October 20, 2018

New study identifies dramatic shifting of the microbiome in inflammatory bowel disease

Inflammatory bowel disease is an autoimmune condition where in most cases there are multiple triggers chronically stimulating the immune system over a long period of time in multiple ways and the immune system gets into overloaded, overwhelmed state and loses its ability to function leading to chronic inflammation causes symptoms such as diarrhea, abdominal pain, and other debilitating symptoms and anemia.

According to a study published four days ago in Nature Microbiology, individuals with IBD commonly have dramatic shifts in gut microbiome compared to that of healthy people.

Although it is well known that there are differences in the gut microbiome in IBD patients, this is one of the largest studies to follow the microbiome over a period of time. The most significant difference researchers saw was how the microbiome shifted, describing it as a “volatile dysbiosis.” These patients have a much less stable microbiome than healthy individuals.

Researchers have known that there are some differences in the microbiomes of patients with IBD patients compared to healthy individuals such as fewer beneficial microbes and many times high amounts of Enterobacteriaceae and E. coli.

It is important to know what bacteria are present and how these bacteria shift as the patient’s symptoms exacerbate or improve.

In this study, researchers followed 137 individuals for 2 years, which included patients with ulcerative colitis, Crohn’s disease, and healthy individuals. They collected stool samples from patients every 3 months for up to 2 years and monitored patients’ symptoms.

The research team found that in healthy people, the gut microbiome was much more stable than those with IBD. The patients with IBD had dramatic shifts in their microbiomes with some bacteria disappearing almost completely at times. In addition, over 50% of their microbiome was displaced by other microbes in just a few months. The biggest swings were seen in patients with ileal Crohn’s disease who had had part of their intestine removed to improve their symptoms.

Also, researchers noted that changes in medication to treat IBD affected the microbiome. Individuals who had taken steroids for part of treatment had more fluctuations in their microbiome and those who were experiencing a flare-up in their symptoms were more likely to have dramatic fluctuations in their microbiome.

These results further support the integrative functional medicine approach to assess the microbiome regularly in these patients so one can take an individualized approach to manipulate the microbiome and keep these IBD patients in remission, especially if medications like corticosteroids can be shift the microbiome leading to an exacerbation of the disease.

I shared a study published last month in the Journal of Clinical Gastroenterology in which researchers demonstrated that a specific carbohydrate diet (SCD) can bring patients with active inflammatory bowel disease (IBD) into remission.

In addition, one must look into the other potential environmental triggers that can cause inflammation such as, food sensitivities, toxins, and molds. Also, the nutrient status of the person. This can be antioxidant status, vitamins, essential fatty acids, vitamin D, etc. Finally, there are toxins that can be affect the status of the immune system. These are heavy metals, xenobiotics, as well as the total toxic burden in the body.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Jonas Halfvarson, Colin J. Brislawn, Regina Lamendella, Yoshiki Vázquez-Baeza, William A. Walters, Lisa M. Bramer, Mauro D’Amato, Ferdinando Bonfiglio, Daniel McDonald, Antonio Gonzalez, Erin E. McClure, Mitchell F. Dunklebarger, Rob Knight, Janet K. Jansson. Dynamics of the human gut microbiome in inflammatory bowel disease. Nature Microbiology, 2017; 2: 17004 DOI: 10.1038/nmicrobiol.2017.4

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