Small intestinal microbial dysbiosis underlies symptoms associated with functional gastrointestinal disorders

George B. Saffouri, Robin R. Shields-Cutler, Jun Chen, Yi Yang, Heather R. Lekatz, Vanessa L. Hale, Janice M. Cho, Eric J. Battaglioli, Yogesh Bhattarai, Kevin J. Thompson, Krishna K. Kalari, Gaurav Behera, Jonathan C. Berry, Stephanie A. Peters, Robin Patel, Audrey N. Schuetz, Jeremiah J. Faith, Michael Camilleri, Justin L. Sonnenburg, Gianrico Farrugia, Jonathan R. Swann, Madhusudan Grover, Dan Knights and Purna C. Kashyap ()
Additional contact information
George B. Saffouri: Mayo Clinic
Robin R. Shields-Cutler: University of Minnesota
Jun Chen: Mayo Clinic
Yi Yang: Imperial College
Heather R. Lekatz: Mayo Clinic
Vanessa L. Hale: The Ohio State University
Janice M. Cho: Mayo Clinic
Eric J. Battaglioli: Mayo Clinic
Yogesh Bhattarai: Mayo Clinic
Kevin J. Thompson: Mayo Clinic
Krishna K. Kalari: Mayo Clinic
Gaurav Behera: Mayo Clinic
Jonathan C. Berry: Mayo Clinic
Stephanie A. Peters: Mayo Clinic
Robin Patel: Mayo Clinic
Audrey N. Schuetz: Mayo Clinic
Jeremiah J. Faith: Icahn School of Medicine at Mount Sinai
Michael Camilleri: Mayo Clinic
Justin L. Sonnenburg: Stanford University
Gianrico Farrugia: Mayo Clinic
Jonathan R. Swann: Imperial College
Madhusudan Grover: Mayo Clinic
Dan Knights: University of Minnesota
Purna C. Kashyap: Mayo Clinic

Nature Communications, 2019, vol. 10, issue 1, 1-11

Abstract: Abstract Small intestinal bacterial overgrowth (SIBO) has been implicated in symptoms associated with functional gastrointestinal disorders (FGIDs), though mechanisms remain poorly defined and treatment involves non-specific antibiotics. Here we show that SIBO based on duodenal aspirate culture reflects an overgrowth of anaerobes, does not correspond with patient symptoms, and may be a result of dietary preferences. Small intestinal microbial composition, on the other hand, is significantly altered in symptomatic patients and does not correspond with aspirate culture results. In a pilot interventional study we found that switching from a high fiber diet to a low fiber, high simple sugar diet triggered FGID-related symptoms and decreased small intestinal microbial diversity while increasing small intestinal permeability. Our findings demonstrate that characterizing small intestinal microbiomes in patients with gastrointestinal symptoms may allow a more targeted antibacterial or a diet-based approach to treatment.

Date: 2019
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DOI: 10.1038/s41467-019-09964-7

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