Living in harmony doesn’t just involve your external surroundings, but your inner community. Your gut flora can either be in or out of balance – the later of which we call dysbiosis. Maintaining a happy microbiome makes all the difference for how happy you feel. Learn what causes dysbiosis, and what you can do to test and treat it. 

By Ana Silva

There are more microbes in your gut than there are cells in your body, therefore it is essential to maintain a balance between the “healthy” and the harmful bacteria. When this equilibrium is disrupted, it can lead to dysbiosis and cause several negative health effects. Learn all about dysbiosis, how to recognise its symptoms and what you can do to treat and prevent it.

What Does Dysbiosis Mean & How Can it Affect Your Gut?

Dysbiosis is a medical term for microbial imbalance in or on the body that can negatively impact health1.

This alteration happens to the microbiome, which is the sum of all the microorganisms that live on or inside the human body. However, dysbiosis is more commonly reported to happen in the gastrointestinal tract – stomach and gut. Moreover, the variety, balance and symbiotic interactions between these microorganisms are crucial for good health.

For instance, having more of one microbe and not enough of others, or a lack of diversity among the different types of microorganisms that make up the microbiome, can lead to dysbiosis.

Dysbiosis is a medical term for microbial imbalance in or on the body that can negatively impact health1.

Several factors can disrupt this fine balance between the amount and diversity of beneficial microbes in the organism. This can be caused by certain conditions, diseases, poor diet, parasites, stress or even certain medications, such as antibiotics2. Dysbiosis is closely associated with Irritable Bowel Syndrome (IBS) and SIBO (Small Intestinal Bacterial Overgrowth), however it is not known whether it is a cause or an effect. Unfortunately, gut dysbiosis has vague symptoms that are often overlooked and undiagnosed despite its importance, as an imbalanced gut can severely impact your daily life.

Dysbiosis is Associated with Several Conditions

Dysbiosis has been recognized as playing a role with several health problems. However, it is not entirely clear what this role is. It is hypothesized that the fine balance of the bacteria in the gut can impact immunity by directly influencing the health of the gut lining. A healthy gut lining has some permeability, allowing nutrients to pass through the gut, whilst also maintaining a barrier function to filter out harmful substances from entering the body (and possibly causing inflammation). Indeed, dysbiosis has been associated with the following illnesses:3–5

  • Inflammatory Bowel Disease (IBD)
  • Irritable bowel Syndrome (IBS)
  • Type II Diabetes
  • Obesity
  • Celiac disease

What Causes Dysbiosis?

Several external factors are at play.

1. Diet

Changes in diet, such as an increase in processed foods, sugar, saturated fats and animal protein can lead to dysbiosis. Typical Western diets that are high in saturated fats, animal protein and sugar are more frequently correlated with dysbiosis6.

2. Lifestyle

Leading a sedentary lifestyle without exercise, as well as smoking, drinking alcohol and experiencing high levels of stress all elevate risk for developing dysbiosis5.

3. Antibiotic Use

Antibiotics can kill many beneficial gut bacteria, subsequently causing an imbalance in the gut microbiome2. The abuse of antibiotics can also lead to opportunistic bacteria and fungi to overgrow and cause infections in the skin, genitals, and GI tract.

4. Parasites

Parasites, viruses and fungi can also cause disturbances in our microbiota7. These are often caused by contaminated water and food and sexually transmitted diseases. The most common parasitic condition is Candida overgrowth, which leads to infection. This usually happens in the vaginal flora, when the levels of our good old bacteria friend Lactobacillus are disrupted. Some risk factors for contracting a parasitic infection include lack of sanitary conditions and clean water, swimming in lakes, and having pets that stay outdoor often.

Depending on the parasite, symptoms can vary a lot. Some can be visible alterations and symptoms in the genital areas in cases of sexually transmitted parasites, others can range from diarrhea, sudden weight loss, nausea, dehydration, flu-like symptoms, extreme fatigue, stomach pain and fever8.

