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About the Gut Microbiome
Trillions of microbes live inside your gut. They have an effect on pretty much every aspect of your overall health, so it's important to keep them happy and healthy. If they aren't, dysbiosis can occur. Dysbiosis has been linked to many diseases and conditions, including IBS.
Find out more about your gut microbiome and its connection to IBS...
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What is the Gut Microbiome?
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Trillions of microorganisms call your GI tract home, right from your mouth all the way to the other end. This miniature world inside you is known as your gut microbiome.
You may hear the terms microbiome and microbiota used interchangeably, but they aren't exactly the same thing. The biome is the whole ecosystem, characterized by its environment and genetic material of the things that live there. The microbiota are actually all the individuals that live there.
For millions of years these microorganisms have co-evolved with us. They've made special adaptations to make use of whatever we can't digest. In return for food and shelter, they perform many important tasks for us. Essentially, we can't live without them.
Many of the microorganisms in your GI tract are bacteria, but there are also others like viruses, fungi and parasites. The many different species of bacteria have been studied the most so far, but research looking at the other types of microbes is ongoing.
Your Gut Microbiome is One of a Kind!
The gut microbiome is kind of like fingerprints, nobody's are exactly alike. That's one of the reasons it's so difficult to determine exactly what a healthy microbiome looks like, because everybody is different.
Many factors can influence your gut microbiome. Genetics play a role in the formation. Infants get their first microbiota during vaginal birth and through breast feeding. Other microbiota are introduced through diet or other environmental factors. By age 2 or 3, the gut microbiome is relatively stable, but it can still change due to factors including diet, exercise, sleep and prescription drugs.
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Where is Your Gut Microbiome?
Your gut microbiome goes right from your mouth to the other end, but most of it can be found in your colon (large intestine). Your microbiota float around or attach to the mucous lining on the inner walls.
Normally you and your microbiota have what is known as a symbiotic relationship. This means that you help each other. But this only works if the microbiota stay at home. If they start to wander to other parts of the system, they lose their beneficial effect and cause problems of their own.
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The Gut Microbiome and Health
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The trillions of microbiota that live in your gut affect each other and their environment in many different ways. They influence pretty much every aspect of your overall health, both within your digestive system and the rest of your body. Your microbiota and the substances they produce interact with many of your body's systems and help with many functions. In fact, they play such an active role that they are often referred to as another organ.
Research in this field is exploding and scientists have learned a lot about the gut microbiome in the last decade. But there is still much more to know.
Hopefully one day soon we will know how your microbiome can predict disease before it happens, be manipulated to protect from the development of disease and even be prescribed to treat disease.
The following are a few ways that your gut microbiome is connected to your overall health.
Digestive System
Your gut bacteria help break down dietary fibre and certain complex carbs that you can't break down on your own. One of the byproducts is short chain fatty acids (SCFAs), an important nutrient that feeds cells in your gut lining and helps to keep your gut healthy.
Your gut microbes also produce enzymes that are necessary to make certain vitamins, including B1, B9, B12 and K.
Your gut microbiota help to digest fat and package it to be transported across your intestinal wall. Without them, you would have trouble digesting a high fat meal.
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Immune System
Your gut is your largest immune system organ, containing about 80% of your body's immune cells. Good microbes in your gut help to train your immune system to tell the difference between helpful and harmful bacteria, as well as training it not to attack itself.
Good microbes also help to clear out the many pathogens that pass through your gut everyday. One way they do this is to compete for real estate and nutrients to keep populations of harmful bacteria low.
SCFAs are also important for the immune system. By keeping your gut healthy, they help to maintain your gut barrier and keep things like bad bacteria and toxins from entering your bloodstream. This can also reduce inflammation.
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Nervous System
Your gut microbiota affect your nervous system through the gut/brain axis. In fact, they affect communication so much between your gut and brain that many researchers often call it the gut/brain/microbiome axis.
Your microbiota produce or help to produce neurotransmitters, like serotonin, that send messages between your gut and your brain.
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Endocrine System
Endocrine cells produce hormones. There are so many of these cells in the lining of your gut, that it could also be considered to be the largest endocrine organ. These cells secrete hormones that regulate things like blood sugar and hunger/fullness.
Your gut microbes and the things they make interact with these endocrine cells in the lining of your gut. In this way they influence your body's systems and functions affected by these hormones.
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What is Dysbiosis?
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Dysbiosis occurs when your gut microbiome is unbalanced or unhealthy. Imagine your gut microbiome is a natural garden with lots of different plants growing together and helping each other to thrive. If the soil becomes depleted or polluted or pests and weeds are allowed to overrun the helpful plants, this can upset the whole ecosystem.
