Inflammatory Bowel Disease And The Microbiome: Insights Into Managing Symptoms

  • Anit JosephBAMS, Ayurvedic Medicine/Ayurveda, Rajiv Gandhi University of Health Sciences
  • Jennifer RuppBachelor of Science, Biomedical Sciences, University of Dundee

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Introduction

The term "inflammatory bowel disease" (IBD) refers to conditions when tissues in the digestive tract have persistent, ongoing inflammation. IBD types include:

  • Ulcerative colitis: The lining of the large intestine (colon) and rectum are affected by this illness, which causes inflammation and ulcers.
  • Crohn's disease: Inflammation of the stomach lining, which frequently affects the deeper layers of the digestive tract, is the hallmark of this kind of IBD. The small intestine is most frequently affected by Crohn's disease. But it can also impact the upper gastrointestinal tract, the mouth, and less frequently, the large intestine.

IBD is simply a mild sickness for certain individuals. For others, it's a crippling illness with potentially fatal consequences.2

For millions of years, humans have evolved to coexist with microorganisms.

Microbes have evolved to play a variety of crucial roles in the human body over this time. It would actually be extremely difficult to survive without the gut microbiota.

Your body is impacted by your gut microbiota from the moment of your birth.

The first time you come into contact with bacteria is when you go through your mother's birth canal. On the other hand, fresh data implies that infants might be exposed to certain microorganisms while still in the womb.

As an individual grows, their gut microbiome diversifies, resulting in a greater variety of bacteria species being present. A more diverse microbiome is thought to be beneficial to your health.

It's interesting to note that your gut flora's variety is influenced by what you eat.3

Causes of IBD

Since IBD is an autoimmune disease, healthy tissues are attacked by the immune system. The cause of this and the reason why some people get IBD while others do not are unknown. Nevertheless, additional research is being done to determine the exact causes of the illness as well as the effects of immunological, environmental, genetic, and other factors, such as the composition of gut flora.

Any racial or ethnic group can be affected by IBD, however statistically, those of Jewish ancestry are more likely to get the condition. In the southern hemisphere, inflammatory bowel disease is uncommon.1

The gut microbiome in health and diseases

Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are two intestinal disorders that may be influenced by the microbiome.

 Gut dysbiosis may be the cause of the bloating, cramps, and stomach pain that IBS sufferers experience. This is because a lot of gas and other chemicals are produced by the microorganisms, which aggravates the symptoms of intestinal discomfort.

But the microbiome's beneficial microorganisms can also enhance intestinal health.

Probiotics and yogurt contain specific Lactobacilli and Bifidobacteria that can help close gaps between intestinal cells and stop leaky gut syndrome.These species are also capable of preventing bacteria that cause disease from adhering to the gut wall.

Actually, using specific probiotics containing Lactobacilli and Bifidobacteria help lessen the symptoms of IBS.3

Insights from research

A two-drug combination that blocks both IL-22 and IL-1R may be used to treat IBD, according to new microbiome-based research. The "upstream cues" of microbial interactions with intestinal cells were investigated by this research. According to their findings, IL-1R and IL-22 have the ability to start "a chain reaction" that intensifies the inflammatory response.

Based on this study, immune system cells found in the intestines are able to identify microorganisms. The IL-1 protein receives signals from these immune cells, and IL-22 protein levels rise. This protein works with IL-1 to activate the intestinal epithelial cells' IL-1 receptor (IL-1R). In addition to other genes that attract inflammatory cells to the tissue, activation of IL-1R also causes ROS gene activity. According to the researchers, this chain reaction causes an overactive inflammatory response that may harm the intestine.

Clinical trials have assessed a few monoclonal antibodies that can block IL-22 or IL-1R for a range of autoimmune disorders.4

Symptoms of IBD

  • Abdominal pain
  • Blood in stool, rectal bleeding
  • Urgency
  • Incontinence
  • Weight loss
  • Anemia
  • Malnourishment 
  • Stunted growth in children with inflammatory bowel disease
  • Depression and anxiety
  • Due to intestinal inflammation, the illness may also result in edema or lumps. As your symptoms are being assessed, your doctor might discover these on X-rays and other tests.

IBD can harm the intestines over time if inflammation is not managed, leading to:

  • Abscesses (infected pockets that have the potential to rupture the intestinal wall).
  • Strictures (bowel segments that narrow).
  • Fistulas (abnormal openings that develop when two organs or veins that shouldn't usually link meet).
  • Increased chances of colon cancer.1

Managing IBD symptoms through microbiome

Rather than being a straightforward cause-and-effect relationship, dysbiosis and the onset of IBD are linked in a complicated and dynamic way. In order to treat IBD, probiotic supplements, particularly those containing butyrate-producing bacteria, and fecal microbiota transplantation (FMT) may be utilized. A probiotic called E. Coli Nissle 1917 has the ability to stop Salmonella and other harmful bacteria from growing.

Iron shortage is commonly observed in IBD patients, and the intestinal milieu that is iron-deficient facilitates the intestinal colonization and potential therapeutic benefit of Escherichia coli Nissle 1917. A diet high in iron may lessen the effectiveness of E. coli Nissle 1917, and treatment plus diet will provide twice the benefits for half the work.