5. Small Intestine Bacterial Overgrowth ( SIBO)

SIBO is a condition in which there is excessive bacteria in the small intestine, which is responsible for nutrient absorption9. This is problematic, as these microorganisms should live in the large intestine instead, where the microbiome is. When food is not moved along the small intestine well enough, it can lead to bacteria growth. If the beneficial bacteria that help you digest food cannot keep up with the “bad” bacteria, this can lead to a fast multiplication of the harmful bacteria and lead to SIBO.

Non-invasive breath tests have been widely used to detect SIBO, namely the glucose and lactulose breath-test, which test for hydrogen and methane respectively10.However these techniques need cautious interpretation as there are many variables that can give a misleading result11. Nevertheless, there is a quantitative test known as the jejejunal aspirate culture, which is still considered as the gold standard diagnosis toll for this condition12.

Symptoms of SIBO are mainly pain the abdomen, fatigue, bloating, diarrhea and constipation. However many other conditions can cause these symptoms. If you have SIBO and it gets worse, your small intestine won’t be able to absorb enough nutrients. This in turn can lead further symptoms such as anemia and weight loss.

How Do You Test for Dysbiosis?

Like IBS, there isn’t really a test or specific diagnostic tool for dysbiosis. Usually, the doctor will assess your medical history, perform physical exams and tests to rule out other associated conditions depending on your symptoms and how you react to certain treatments.

Some tests include imaging and endoscopic tests (eg. Colonoscopy, CT Scan), laboratory tests such as lactose and gluten intolerance, breath tests (usually used to check for SIBO) and stool tests.

Can I Test for Dysbiosis with GUTXY?

Our wellness reports do not diagnose health conditions, including dysbiosis, neither does it replace medical advice. Our tests are aimed for those who want to learn more about their body and the health of their gut.

However, some healthcare providers use microbiome tests in complement with the standard diagnosis tools. With our test kits you can get an overview on the wellness of your microbiome. Using sequencing technology, our team makes a detailed analysis report on the variety, richness and balance between the different microbes in your gut. In addition, if you choose our RESET program, you can get a personalized diet plan tailored to your own unique microbiome, aimed specifically to provide you stomach relief with many other tips.

Unfortunately, gut research is still at a very premature stage and microbiome tests are not (yet) recognized as a diagnosis tool. So before making any major lifestyle changes you should always consult a healthcare professional first! We even offer our own personal microbiome consultations. Reach out to us if you’d like to learn more. 

Treating Dysbiosis

Most of the treatment will depend on the severity of your symptoms and how well you react to. In current medicine practice, diagnosis and treatment is prescribed by comparison to the general population, and your own unique features, like your microbiome, are most likely disregarded.

However, researchers predict that in the near future, doctors will analyze your microbiome and prescribe treatment according to your own gut features as a form of personalized medicine13.

Meanwhile, you can have control over what you eat. Switching up to a healthy diet combined with an active lifestyle, and avoiding foods that trigger you is usually the way to start.

Diet and Lifestyle Changes

Diet can have a profound effect in your gut flora. Here are a few things you can try:

  • Avoid your own unique triggers. Keep a food diary and track your symptoms. Together with a nutritional specialist, you can figure out how best to design your diet. 
  • Reduce intake of FODMAPS. A recent study of low-FODMAP diet intervention indicates an improvement in symptoms for at least 50% of IBS patients14.
  • Avoid SAD diets. Western style diets are associated with less microbiome diversity6. In this diet, the foods that should be avoided include mostly dairy, processed meats, white bread, saturated fats and refined sugar.
  • Avoid alcohol and smoking. 
  • Try mindfulness techniques. 

Probiotics

“Probiotic therapies have attempted to modify disease expression by favourably altering bacterial composition, immune status, and inflammation4.

You probably have heard of probiotics – the live bacteria and yeast that provide numerous health benefits, by improving the composition of your gut microbiome.
There is emerging evidence that show that supplementing probiotics can ameliorate symptoms related to dysbiosis and IBS15. However, it is still unclear what specific combination of strains is the most effective, also partly because your microbiome is unique.

Fecal microbiota transplantation (FMT)

Fecal microbiota transplantation (FMT) has been receiving a lot of attention recently. FMT is the administration of a solution of fecal matter from a healthy donor into the large intestine of a receiver, in order to restore the unbalanced microbial composition16. This approach has been successful in the treatment of recurrent Clostridium difficile infection17, yet more evidence is needed to prove its overall long term efficiency and safety for this process to become a standardized treatment for dysbiosis.

