What is the diagnosis and treatment for dysbiosis (microbial imbalance)?

From the Guidelines

Dysbiosis should be addressed through a multi-faceted approach including dietary modifications, probiotic supplementation, and lifestyle changes to restore microbial balance and reduce the risk of associated health conditions. To diagnose dysbiosis, healthcare professionals can use a combination of medical history, physical examination, and diagnostic tests such as stool tests or endoscopy to identify an imbalance in the gut microbiome. The treatment of dysbiosis involves:

• Consuming a diverse, fiber-rich diet with plenty of fruits, vegetables, whole grains, and fermented foods to help restore microbial balance, as suggested by 1
• Probiotic supplements containing Lactobacillus and Bifidobacterium strains at doses of 10-50 billion CFU daily for 1-3 months to reestablish beneficial bacteria, as recommended by 1
• Prebiotics like inulin or fructooligosaccharides (3-5g daily) to feed beneficial bacteria
• Avoiding unnecessary antibiotics, reducing stress, getting adequate sleep, and regular exercise to support microbial health Some key points to consider:
• Dysbiosis is linked to numerous health conditions including irritable bowel syndrome, inflammatory bowel disease, obesity, and even mental health disorders because the gut microbiome influences digestion, immune function, and even neurotransmitter production through the gut-brain axis, as noted in 1 and 1
• Severe cases may require medical intervention with targeted antimicrobials followed by intensive probiotic therapy under healthcare supervision, as mentioned in 1
• The effects of probiotics on gut microbiota and disease prevention or treatment can vary depending on the specific strains used, the dosage, and individual factors, highlighting the importance of choosing probiotic products that have been scientifically studied and shown to have beneficial effects on the desired health outcomes, as emphasized in 1

From the Research

Diagnosis of Dysbiosis

• Dysbiosis is a clinical condition marked by altered gut microbiota resulting from external and internal host factors 2
• The symptomatology of dysbiosis is broad and nonspecific, making it challenging to diagnose 2
• Common symptoms associated with dysbiosis include abdominal distension, abdominal pain, and diarrhea 2
• Chronic and metabolic diseases, such as inflammatory bowel disease, irritable bowel syndrome, and diabetes, are often linked to dysbiosis 2, 3, 4

Treatment of Dysbiosis

• Probiotics are commonly used as co-adjuvant treatments for antibiotic-associated diarrhea, irritable bowel syndrome, and childhood allergic diseases 2
• Specific probiotics, such as Weizmannia coagulans, Alkalihalobacillus clausii, Lacticaseibacillus rhamnosus, Limosilactobacillus reuteri, and Saccharomyces boulardii, have been shown to be effective in treating dysbiosis 2
• Faecal microbial transplantation (FMT) is an optional treatment for inflammatory bowel disease, particularly for patients with recurrent Clostridium difficile-induced pseudo-membrane colitis 3, 5
• Dietary interventions, prebiotics, and drugs are also used to impact dysbacteriosis and associated intestinal diseases 4
• Restoration of a healthy microbiome via probiotics or other 'dysbiosis therapies' may be an optimal alternative or parallel treatment option to antibiotics in critical illness 5