As a local probiotic, the genetically modified E. coli Nissle strain shielded mice from chemically induced colitis and encouraged mucosal repair. Probiotics were observed to lower the incidence of side effects, including steroid treatment, hospitalization, and surgery, in a retrospective examination of 200 IBD patients.5

Ways to improve your gut microbiome

Your gut microbiota can be improved in a variety of ways, such as:

  • Consuming a variety of meals which can result in a varied microbiome, a sign of healthy gut flora. Legumes, beans, and fruit in particular are high in fibre and can encourage the growth of beneficial Bifidobacteria.
  • Consume foods that have undergone fermentation: foods like kefir, sauerkraut, and yoghurt all include Lactobacilli, which are beneficial bacteria that help lower the number of disease-causing species in the gut.
  • Reduce how often you use artificial sweeteners. According to certain research, aspartame and other artificial sweeteners raise blood sugar levels by encouraging the growth of harmful bacteria like Enterobacteriaceae in the gut microbiome.
  • Consume foods high in prebiotics: prebiotics are a kind of fibre that promotes the development of beneficial microorganisms. Apples, bananas, asparagus, oats, and artichokes are among foods high in prebiotics.
  • Breastfeeding is crucial for development of the gut microbiome and should be carried out for at least six months. Compared to bottle-fed children, breastfed children have higher levels of beneficial Bifidobacteria for at least six months.
  • Consume entire grains. Whole grains are high in fibre and beneficial carbohydrates like beta-glucan, which is broken down by gut microbes to help with diabetes, weight, cancer risk, and other conditions.
  • Give a plant-based diet a try. Diets high in vegetables may help lower cholesterol and inflammatory levels, as well as microorganisms that cause diseases like E. coli.
  • Consume a diet high in polyphenol-rich foods. Plant components called polyphenols can be found in whole grains, olive oil, red wine, green tea, and dark chocolate. The microbiome breaks them down to promote the growth of beneficial microorganisms.
  • Take a probiotic supplement. After dysbiosis, probiotics, which are living bacteria, can aid in reestablishing the gut's natural balance. They "reseed" it with beneficial bacteria to do this.
  • Use antibiotics only when required. Antibiotic resistance and weight gain may be related to the killing of several beneficial and harmful bacteria in the gut microbiome by antibiotics. Take antibiotics only when prescribed by a physician.3

Summary

In conclusion, the intricate relationship between inflammatory bowel disease (IBD) and the microbiome underscores the significance of microbial dysbiosis in disease pathogenesis. Research suggests that alterations in the gut microbiota composition and function can contribute to the onset and progression of IBD, influencing immune responses and gut barrier integrity. While certain microbial species may exacerbate inflammation, others play protective roles. Understanding this interplay opens avenues for therapeutic interventions, such as microbiota-targeted treatments and dietary modifications, aimed at restoring microbial balance and ameliorating disease symptoms. 

Moreover, advancements in metagenomics and computational techniques offer promising tools for unravelling the complex microbial signatures associated with IBD subtypes, facilitating personalised medicine approaches. Ultimately, ongoing exploration of the microbiome's role in IBD holds immense potential for developing novel strategies to better manage and potentially prevent these debilitating conditions.

Many different kinds of bacteria, fungi, and other microorganisms make up your gut microbiome. The gut microbiome regulates digestion, strengthens the immune system, and supports numerous other elements of health, all of which have a significant positive impact on overall health. Weight gain, excessive blood sugar, high cholesterol, and other conditions may be influenced by an unbalanced population of beneficial and harmful bacteria in the intestines. Eat a wide range of fruits, vegetables, whole grains, and fermented foods to promote the growth of beneficial bacteria in your digestive system.

References

  1. Inflammatory bowel disease (IBD) [Internet]. Hopkinsmedicine.org. 2022 [cited 2024 Apr 18]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/inflammatory-bowel-disease
  2. Inflammatory bowel disease (IBD) [Internet]. Mayo Clinic. 2022 [cited 2024 Apr 18]. Available from: https://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/symptoms-causes/syc-20353315
  3. Robertson R. How does your gut microbiome impact your overall health? [Internet]. Healthline. 2017 [cited 2024 Apr 18]. Available from: https://www.healthline.com/nutrition/gut-microbiome-and-health
  4. Branca M. Microbiome points to inflammatory bowel disease treatment [Internet]. Inside Precision Medicine. 2023 [cited 2024 Apr 18]. Available from: https://www.insideprecisionmedicine.com/news-and-features/microbiome-points-to-inflammatory-bowel-disease-treatment/
  5. Qiu P, Ishimoto T, Fu L, Zhang J, Zhang Z, Liu Y. The gut Microbiota in inflammatory bowel disease. Front Cell Infect Microbiol [Internet]. 2022;12. Available from: http://dx.doi.org/10.3389/fcimb.2022.733992

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Anit Joseph

BAMS, Ayurvedic Medicine/Ayurveda, Rajiv Gandhi University of Health Sciences

Anit Joseph is a skilled Ayurvedic practitioner with a Bachelor's degree from Rajiv Gandhi University of Health Sciences. She excels in diagnosis, herbal remedies, and personalized treatment plans, aiming to empower her clients to achieve holistic wellness through Ayurveda.

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