrum.01651-22","article-title":"Probiotics (Lactobacillus plantarum HNU082) Supplementation Relieves Ulcerative Colitis by Affecting Intestinal Barrier Functions, Immunity-Related Gene Expression, Gut Microbiota, and Metabolic Pathways in Mice","volume":"10","author":"Wu","year":"2022","journal-title":"Microbiol Spectr"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.36877\/pmmb.a0000069","article-title":"Role of low FODMAP diet and probiotics on gut microbiome in irritable bowel syndrome (IBS)","volume":"3","author":"Selvaraj","year":"2020","journal-title":"Prog. 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