NPR covers new IBD microbiome study

The study was for crohn's but it's of obvious interest to us all

www.npr.org/blogs/health/2014/03/12/289041150/mix-of-gut-microbes-may-play-role-in-crohns-disease

Well here is another one of interest.

I found the first one pro posted about 30 seconds after it came out but was so p'owed that it was

a pay article I forgot to post it.

Old Mike

http://medicalxpress.com/news/2014-03-relationship-gut-bacteria-blood-cell.html

Here you go Gary what I can dig up on the bacteria.

http://www.cell.com/cell-host-microbe/abstract/S1931-3128(14)00063-8

What I find interesting about the results is that they tie into this older paper from a few months ago:

Scientists find key to growth of 'bad' bacteria in inflammatory bowel disease:
www.sciencedaily.com/releases/2013/02/130207172102.htm

I hear ya.

I don't think I buy into the gut flora theory. For a start, antibiotics (killing the bad guys) and probiotics (replenishing the good guys) do not have a good track record in treating Crohn's, suggesting that manipulating the gut flora is not very relevant.

Secondly, in my case I hadn't been on any antibiotics, been abroad, had an illness, etc, before I came down with chronic diarrhoea for the first time in my life. What would have changed my gut flora to trigger Crohn's?

I really think this is the case of the chicken and the egg: what comes first, IBD or the altered gut flora? Until that can be established, I will continue to suspect that altered gut flora is more likely to be a consequence of IBD than its trigger.

I agree with NCOT and Gary. There is no evidence [yet] of what causes the dysbiosis, or what to do to reverse the change. I do think it is very important that people are focusing more on this issue. Small steps, my friends. Defining the problem is just the beginning.

If it were as simple as taking a probiotic to cure IBD, we would all be doing that. The fact is that those of us who improve with probiotics must maintain our diligence for ever more. The prebiotics idea is a good one too, and perhaps that kind of dietary change can prevent further degradation in the gut's biosphere. But none of this is a "cure."

Gary I posted a study a few months back, on early onset UC just like this Crohns study,
they said no dysbiosis for UC early on. But as we all know dysbiosis happens somewhat later.

So we get some event/mucosal breech,immune system goes nuts kills off as much as it can,causing
dysbiosis. While this is going on the bacteria that survive are becoming more pathogenic.

Why the immune system does not shut off after the initial breech/event might be the question.

Then again what if the mucosal breach is not fixed for some reason,the inflammation might go on for ever.

Since UC starts distally, and the bacteria load is highest distally, and also the mechanical abrasion and pressure

are real high in the rectum,a thinned out mucus layer would not be good.

I don't know about now but when first checked by scope, I only had the first 6 cm involved.

Old Mike

Post Edited (Old Mike) : 3/13/2014 12:41:58 PM (GMT-6)

Thanks for posting this. I'm glad they're researching this, but I have also read about studies not knowing whether the dysbiosis is a result of IBD or the cause as stated above.

As far as probiotics, there are so many different bacteria in our guts that it doesn't seem that the minimal strains that are introduced by probiotics would be enough to even touch what we have going on. That's where I think more research on fecal transplants would be helpful, since those would have a multitude more of bacteria than a probiotic. The issues I can think of though, are how do we know we're compatible with another person's, um, probiotic. I read a study where there are three entereotypes, kind of like blood types, but for gut flora. So maybe that needs to be taken into account. Also, I wonder how many people actually would be a good donor with so many people having been on antibiotics, eating poor diets etc.

Of course, yes, if the issue is our immune system, who knows if that would really help.

My crohn's colitis was stirred up by taking antibiotics, and then for a long time, the only way I could get into remission, even while being on biologics, steroids and methotrexate, was to take Cipro. So I can see directly how this applies to me.

NCOT- your gut flora can be changed by factors other than antibiotics, leaving the country or an illness. It can be changed by stress (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2849416/?tool=pubmed) and your diet as well.

"Patients with IBD have a compromised mucus layer and an epithelial surface that is densely coated with bacteria"

This has been shown in many studies now. Bring two things to my mind:

1) What happens if you just obliterate all bacteria and start fresh - would one heal? Somewhat like those that get scoped and the procedure cleans them out so to speak and they no longer have IBD. Or like the people with Sepsis where they flush the colon with PEG and the people recover.

2) What in the world is causing the defective mucus barrier? Bacteria, fungus, autoimmune or perhaps virus? Like chronic viral infection which isn't all that often looked into. Makes me curious. Especially with the change in symptoms I had from my recent viral infection (head cold). It totally effected mucus production out my butt as well. Though I seem to be good again now that I've recovered from the head cold.

Although I'm 100% bacteria biased, my deep dirty secret is that I'm honestly terrified we do have an "autoimmune" condition... At least with a bacterial infection we can hope for a quick fix if it can be proved. "autoimmune" scares the crap out of me cause I immediately think more of a life time of medications and side effects.

Sorry I should have said spontaneous remission instead of "no longer have IBD", haha - But yes there is some evidence of people going into remission from prep. Though I think somewhat rare. Many are aggravated by the prep. Others on here will tell you they feel awesome after the procedure. I am one of those that always feels like a million bucks after the procedure and the next few days. Always made me wonder what it might be flushing out. I seriously asked my GI when I got into the room to spray away with the flush and vacuum thing cause it felt good after.

But it also might flush out the good guys...

Old Mike knows what this is called. i can't think of it right now.

FYI - for UC'ers having success with nicotine patches I read but cannot find the link anymore about nicotine enema's being successful in some with left sided colitis. In part I come back to thinking about the antibacterial aspect of nicotine and well.. i never would have thought about a nicotine enema!

Well OM - perhaps one could take anther pass down the fungus road. These two taken together are intriguing:

Fighting for oral dominance: Good fungi keep bad ones in check in healthy mouths
www.sciencedaily.com/releases/2014/03/140313173505.htm

Immune cells need each other to combat deadly lung-invading fungus
www.sciencedaily.com/releases/2014/03/140313122540.htm

The need to involve both starting with neutrophils and then some back-up from bone marrow derived fighters is eerily similar to IBD response.