Poo bacteria reveal bowel disease

People with chronic bowel diseases have an irregular gut flora. That is the conclusion of Arnau Vich Vila, a researcher at the UMCG from the group of gastroenterologist Professor Rinse Weersma. ‘What is surprising is that this is also true for irritable bowel syndrome,’ he explains. The research, which could lead to the development of new diagnosis and treatment strategies, was published this week in Science Translational Medicine.

The researchers studied three diseases: two inflammatory bowel diseases – Crohn’s disease and ulcerative colitis – and irritable bowel syndrome. The latter is the collective name for long-term digestive problems that do not cause any apparent inflammation. About 15% of the population has been diagnosed with it. People with this syndrome do appear to have one thing in common: an irregular gut flora.

New possibilities

‘We can therefore see that the gut flora of patients with a digestive disease differs from that of healthy people. The gut flora (microbiome) is to a certain extent comparable with these three diseases,’ says Vich Vila. This provides options for potential treatment methods. ‘We could influence the gut flora with, for instance, probiotics, an adapted diet or even faecal transplantation,’ he says. The researchers’ job is by no means done. ‘The next step is to research whether we can use a relatively simple test to measure the presence of gut bacteria in poo.’ This is because the exact gut flora is different for each disease. For this research, they have already been awarded a grant by the Stomach Liver Gut Foundation. This should make it possible to make a diagnosis from faeces. That would be a much better option for patients than the current colonoscopy, which involves looking inside the intestine with a camera mounted on a tube.

Frozen poo

About 1,800 people took part in the study. The healthy participants came from Lifelines, a three-generation research population from the northern Netherlands that is being followed for a longer period of time. ‘It is important for this research that the participants’ poo is frozen fast. We therefore asked them to freeze it themselves. Students collected the faeces from the participants’ homes and transported it frozen to the UMCG. This meant we could be sure that the gut flora hadn’t changed much over time.’ The participants with irritable bowel syndrome came from Maastricht University Medical Center (Maastricht UMC+). Once the faeces had arrived in the lab, the researchers analyzed its DNA. This provided information on not only the type of bacteria in the gut, but also the ratio in which they are present and what they do. This technique also reveals characteristics such as antibiotic resistance.

Microbiome characterized

The Groningen researchers are also using these new techniques to characterize the microbiome of the Dutch population. ‘For this new project, we’ve collected the faeces of about 10,000 Lifelines participants from the northern Netherlands. We can’t wait to see what kind of new information about the gut flora and health this will reveal.’ Such large projects should yield more interesting information about the link between gut flora and diet, and between disease and health.