Altered profiles of intestinal microbiota and organic acids may be the origin of symptoms in irritable bowel syndrome

Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Neurogastroenterology and Motility (Impact Factor: 3.59). 11/2009; 22(5):512-9, e114-5. DOI: 10.1111/j.1365-2982.2009.01427.x
Source: PubMed


The profile of intestinal organic acids in irritable bowel syndrome (IBS) and its correlation with gastrointestinal (GI) symptoms are not clear. We hypothesized in this study that altered GI microbiota contribute to IBS symptoms through increased levels of organic acids.
Subjects were 26 IBS patients and 26 age- and sex-matched controls. Fecal samples were collected for microbiota analysis using quantitative real-time polymerase chain reaction and culture methods, and the determination of organic acid levels using high-performance liquid chromatography. Abdominal gas was quantified by image analyses of abdominal X-ray films. Subjects completed a questionnaire for GI symptoms, quality of life (QOL) and negative emotion.
Irritable bowel syndrome patients showed significantly higher counts of Veillonella (P = 0.046) and Lactobacillus (P = 0.031) than controls. They also expressed significantly higher levels of acetic acid (P = 0.049), propionic acid (P = 0.025) and total organic acids (P = 0.014) than controls. The quantity of bowel gas was not significantly different between controls and IBS patients. Finally, IBS patients with high acetic acid or propionic acid levels presented with significantly worse GI symptoms, QOL and negative emotions than those with low acetic acid or propionic acid levels or controls.
These results support the hypothesis that both fecal microbiota and organic acids are altered in IBS patients. A combination of Veillonella and Lactobacillus is known to produce acetic and propionic acid. High levels of acetic and propionic acid may associate with abdominal symptoms, impaired QOL and negative emotions in IBS.

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    • "In addition, PPA increases contraction of colonic smooth muscle [17], dilates colonic arteries [18], activates mast cells [19] and increases the release of serotonin from gut enterochromaffin cells [20], [21]. In spite of the multiple beneficial effects of SCFA on host gastrointestinal activity, excessive quantities of PPA have been reported in gingival inflammation [22], acne [23], irritable bowel syndrome [24] and in the neurometabolic disorder propionic acidemia [25]. In this heterogeneous inborn error of metabolism, which may be underreported [26], accumulation of PPA is associated with developmental delay, seizure and extrapyramidal findings, often accompanied by gastrointestinal symptoms [25], [27], confirming that a homeostatic balance of SCFA may be necessary. "
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    • "Although it is unclear how these molecules influence central neurotransmission, it is possible that they can alter the central levels of neurotransmitters in the brain, leading to behavioral changes (Swain, 2006). Support for the premise that the intestinal microbiota can influence behavior comes from studies that have found an association between high levels of self-reported anxiety and elevated fecal concentrations of propionic acid (Tana et al., 2010) as well as the findings that commensal lactobacilli and bifidobacteria produce gammaaminobutyric acid (Barrett, Ross, O'Toole, Fitzgerald, & Stanton , 2012), an amino acid neurotransmitter with anxiolytic properties . Gut bacteria also produce serotonin (5-HT), dopamine (D), noradrenaline (NA), and acetylcholine (ACh). "
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    Biological Research for Nursing 07/2014; 17(2). DOI:10.1177/1099800414541541 · 1.43 Impact Factor
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    • "Subjects in the control group may for instance be suffering from irritable bowel syndrome (IBS) which is a common intestinal disorder. The fecal microbiota has also been shown to be altered in patients suffering from IBS [52, 53], and discriminating IBS from IBD is a common clinical challenge [54]. The control patients in the present study all had symptoms without inflammation, probably also including IBS in several cases. "
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