Intestinal Dysbiosis in Irritable Bowel Syndrome

Intestinal dysbiosis is a term used to describe an imbalance in the gut commensal (normally resident) microbiome. When the balance of the gut bacteria is thrown off, usually due to a diet high in sugars and refined carbohydrates, the gut contents become more acidic. This promotes the overgrowth of Streptococcus and undergrowth of e-Coli. BNC clinicians, in collaboration withBioscreen Medical, have been observing gastrointestinal changes in the abnormal faecal tests of patients with IBS, as well as those with ASD and anxiety. These observations have enabled us to formulate effective therapy protocols, which have resulted in significant improvements, even the normalisation, of gut function in IBS sufferers.

Intestinal Bacteria in IBS

A healthy gastrointestinal tract has specific bacteria living within it. Normally, it is difficult to change the number and type of healthy bacteria, since they remain remarkably stable across populations and cultures. It is now widely recognised that changes in these bacterial population can have an adverse impact on our physical and mental health. This is because the bacteria in our digestive tract produce many vitamins, micronutrients, and chemicals that maintain the health of our bodies. When these bacteria are not normally distributed, chemicals that are detrimental to our health may be produced in larger amounts, causing dysfunction. That is why many bacterial supplements (such as probiotics) have become available. For example, probiotics containing Lactobacillus acidophillus and Bifidobacterium have been greatly touted. Unfortunately, it is not as simple as taking probiotics.

Often the bacteria that are overgrown in the gut will result in increased amine production, which can cause cognitive and attention deficits, depression, and tiredness.

Aerobic & Anaerobic Bacteria

There are two main classes of bacteria in our large intestines: aerobic bacteria, which need oxygen to survive, and anaerobic bacteria, which will die in the presence of oxygen. The most common aerobic bacteria (or aerobe) found in healthy individuals is Escherichia coli (E.coli)and it accounts for 90-95% of all aerobic bacteria. The second most common aerobe is Enterococcus, although it is a lot less common than E.coli at an average of 5% in the gut.

In our experience, the E.coli(aerobe) count is often quite low in IBS, at approximately 50% compared to the normal 90-95%. In ~ 80% of IBS patients at BNC, the percentage of E.coliis less than 10% and is associated with depression and fatigue. In 20% streptococcus is overgrown, and has replacedE.coli.

Changes to the anaerobes are also common. Normally, Bacteroides are the most abundant anaerobic bacteria in our large bowel. In the faeces of IBS patients, we consistently find a significant decrease in Bacteroides, and an increase in the number of Bifidobacteria compared to healthy controls.

Urinary Amino Acids in IBS

Analysis of the urinary amino acids of people with IBS patients shows reductions in key neurotransmitter precursors(amino acids and other organic acids) involved in energy production and muscle metabolism. Tryptophan is of particular importance since it is the precursor of Serotonin. Serotonin is an important brain neurotransmitter since it is essential to the maintenance of gastrointestinal motility and function. Interestingly,E.Coli and bacteroides both produceTryptophan by breaking down proteins.

Treatment of Intestinal Dysbiosis in IBS

At BNC, we use Pathlab urine tests and Bioscreen faecal tests to identify abnormalities in the body’s biochemistry, microbiology, and digestive capacity. The results of these tests help guide the course of treatment for the individual. Treatment options may include:

  • Normalisation of the patient’s gastrointestinal bacteria through specific antibiotics that target overgrown bacteria and replace undergrown bacteria (e.g., specific probiotics, prebiotics, and nutritional supplementation).
  • Supplementing the patient’s diet with amino acids based on their unique amino acid deficiencies (detected via the urine test).
  • Supplementing the patient’s diet with digestive enzymes, electrolytes, and other essential minerals to help impaired digestion and metabolism.
  • Nutritional supplementation to improve gut cell wall integrity and function.