The word dysbiosis within medicine refers to the abnormal make up of colonic bacteria.
Newer methods of identifying bacteria within the gut has outlined the fact that there are good and bad mixes of bacteria within the gut. When bad mixes are present, the condition is called dysbiosis. It is not a disease in and of itself. Dysbiosis results in the following known changes within the colon and body:
- Barrier dysfunction of the colon wall (leaky gut)
- Endotoxemia with bacterial products and their metabolites translocating into the portal and systemic blood.
- Mild inflammation within the colon wall and systemically
- Increased calories produced within the colon by the different bacteria that make up the dysbiotic complex
- Increased insulin resistance
Dysbiosis has now been demonstrated to be present in the following disorders:
- Celiac disease
- Crohns Disease
- Ulcerative colitis
- Irritable bowel syndrome
- Colon cancer
- Non Alcoholic Fatty Liver Disease
- Non Alcoholic Steato-hepatitis
- Diabetes type 2
- Metabolic syndrome
- High saturated fat diet
- Rheumatoid arthritis
- Antibiotic use
High Saturated Fat Diet
There is now considerable evidence that a high saturated fat diet is associated colonic barrier dysfunction and endotoxemia. Conversely, reducing the diet from 40% fat to 20% fat results in a dramatic reduction of inflammatory factors in the blood, indicating a significant improvement in barrier dysfunction.
Probiotics have been studied in animals for their effect on reversal of barrier dysfunction and dysbiosis. Some effects have been seen with certain probiotics in rat studies, but no human studies have been reported.
Prebiotics have been found to be effective in changing a dysbiotic bowel. A major 65 page 2010 review on Prebiotics says “ A large number of human intervention studies have been performed that have demonstrated that dietary consumption of certain food products can result in statistically significant changes in the composition of the gut microbiota in line with the prebiotic concept.”
A prebiotic product would seem to fit the FDA definition of Medical Food. It would be offered for the “dietary management” of dysbiosis which is not a “disease” but rather a “condition” found with many diseases. There is presently nothing on the market in the medical field in the prebiotic arena.
1. Dysbiosis. This term means that the 1000+ species of bacteria in the gut are slanted to a “bad” group. The major bad group or phylum is called Firmicutes. The good ones are call Bacteriodetes and include the Bifidobacter and lactobacillus groups. The diet high in saturated fat and red meat leads to a predominance of firmicutes.
2. Barrier dysfunction, permeability of the gut and leaky gut-they all mean the same thing. Normally the epithelial cells that line the colon are tight together one against the other. This is assured when certain hormones-called tight junction hormones- are copious in this area. When dysbiosis is present then these hormone concentrations are not as high and the cells loosen one from the other. Spaces between the cells occur. 3 known things then can slide through and get into the portal vein and hence to the liver. All blood from the gut goes to the liver first via the portal vein.
3. Endotoxemia– the term means loosely anything bad that gets into the blood. Endo-means that it is made in the body. There are 3 main elements that get into the blood:
- Lipopolysaccharide-LPS– Well known in research. LPS comes from the wall of certain E coli bacteria. The bacteria die in the colon, break apart and in the presence of a leaky gut, slide across the epithelial border and enter the portal vein. LPS has been extremely well studied and is a major known inflammatory factor in the body, giving rise to mild but definite inflammation everywhere including the coronary arteries.
- Whole bacteria– these too get into the blood. They have been found in the plaque in coronary arteries. Less research is known about these.
- Metabolites-There are likely well over 300 metabolites or chemicals made by the 100+ bacteria within the gut. While most of these are benign or even helpful, some are known to be toxic. Two such toxins are p-cresyl and indoxyl whixh are aborbed in the colon or get into the blood via a leaky gut. They are quite injurious to the kidneys and heart. In particular, patients with bad kidneys on dialysis have high levels of these toxins coming from the gut.
Our Prebiotin changes the bacterial makeup in the colon to a predominant bacteroidetes one, which tightens up the leaky gut and in so doing reduces endotoxins, bacteria products and nasty metabolites that that can get into the blood.
1. This 63 page reference is filled with data and references on prebiotics and their effect within the colon. At the top of the list on Table 2 is:
“Improvement and/or stabilization of gut microbiota composition”.
There is also extensive reference to calcium absorption, energy harvesting (weight reduction) immunity enhancement and :
“Improvement of untestinal barrier function, reduction of metabolic endotoxemia”
2. This is a very well done study on a tightly controlled group of young persons given a western style, 40% saturated fat diet. Blood endotoxins increased 71% over base level. Hen the same subjects were given a prudent 20% saturated fat diet, the endotoxins in the blood were reduced 31% fro baseline. This demonstrated the effect of diet on barrier function of the colon and its relation to diet.
3. Dysbiosis and diabetes
4. This article references many disorders with dysbiosis and their dietary management with prebiotics.
5. This article reviews what is known bout bad gut bacteria or dysbiosis and irritable bowel syndrome, inflammatory bowel disease, colorectal cancer, obesity, diabetes, atherosclerosis and fatty liver disease. No cause and effect is known but the association between dysbiosis and these disorders is now clearly known.