Abstract

Small intestinal bacterial overgrowth (SIBO) has been implicated in symptoms associated with functional gastrointestinal disorders (FGIDs), though mechanisms remain poorly defined and treatment involves non-specific antibiotics. Here we show that SIBO based on duodenal aspirate culture reflects an overgrowth of anaerobes, does not correspond with patient symptoms, and may be a result of dietary preferences. Small intestinal microbial composition, on the other hand, is significantly altered in symptomatic patients and does not correspond with aspirate culture results. In a pilot interventional study we found that switching from a high fiber diet to a low fiber, high simple sugar diet triggered FGID-related symptoms and decreased small intestinal microbial diversity while increasing small intestinal permeability. Our findings demonstrate that characterizing small intestinal microbiomes in patients with gastrointestinal symptoms may allow a more targeted antibacterial or a diet-based approach to treatment.

Small intestinal bacterial overgrowth (SIBO) has been associated with functional gastrointestinal disorders. Here, the authors show that SIBO may be a result of dietary preferences, and patient symptoms correlate with changes in small intestinal microbial composition but not with SIBO.

Details

Title
Small intestinal microbial dysbiosis underlies symptoms associated with functional gastrointestinal disorders
Author
Saffouri, George B 1 ; Shields-Cutler, Robin R 2 ; Chen, Jun 3 ; Yang, Yi 4 ; Lekatz, Heather R 1 ; Hale, Vanessa L 5 ; Cho, Janice M 6 ; Battaglioli, Eric J 1 ; Bhattarai Yogesh 1 ; Thompson, Kevin J 3 ; Kalari, Krishna K 3 ; Behera Gaurav 1 ; Berry, Jonathan C 7 ; Peters, Stephanie A 1 ; Patel, Robin 7 ; Schuetz, Audrey N 7 ; Faith, Jeremiah J 8 ; Camilleri, Michael 9 ; Sonnenburg, Justin L 10 ; Farrugia Gianrico 11 ; Swann, Jonathan R 4   VIAFID ORCID Logo  ; Grover Madhusudan 9   VIAFID ORCID Logo  ; Knights, Dan 12 ; Kashyap, Purna C 9   VIAFID ORCID Logo 

1  Mayo Clinic, Division of Gastroenterology and Hepatology, Rochester, USA (GRID:grid.66875.3a) (ISNI:0000 0004 0459 167X) 
2  University of Minnesota, BioTechnology Institute, College of Biological Sciences, Minneapolis, USA (GRID:grid.17635.36) (ISNI:0000000419368657); Macalester College, Department of Biology, Saint Paul, USA (GRID:grid.259382.7) (ISNI:0000 0001 1551 4707) 
3  Mayo Clinic, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Rochester, USA (GRID:grid.66875.3a) (ISNI:0000 0004 0459 167X) 
4  Imperial College, Computational and Systems Medicine Section of the Department of Surgery and Cancer, (London), UK (GRID:grid.7445.2) (ISNI:0000 0001 2113 8111) 
5  The Ohio State University, Department of Veterinary Preventive Medicine, Columbus, USA (GRID:grid.261331.4) (ISNI:0000 0001 2285 7943) 
6  Mayo Clinic, Division of Internal Medicine, Rochester, USA (GRID:grid.66875.3a) (ISNI:0000 0004 0459 167X) 
7  Mayo Clinic, Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Rochester, USA (GRID:grid.66875.3a) (ISNI:0000 0004 0459 167X) 
8  Icahn School of Medicine at Mount Sinai, Department of Genetics and Genomic Sciences, Medicine, and Clinical Immunology, New York, USA (GRID:grid.59734.3c) (ISNI:0000 0001 0670 2351) 
9  Mayo Clinic, Division of Gastroenterology and Hepatology, Rochester, USA (GRID:grid.66875.3a) (ISNI:0000 0004 0459 167X); Mayo Clinic, Department of Physiology and Biomedical Engineering, Rochester, USA (GRID:grid.66875.3a) (ISNI:0000 0004 0459 167X) 
10  Stanford University, Department of Microbiology and Immunology, Stanford, USA (GRID:grid.168010.e) (ISNI:0000000419368956) 
11  Mayo Clinic, Division of Gastroenterology, Jacksonville, USA (GRID:grid.417467.7) (ISNI:0000 0004 0443 9942) 
12  University of Minnesota, BioTechnology Institute, College of Biological Sciences, Minneapolis, USA (GRID:grid.17635.36) (ISNI:0000000419368657); University of Minnesota, Department of Computer Science and Engineering, Minneapolis, USA (GRID:grid.17635.36) (ISNI:0000000419368657) 
Publication year
2019
Publication date
2019
Publisher
Nature Publishing Group
e-ISSN
20411723
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41467-019-09964-7
ProQuest document ID
2218262803
Copyright
© The Author(s) 2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.