Intestinal dysbiosis is a disorder of the quantitative and qualitative composition of microorganisms (bacteria, viruses, fungi) forming the human intestinal microbiota. So what exactly? – You can ask. Simply put, dysbiosis occurs when, for example, there is an overgrowth of pathogenic bacteria in the intestine and the number of beneficial microorganisms decreases, and also when the diversity of these microorganisms changes.

Intestinal dysbiosis leads to unfavorable health consequences. As I can guess, you probably know these sayings: “immunity comes from the gut”, “gut is our second brain”, “health begins in the gut”. It’s all true.

What are the functions of the intestinal microbiota? 

• participates in the production of vitamins, digestive enzymes and the so-called short-chain fatty acids,
• maintains the tightness of the intestinal barrier (health problems occur when it is unsealed),
• regulates metabolism,
• thanks to it, complex polysaccharides derived from plant products are fermented, which are not digested by human digestive enzymes,
• shapes immunity (the more harmonious the composition of the microbiota, the lower the frequency of illnesses and infections),
• supports the production of serotonin (the so-called “happiness hormone”), neurotransmitters,
• inhibits the growth of pathogenic microbiota, i.e. microorganisms that cause undesirable ailments and lead to the development of diseases,
• thanks to the production of specific metabolites, it affects the proper functioning of the nervous system (in some neurological diseases, e.g. autism, Parkinson’s disease, there are disturbances in the quantitative and qualitative composition of the microbiota),
• has an impact on the vaginal microbiota, reducing the risk of bacterial or fungal infections in women.

INTESTINAL DYSBIOSIS – WHAT CAUSES IT?

There are many factors affecting the disturbance of the quantitative and qualitative composition of the intestinal microbiota. The most common causes of dysbiosis include:

• medications taken, e.g. non-steroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitors (used in reflux, heartburn), antidepressants, hormonal drugs, statins ( HEREyou will find an article on how drugs destroy the microbiota),
• antibiotics used as medicines, but also taken with food, often without our awareness,
• highly processed diet western, with a small amount of vegetables and fruits, fiber, with a high consumption of processed products,
• bacterial, viral and fungal infections,
• low physical activity,
• alcohol,
• smoking,
• chronic stress,
• environmental and food contamination,
• excessive hygienization.

INTESTINAL DYSBIOSIS – SYMPTOMS AND MORE SERIOUS HEALTH CONSEQUENCES

The symptoms of intestinal dysbiosis are often non-specific and it is difficult to determine whether the symptoms that accompany a given person are caused by dysbiosis or, for example, a specific disease or problem related to anatomical changes in specific organs/tissues.

Therefore, dysbiosis can manifest itself slightly differently in each person, and the severity of symptoms is also an individual feature and related to the specific health situation of a given person. I would also like to emphasize here that at the moment it is very difficult to assess what the composition of the dysbiotic intestinal microbiota looks like. 

The reason is that the microbiota of each person is different, unique. Just like fingerprints or the composition of breast milk. It depends on many factors, e.g. health and existing diseases, diet, age, sex, hormonal balance, environment and living conditions, as well as latitude. The intestinal microbiota is also affected by how we were born and whether we were fed breast milk.

But back to the symptoms of dysbiosis. What can worry us?

• frequent and recurrent ailments from the gastrointestinal tract : constipation, diarrhoea, flatulence, gas or, for example, alternating experiences of constipation and diarrhea,
• abnormal consistency of the stool (e.g.  the Bristol stool scalemay help in the assessment ), the presence of mucus in the stool, sometimes blood,
• nausea and/or vomiting (recurring, with no other apparent cause),
• unpleasant smell from the mouth,
• heartburn,
• various types of skin problems, e.g. acne, dandruff,
• recurrent urogenital infections,
• headaches also defined as migraines,
• problems with concentration, fatigue,
• decreased libido,
• upper respiratory tract infections.

Consequences of intestinal dysbiosis: 

• promotes gastrointestinal ailments, such as: constipation, diarrhoea, bloating, gases – significantly reducing the quality of life,
• causes chronic inflammation in the body,
• adversely affects the digestion and absorption of nutrients, leading to nutritional deficiencies,
• may increase the risk of developing allergies and food intolerances,
• causes leakage of the intestinal barrier,
• contributes to fertility problems,
• increases the risk of depression (including postpartum depression) and other mental problems,
• may lead to exacerbation of the symptoms of specific diseases or be one of the factors causing them, e.g. diabetes, autoimmune diseases (Hashimoto’s, multiple sclerosis), obesity, PCOS, small intestinal bacterial overgrowth(SIBO ), Leśniowski’s disease Crohn’s, ulcerative colitis.

INTESTINAL DYSBIOSIS – HOW TO DIAGNOSE IT?

As I mentioned earlier, we do not have a pattern of dysbiotic microbiota . Therefore, it is very difficult to conduct targeted treatment, especially since it will vary greatly from person to person due to different health conditions.

Although we know more and more about the microbiota, and new data is coming, there are still many questions that we do not know the answers to. Consequently, there are currently no sensitive and specific diagnostic tools that would allow us to assess the scale of intestinal microbiota disorders and introduce targeted treatment. 

Some specialists (doctors or nutritionists) recommend their patients to perform a stool test. This is an imperfect method and still controversial in the scientific community, although taking into account the fact that the stool is in contact with the intestinal wall and microbiota, its examination may partially indicate the condition of the microbiota and intestines.

The advantage of such a test is its non-invasiveness and providing a large amount of information.

Urine can also be an indirect way to assess the microbiota. It explores, among other things, the presence of organic acids, which are metabolic products of intestinal bacteria. An example is the high concentration of d-arabinitol, which is a product of Candida yeast metabolism. Usually, its excess in the urine indicates a fungal overgrowth in the intestines.

What can also indirectly be used to assess intestinal dysbiosis is based on the  determination of markers related to, for example, intestinal barrier permeability , which I wrote about in the  article about intestinal microbiota in insulin resistance . It is in the situation of intestinal dysbiosis that its integrity is lost. It becomes permeable for toxins, pathogens, allergens, antibodies that penetrate into the blood and cause e.g. inflammation.

Such indirect markers of “tracking” intestinal dysbiosis may include:

• calprotectin,
• alpha-1-antitrypsin,
• beta-defensyny,
• laktoferyna,
• secretory immunoglobulin A,

For the record:

The intestinal barrier is a structure that is built of one layer of intestinal epithelial cells, which is covered with a protective layer of mucus with microbiota living in it. Under the epithelium there are cells the lymphatic, nervous, circulatory or immune systems.

INTESTINAL DYSBIOSIS – TREATMENT

What can be done to help a patient treat dysbiosis is based on their individual health situation. If a patient has a specific set of diseases or disorders, and we have a significant range of knowledge related to what the intestinal microbiota of such people is usually characterized by, we have the results of diagnostic tests, we can help relatively effectively. Of course, this goes hand in hand with dietary and lifestyle recommendations as well as appropriate supplementation, including probiotic therapy.

A good example of a disease entity with intestinal dysbiosis is the irritable bowel syndrome (IBS). We know (thanks to clinical trials) which probiotic strains can help such patients restore the comfort of life (reduce abdominal pain, bloating, gas, diarrhea/constipation), but also what diet is beneficial for them (low FODMAP diet).

In patients with IBS, the probiotic Sanprobi IBS, containing the bacterial strain Lactobacillus plantarum 299v , which has a widely documented clinical effect, will be perfect. I wrote about this strain in the context of improving the absorption of iron from the diet. If you have iron deficiency, I recommend you  an article about a diet that supports the absorption of this ingredient.