Multiomics insights into functional constipation: Exploring microbiome, metabolome, and lipidome independent of transit time

Background/aims: Functional constipation (FC) is a prevalent form of functional gastrointestinal disorder with an elusive etiology. Despite numerous investigations into the role of the gut microbiome in FC, no study has yet integrated microbiome, metabolome, and lipidome profiling to characterize FC. Methods: In this study, fecal samples were collected from patients with FC both before and after laxative administration to minimize the impact of intestinal transit time and to identify the characteristics unique to patients with FC. These samples underwent comprehensive microbiome, metabolome, and lipidome analyses to discern the unique properties of FC. Results: Beneficial microbiota such as Anerobutyricum hallii, Blautia luti, Blautia wexlerae, Collinsella aerofaciens, and Fusicatenibacter saccharivorans were predominantly found in healthy controls (HC), while harmful microbiota, Blautia faecis, was prevalent in patients with FC. Metabolome profiling showed that chenodeoxycholic acid, glucose, glycine, malic acid, phenylalanine, ribose, serine, and uracil decreased in patients with FC, suggesting a decreased energy metabolism and a reduced nutrient utilization for energy production compared to HCs. In terms of lipidome profiling, no significant differences in lipid levels were observed between pre- and post-laxative FC samples. Conclusions: Our findings offer novel insights into FC-specific alterations in the gut microbiota and metabolome and potentially lead to the development of targeted therapeutic approaches for FC.