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Small intestinal microbial dysbiosis underlies symptoms associated with functional gastrointestinal disorders

Small intestinal microbial dysbiosis underlies symptoms associated with functional gastrointestinal disorders
Small intestinal microbial dysbiosis underlies symptoms associated with functional gastrointestinal disorders

Small intestinal bacterial overgrowth (SIBO) has been implicated in symptoms associated with functional gastrointestinal disorders (FGIDs), though mechanisms remain poorly defined and treatment involves non-specific antibiotics. Here we show that SIBO based on duodenal aspirate culture reflects an overgrowth of anaerobes, does not correspond with patient symptoms, and may be a result of dietary preferences. Small intestinal microbial composition, on the other hand, is significantly altered in symptomatic patients and does not correspond with aspirate culture results. In a pilot interventional study we found that switching from a high fiber diet to a low fiber, high simple sugar diet triggered FGID-related symptoms and decreased small intestinal microbial diversity while increasing small intestinal permeability. Our findings demonstrate that characterizing small intestinal microbiomes in patients with gastrointestinal symptoms may allow a more targeted antibacterial or a diet-based approach to treatment.

Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents, DNA, Bacterial/isolation & purification, Dietary Fiber/administration & dosage, Dietary Sugars/adverse effects, Dysbiosis/diet therapy, Female, Gastrointestinal Diseases/diet therapy, Gastrointestinal Microbiome/physiology, Healthy Volunteers, Humans, Intestinal Mucosa/metabolism, Intestine, Small/metabolism, Male, Middle Aged, Permeability, Pilot Projects, Young Adult
2041-1723
1-11
Saffouri, George B.
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Shields-Cutler, Robin R.
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Chen, Jun
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Yang, Yi
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Lekatz, Heather R.
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Hale, Vanessa L.
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Cho, Janice M.
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Battaglioli, Eric J.
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Bhattarai, Yogesh
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Thompson, Kevin J.
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Kalari, Krishna K.
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Behera, Gaurav
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Berry, Jonathan C.
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Peters, Stephanie A.
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Patel, Robin
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Schuetz, Audrey N.
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Faith, Jeremiah J.
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Camilleri, Michael
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Sonnenburg, Justin L.
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Farrugia, Gianrico
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Swann, Jonathan R.
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Grover, Madhusudan
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Knights, Dan
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Kashyap, Purna C.
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Saffouri, George B.
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Shields-Cutler, Robin R.
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Chen, Jun
ae8e5c6b-5ab6-4682-8ff4-519d7a2768a2
Yang, Yi
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Lekatz, Heather R.
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Hale, Vanessa L.
e26577f9-3eea-4e16-b964-3262cbafda38
Cho, Janice M.
73bca7d1-209b-4639-826c-c66304d5ca7f
Battaglioli, Eric J.
3e06c732-66c7-4047-bf93-8ea23179e747
Bhattarai, Yogesh
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Thompson, Kevin J.
a23831d5-129c-4749-8df7-c7eeb70e2315
Kalari, Krishna K.
1d0b549a-653c-4b78-970d-3e18861f37d5
Behera, Gaurav
fa511bac-4c91-464b-8ff3-7e0ae41e587c
Berry, Jonathan C.
a9872e48-7174-4925-bd79-0ef3f6f386f7
Peters, Stephanie A.
acc33492-eab0-41eb-a3e8-b6c1100331d4
Patel, Robin
600cdfc2-e24c-4750-b6a3-28f17756ced0
Schuetz, Audrey N.
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Faith, Jeremiah J.
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Camilleri, Michael
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Sonnenburg, Justin L.
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Farrugia, Gianrico
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Swann, Jonathan R.
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Grover, Madhusudan
6b35b1ec-3089-4d97-8b04-1f77ee12f4a6
Knights, Dan
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Kashyap, Purna C.
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Saffouri, George B., Shields-Cutler, Robin R., Chen, Jun, Yang, Yi, Lekatz, Heather R., Hale, Vanessa L., Cho, Janice M., Battaglioli, Eric J., Bhattarai, Yogesh, Thompson, Kevin J., Kalari, Krishna K., Behera, Gaurav, Berry, Jonathan C., Peters, Stephanie A., Patel, Robin, Schuetz, Audrey N., Faith, Jeremiah J., Camilleri, Michael, Sonnenburg, Justin L., Farrugia, Gianrico, Swann, Jonathan R., Grover, Madhusudan, Knights, Dan and Kashyap, Purna C. (2019) Small intestinal microbial dysbiosis underlies symptoms associated with functional gastrointestinal disorders. Nature Communications, 10 (1), 1-11. (doi:10.1038/s41467-019-09964-7).

Record type: Article

Abstract

Small intestinal bacterial overgrowth (SIBO) has been implicated in symptoms associated with functional gastrointestinal disorders (FGIDs), though mechanisms remain poorly defined and treatment involves non-specific antibiotics. Here we show that SIBO based on duodenal aspirate culture reflects an overgrowth of anaerobes, does not correspond with patient symptoms, and may be a result of dietary preferences. Small intestinal microbial composition, on the other hand, is significantly altered in symptomatic patients and does not correspond with aspirate culture results. In a pilot interventional study we found that switching from a high fiber diet to a low fiber, high simple sugar diet triggered FGID-related symptoms and decreased small intestinal microbial diversity while increasing small intestinal permeability. Our findings demonstrate that characterizing small intestinal microbiomes in patients with gastrointestinal symptoms may allow a more targeted antibacterial or a diet-based approach to treatment.

Text
s41467-019-09964-7 - Version of Record
Available under License Creative Commons Attribution.
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Accepted/In Press date: 3 April 2019
e-pub ahead of print date: 1 May 2019
Published date: 1 May 2019
Keywords: Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents, DNA, Bacterial/isolation & purification, Dietary Fiber/administration & dosage, Dietary Sugars/adverse effects, Dysbiosis/diet therapy, Female, Gastrointestinal Diseases/diet therapy, Gastrointestinal Microbiome/physiology, Healthy Volunteers, Humans, Intestinal Mucosa/metabolism, Intestine, Small/metabolism, Male, Middle Aged, Permeability, Pilot Projects, Young Adult

Identifiers

Local EPrints ID: 440781
URI: http://eprints.soton.ac.uk/id/eprint/440781
DOI: doi:10.1038/s41467-019-09964-7
ISSN: 2041-1723
PURE UUID: 6e8705ef-595f-468c-9e8f-4eb851b691e2
ORCID for Jonathan R. Swann: ORCID iD orcid.org/0000-0002-6485-4529

Catalogue record

Date deposited: 18 May 2020 16:33
Last modified: 17 Mar 2024 04:00

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Contributors

Author: George B. Saffouri
Author: Robin R. Shields-Cutler
Author: Jun Chen
Author: Yi Yang
Author: Heather R. Lekatz
Author: Vanessa L. Hale
Author: Janice M. Cho
Author: Eric J. Battaglioli
Author: Yogesh Bhattarai
Author: Kevin J. Thompson
Author: Krishna K. Kalari
Author: Gaurav Behera
Author: Jonathan C. Berry
Author: Stephanie A. Peters
Author: Robin Patel
Author: Audrey N. Schuetz
Author: Jeremiah J. Faith
Author: Michael Camilleri
Author: Justin L. Sonnenburg
Author: Gianrico Farrugia
Author: Jonathan R. Swann ORCID iD
Author: Madhusudan Grover
Author: Dan Knights
Author: Purna C. Kashyap

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