Ulcerative colitis, Crohn's disease and irritable bowel syndrome patients need fecal transplant research and treatment
Department of Complementary & Alternative Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa,651 Ilalo Street, MEB 223 , Honolulu, HI 96813, USA. Electronic address: .Journal of Crohn s and Colitis (Impact Factor: 3.56). 10/2013; 8(2). DOI: 10.1016/j.crohns.2013.09.011
Full-textDOI: · Available from: Amy C. Brown, Jun 17, 2014
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ABSTRACT: A new frontier of basic human biology has opened up, which is changing our understanding of what constitutes the human body. This new knowledge is fuelling a paradigm shift from the dominant, 20th century view that viruses, bacteria and fungi operated independently to cause disease. Now, we are beginning to view a more complex and nuanced interpretation with increased recognition of the importance of commensalism, synergy and balance of microbiota in human health.1 In this commentary we hope to briefly summarise studies into the bacterial and viral microbiome and how this shifting paradigm affects epidemiology. Metagenomic epidemiology The distribution of human diseases is directly linked to how different people form groups and interact with each other and their environment box 1. This interaction defines a community structure. Community structure has been long recognised as a major determinant of the spread of traditional infectious diseases. Examples range from tuberculosis in crowded slums to the recent spread of Ebola in Africa, where the human behaviours that create community structure often dictate infectious disease spread. These diseases are very sensitive to the social network configuration of the population in which they occur.2 Moreover, social networks within these populations are also important determinants of chronic and traditionally non-infectious diseases. For example, obese individuals are more likely to have other obese individuals as contacts.3 However, even in these ‘non-infectious’ diseases, microorganisms may play a greater role than previously thought. Box 1 Definitions: METAGENOMIC EPIDEMIOLOGY- The study of the distribution and determinants of the microbiome structures and their relationship to disease. MICROBIOTA- A community of microorganisms (viruses, bacteria, fungi, archea) living in a defined niche MICROBIOME- The community of commensal, symbiotic, and pathogenic microorganisms (microbiota) or their genomes sharing the human body. METAGENOME- The totality of non-human nucleic acids belonging to all the microbiotas …Journal of Epidemiology & Community Health 09/2014; 69(4). DOI:10.1136/jech-2014-203997 · 3.29 Impact Factor
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ABSTRACT: Irritable bowel syndrome (IBS) is a common condition characterized by abdominal pain or discomfort, bloating, and altered stool form and passage. Small intestinal bacterial overgrowth (SIBO) is a condition in which there is overgrowth of bacteria in small bowel in excess of 10(5) colony forming units per milliliter on culture of the upper gut aspirate. Frequency of SIBO varied from 4%-78% among patients with IBS and from 1%-40% among controls. Higher frequency in some studies might be due to fallacious criteria [post-lactulose breath-hydrogen rise 20 PPM above basal within 90 min (early-peak)]. Glucose hydrogen breath test (GHBT) has a low sensitivity to diagnose SIBO. Hence, studies based on GHBT might have under-estimated frequency of SIBO. Therefore, it is important to analyze these studies carefully to evaluate whether the reported association between IBS and SIBO is over or under-projected. This review evaluates studies on association between SIBO and IBS, discordance between different studies, their strength and weakness including methodological issues and evidence on therapeutic manipulation of gut flora on symptoms of IBS.World Journal of Gastroenterology 03/2014; 20(10):2482-2491. DOI:10.3748/wjg.v20.i10.2482 · 2.43 Impact Factor