From the Guidelines
Populations at risk for dysbiosis in the colon include individuals with inflammatory bowel disease (IBD), as evidenced by the 2024 study published in Gastroenterology 1, which highlights the role of gut dysbiosis in the pathogenesis of IBD. These populations also encompass those consuming Western diets high in processed foods and low in fiber, the elderly, immunocompromised individuals, and those with chronic conditions like diabetes or obesity. Key factors contributing to dysbiosis include:
- Antibiotic use, which disrupts the normal microbial balance by killing beneficial bacteria alongside pathogens, with broad-spectrum antibiotics like ciprofloxacin, clindamycin, and amoxicillin-clavulanate being particularly disruptive 1.
- Stress, poor sleep, excessive alcohol consumption, and certain medications including proton pump inhibitors (such as omeprazole), metformin, and non-steroidal anti-inflammatory drugs, which can also contribute to dysbiosis. The risk increases with age due to natural changes in gut physiology and decreased immune function. Dysbiosis occurs when the delicate balance of the gut microbiome is disrupted, leading to an overgrowth of potentially harmful microorganisms and a reduction in beneficial bacteria. This imbalance can compromise gut barrier function, alter immune responses, and affect the production of beneficial metabolites like short-chain fatty acids, potentially contributing to both gastrointestinal and systemic health problems, as supported by the 2023 guideline on clinical nutrition in inflammatory bowel disease published in Clinical Nutrition 1. Furthermore, a diet rich in fruits and vegetables, rich in n-3 fatty acids, and low in n-6 fatty acids is associated with a decreased risk of developing Crohn's disease or ulcerative colitis, as recommended by the 2017 ESPEN guideline on clinical nutrition in inflammatory bowel disease 1. Overall, managing dysbiosis requires a comprehensive approach that considers dietary changes, reduction of antibiotic use, and management of underlying health conditions, with the goal of restoring the balance of the gut microbiome and improving overall health outcomes.
From the Research
Populations at Risk for Dysbiosis in the Colon
The following populations are at risk for dysbiosis in the colon:
- Individuals with inflammatory bowel disease (IBD), such as ulcerative colitis and Crohn's disease 2, 3, 4, 5, 6
- People with gastrointestinal (GI) disorders, including irritable bowel syndrome, colorectal cancer, and antibiotic-associated diarrhea 3
- Individuals with a family history of IBD or other GI disorders 5
- People living in developed countries with modernized environmental changes, which can lead to an increase in pathobionts and a decrease in beneficial microbes 4
- Individuals consuming a westernized diet high in sugar, animal fat, and low in fiber and vegetables, which can contribute to dysbiosis and IBD 5
Factors Contributing to Dysbiosis
Several factors can contribute to dysbiosis in the colon, including:
- Genetic predisposition 5
- Environmental factors, such as changes in diet and lifestyle 4, 5
- Alterations in the composition and functionality of the gut microbiome 5
- Increased release of pro-inflammatory molecules and microbial dysbiosis in gut microflora 3
- Certain pathogens that can play a key role in the development of IBD 3