There are three main reasons for dysbiosis:
1) Not enough or loss of good bacteria
2) Overgrowth of potentially bad (pathogenic) bacteria
3) Loss of overall diversity (not enough different kinds of bacteria)
Although dysbiosis will probably start with one of these three factors, the others aren't usually far behind. Not enough or loss of good bacteria leaves more real estate for disease causing or invasive kinds that can overrun your gut leading to less bacterial diversity.
Is There a Test?
You will find tests that say they can test the health of your gut microbiome, but currently they aren't recommended. Researchers have learned a lot about the gut microbiome in the last few years, but they still don't know enough about how they affect health to make a test really useful.
But this is a space to watch, as perhaps sometime in the future there will be a test that can give you personalized advice about your own unique microbiome.
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Conditions Related to Dysbiosis
There are a number of conditions that have been found to be related to dysbiosis.
Conditions directly related include SIBO (small intestinal bacterial overgrowth), IBD (inflammatory bowel disease), cardiovascular issues and infections.
Conditions also related to dysbiosis include allergies, depression, anxiety, diabetes, rheumatoid arthritis and ... IBS.
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The Gut Microbiome and IBS
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More and more evidence is showing that dysbiosis in the intestines is deeply connected to the development and symptoms of IBS. But as of yet, researchers haven't found a specific kind of dysbiosis that could be the cause of IBS.
Studies have found differences in the gut microbiome of people with IBS, but they still aren't sure if these differences are the cause of IBS or if it's the other way round and IBS causes changes in the gut microbiome. Many people who have IBS change the way they eat to try and lessen their gut symptoms, so again it's hard to tell which came first.
The gut microbiome has been linked to pretty much every possible cause of IBS.
Go to What Causes IBS? in the About IBS section to learn more.
The following are a few of the ways that IBS and the gut microbiome are connected.
Infections
A healthy gut microbiome keeps the number of invasive pathogens (disease causing) at a manageable level and keeps the walls of your intestines healthy as well. Dysbiosis can lead to temporary or long lasting infections in your gut, often caused by viruses, bacteria, bacterial toxins and parasites. Infection in the GI tract is a strong risk factor for post infectious IBS.
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Inflammation
Infections and a weakened gut barrier can trigger the immune system, leading to increased inflammation in the walls of the intestines. Chronic, low-grade inflammation of the inner lining of the intestines has been found to be involved in the disease process of IBS.
For more on inflammation and its connection to IBS go to the Inflammation section.
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Motility
Motility refers to the movement of food and waste through your GI tract. This movement helps to distribute different microbes into different places along the way. Then your crop of microbes "turns over" by moving through your colon and leaving your body in your poop.
Regular bowel movements ensure this process works as it should. But if things move too fast your microbes may not have time to do their jobs. If things move too slowly then they might get too comfortable, settling in and then taking over territory that doesn't belong to them.
It's a chicken and egg situation, because the gut microbiome could affect motility and motility could affect the gut microbiome. But no matter who started it, your gut could get caught in a negative feed back loop.
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The Gut/Brain Axis
IBS has been classified as a disorder of gut/brain communication. Your microbes are an important part of good communication between your gut and your brain. They can directly stimulate nerves that travel to your brain and receive messages from your central nervous system. Your microbes also talk to the brain through the immune system, as they can affect immune cells in your gut as well as your brain. They also make or help to make compounds like neurotransmitters and hormones that travel around the body, including the brain.
In fact, your gut microbes are such an important part of this communication system, that many researchers actually refer to the gut/brain/microbiota axis.
Stress
Remember that stress is one of the topics that the brain and gut discuss a lot. Poorly managed stress is another one of those chicken and egg situations when it comes to the relationship between IBS and the gut microbiome. Your gut microbiota can be influenced by stressors and the gut microbiome can influence your stress response.
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Mental Health
Several different kinds of gut microbiota have been shown to affect mental health through the microbiota–gut–brain axis. This can happen through a number of different pathways, including the production and regulation of neurotransmitters like serotonin and dopamine. These neurotransmitters play important roles in brain activity and mental health. Gut microbiota dysbiosis has been linked to mental disorders, such as anxiety, depression, and eating disorders.
IBS has also been linked to anxiety, depression and eating disorders.
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FODMAPs
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FODMAPs are short chain carbohydrates (sugars) that aren't well digested in your intestines. When they reach your large intestine, they are readily fermented by your gut bacteria. Many FODMAPs are prebiotics, which means they provide fuel for your gut microbes and help to protect the health of your gut microbiome.
However, a lot of gas is created when your gut microbiota ferment FODMAPs. This causes mild discomfort for many people, but for people with IBS and a hypersensitive gut, this stretching of the walls of the intestine may be felt as pain.
Some studies have shown that eliminating FODMAPs can increase the risk of dysbiosis, which has been linked to IBS and many other health conditions. There is much debate in the IBS community about the FODMAP elimination diet and the risk of dysbiosis, which could make IBS symptoms worse. Yet another reason to work with someone trained in the FODMAP elimination diet if you are considering trying it.