Medication

The use of certain antibiotics still needs more confirmation, although promising results have been reported with use of rifaximin16, a large spectrum antibiotic that has low impact on the gut flora.


Final Considerations

The equilibrium and diversity between the different microbes in your gut are crucial to living a healthy lifestyle. Dysbiosis can be a temporary imbalance and it can be either the root or consequence of a gut illness. Therefore it is important to listen to your gut so you can intervene as soon as possible and avoid serious complications. Also bear in mind that it is crucial that you only take antibiotics under your doctor’s supervision.


References:

  1. Wilkins, L. J., Monga, M. & Miller, A. W. Defining dysbiosis for a cluster of chronic diseases. Sci. Rep. 9, 12918 (2019).
  2. Hawrelak, J. A. & Myers, S. P. The causes of intestinal dysbiosis: a review. Altern. Med. Rev. 9, 180–197 (2004).
  3. Carding, S., Verbeke, K., Vipond, D. T., Corfe, B. M. & Owen, L. J. Dysbiosis of the gut microbiota in disease. Microb. Ecol. Health Dis. 26, 26191 (2015).
  4. Tamboli, C. P., Neut, C., Desreumaux, P. & Colombel, J. F. Dysbiosis in inflammatory bowel disease. Gut 53, 1–4 (2004).
  5. DeGruttola, A. K., Low, D., Mizoguchi, A. & Mizoguchi, E. Current understanding of dysbiosis in disease in human and animal models. Inflamm. Bowel Dis. 22, 1137–1150 (2016).
  6. Conlon, M. A. & Bird, A. R. The impact of diet and lifestyle on gut microbiota and human health. Nutrients 7, 17–44 (2014).
  7. Toro-Londono, M. A., Bedoya-Urrego, K., Garcia-Montoya, G. M., Galvan-Diaz, A. L. & Alzate, J. F. Intestinal parasitic infection alters bacterial gut microbiota in children. PeerJ 7, e6200 (2019).
  8. Parasitic Infections | Definition and Patient Education. at <https://www.healthline.com/health/parasitic-infections>
  9. Dukowicz, A. C., Lacy, B. E. & Levine, G. M. Small intestinal bacterial overgrowth: a comprehensive review. Gastroenterol. Hepatol. (N.Y.) 3, 112–122 (2007).
  10. Charlesworth, R. P. & Winter, G. Small Intestinal Bacterial Overgrowth and Coeliac Disease – Coincidence or Causation? Expert Rev Gastroenterol Hepatol (2020). doi:10.1080/17474124.2020.1757428
  11. Simrén, M. & Stotzer, P. O. Use and abuse of hydrogen breath tests. Gut 55, 297–303 (2006).
  12. Losurdo, G. et al. Breath Tests for the Non-invasive Diagnosis of Small Intestinal Bacterial Overgrowth: A Systematic Review With Meta-analysis. J Neurogastroenterol Motil 26, 16–28 (2020).
  13. Behrouzi, A., Nafari, A. H. & Siadat, S. D. The significance of microbiome in personalized medicine. Clin. Transl. Med. 8, 16 (2019).
  14. Menees, S. & Chey, W. The gut microbiome and irritable bowel syndrome. [version 1; peer review: 3 approved]. F1000Res. 7, (2018).
  15. Ford, A. C., Harris, L. A., Lacy, B. E., Quigley, E. M. M. & Moayyedi, P. Systematic review with meta-analysis: the efficacy of prebiotics, probiotics, synbiotics and antibiotics in irritable bowel syndrome. Aliment. Pharmacol. Ther. 48, 1044–1060 (2018).
  16. Dale, H. F. & Lied, G. A. Gut microbiota and therapeutic approaches for dysbiosis in irritable bowel syndrome: Recent developments and future perspectives. Turk. J. Med. Sci. (2020). doi:10.3906/sag-2002-57
  17. Gupta, S., Allen-Vercoe, E. & Petrof, E. O. Fecal microbiota transplantation: in perspective. Therap. Adv. Gastroenterol. 9, 229–239 (2016).