IBD is a collective term for a group of serious inflammatory conditions of the colon and small intestine that can cause a whole host of problems in those who suffer from these conditions. There is currently tremendous interest among researchers to understand the causes behind these conditions and to find cures. One of the things the research has shown is that the gut flora can provide clues and may be the key to how we treat IBD in the future.
IBD, which should not be confused with IBS, is also called inflammatory bowel disease and includes several chronic inflammatory conditions of the colon and small intestine, e.g. Crohn’s disease and ulcerative colitis. Along with Canada, Sweden has the largest proportion of IBD sufferers in the world, and every year, approximately 3,000 Swedes are diagnosed with IBD. The symptoms usually present as a flare up, which means that you sometimes experience very severe problems. This is generally interspersed with periods of moderate symptoms or no symptoms at all. Examples of symptoms are diarrhoea, frequent and/or urgent bowel movements, abdominal pain, fever, fatigue, severe weight loss, blood in the stool and joint pain.
The cause of IBD is still not entirely clear. Some links have been identified to genetics as well as smoking, but there is also a lot of research on how IBD can be caused by our diet and antibiotic use. IBD is generally considered a disease of affluence because it is more common in countries with a high standard of living. It has also been theorised that vitamin D deficiency could be a risk factor, as the diseases are more common in northern countries.
As IBD is an intestinal disease, the need for expanded research into the gut flora is a given. Research has shown that the gut flora is altered in people with IBD when they are in the active phases of the disease (flare-ups). For example, a study of 137 IBD patients conducted in Örebro, Sweden showed that during a flare-up, the good bacteria decreased sharply while the bad bacteria increased. In parallel with this observation, it was also seen that inflammatory markers increased, and anti-inflammatory markers decreased. The results were compared with data from healthy subjects whose gut flora remained significantly more balanced over time.
IBD is generally treated with a variety of drugs adapted to the specific intestinal disease the individual suffers from. In some cases, surgery may be necessary for recovery from the illness. Some researchers also believe that in the future we will be able to develop treatments that will help keep the gut flora stable, thus alleviating the problems associated with IBD.
Recent research has also emerged that may provide more clues as to how IBD can be treated. For example, a study from 2019 showed that the gut flora changes that occur during flare-ups are preceded by increased levels of polyunsaturated fats, very low levels of vitamins B5 and B3 and fewer microbially biodegradable chemicals. These results may provide the basis for us to be able to detect disease activity at an earlier stage in the future, which increases the chances for IBD sufferers to receive effective treatment as early as possible.
The hope is that the results from this research can lead to guidelines for the design of new treatments that can both prevent flare-ups and help when they do occur.
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