From the Guidelines
Dysbiosis is a condition characterized by an imbalance in the microbial communities of the human body, particularly in the gut microbiome, and is clinically relevant due to its association with various health conditions, including inflammatory bowel disease, irritable bowel syndrome, and obesity, as supported by recent studies 1.
Definition and Clinical Relevance
Dysbiosis occurs when the diversity and abundance of beneficial bacteria decrease, while potentially harmful microbes increase, disrupting the symbiotic relationship between the host and microbiota. This condition has been linked to numerous health conditions, including inflammatory bowel disease, irritable bowel syndrome, obesity, diabetes, allergies, autoimmune disorders, and even neurological conditions.
Diagnosis and Treatment
Diagnosing dysbiosis typically involves:
- Stool analysis
- Breath tests
- Advanced microbiome sequencing Treatment approaches focus on restoring microbial balance through:
- Dietary modifications (increasing fiber intake and reducing processed foods)
- Probiotics (such as Lactobacillus and Bifidobacterium species at doses of 1-10 billion CFU daily) 1
- Prebiotics (like inulin or fructooligosaccharides)
- Antibiotics to target overgrowth of specific harmful bacteria Fecal microbiota transplantation may be considered in severe cases, particularly for recurrent Clostridioides difficile infections, as discussed in recent guidelines 1.
Importance of the Microbiome
The concept of dysbiosis highlights the importance of the microbiome in maintaining overall health and offers potential therapeutic targets for various conditions by addressing the underlying microbial imbalance rather than just treating symptoms. Recent studies have demonstrated the efficacy of fecal microbiota transplantation in treating recurrent Clostridioides difficile infections, with cure rates as high as 100% and a mean cure rate of 87-90% 1.
From the Research
Definition of Dysbiosis
- Dysbiosis is considered an alteration of diversity and abundance of intestinal microbes, which contributes to the onset of many disorders 2
- It is a clinical condition marked by altered gut microbiota resulting from external and internal host factors 3
- Dysbiosis is an imbalance in microbial communities, linked with disease when this imbalance disturbs microbiota functions essential for maintaining health or introduces processes that promote disease 4
Causes of Dysbiosis
- Several factors cause dysbiosis, depending on life-style (nutrition, stress, environment, smoking, physical activity) or particular diseases (inflammatory, autoimmune, chronic diseases) 2
- Drugs (i.e. antibiotics, anticancer drugs), as well as medical and surgical procedures, can often cause dysbiosis 2
- Genetic factors, lifestyle habits, diet including ultra-processed foods and food additives, as well as medications can influence dysbiosis 5
Clinical Relevance of Dysbiosis
- Dysbiosis is strongly associated with gastrointestinal and extraintestinal alterations, with a broad and nonspecific symptomatology 3
- Chronic and metabolic diseases are the conditions most strongly associated with dysbiosis 3
- Dysbiosis has been associated with many systemic diseases, including inflammatory bowel diseases (IBD), irritable bowel syndrome (IBS), diabetes, obesity, cancer, cardiovascular and central nervous system disorders 4, 6
- Dysbiosis can be addressed by altering lifestyle factors, proper diet and microbial modulation, with tremendous potential for the human microbiome in the diagnosis, treatment, and prognosis of diseases 5
Diagnosis and Management of Dysbiosis
- Dysbiosis cannot be diagnosed through standard blood tests or investigations, but microbiota derived metabolites can be analyzed and can be useful in the management of dysbiosis 5
- Whole body system-based approach to the diagnosis of dysbiosis is better than a pure taxonomic approach 5
- Probiotics are commonly used as co-adjuvant treatments for antibiotic-associated diarrhea, irritable bowel syndrome, and childhood allergic diseases 3