Dysbiosis of the microbiota: is it possible to diagnose it?

We have already defined it in another article that dysbiosis is the opposite of eubiosis: that is, an alteration of the subtle balance that exists between the intestinal microbiota and the host but also between the different colonies (bacterial, fungal and viral) of the microbiota.

In a physiological situation, the populations that make up the digestive flora live in good harmony and synergy. Some are more numerous, others a minority, they share “the available space” (the 7 meters of intestine) according to their own needs for favorable environmental conditions and interact with each other and with the host, in particular carrying out absolutely essential biological functions (production of certain vitamins, digestion and metabolization of certain nutrients to cite two examples).

When dysbiosis sets in, therefore, it can take many forms:

– excessive growth of certain bacterial or fungal colonies

– rarefaction of certain bacterial or fungal strains

– general depletion of all microorganisms

– displacement of part or all of the microbiota in an atypical area for it

– a mixed situation of the above anomalies

For example:

intestinal candidiasis is an excessive proliferation of Candida albicans

– SIBO methane corresponds to an “ascent” of the colonic microbiota towards the small intestine associated with an overgrowth of certain bacterial strains

We therefore understand that there is not a single type of dysbiosis but many dysbioses, different from each other due to the characteristics according to which the microbiota is altered and located.

Knowing that the path that this imbalance takes is determined by a series of parameters such as the individual particularities of the subject (age, sex, hormonal context, previous “imprint” of the microbiota, etc.), the context in which it occurs and develops dysbiosis (thyroiditis, food poisoning, parasitosis, etc.), the factors that led to dysbiosis (antibiotics, antifungal therapy, stress, trauma, etc.);

and knowing that the number of species of microorganisms that inhabit the intestine is around a thousand;

it seems obvious that the possible recombinations of the microbiota are extremely numerous (if not infinite).

Therefore, we can conclude that dysbiosis is not something unique: each person develops a different dysbiosis.

In summary, the dysbiotic rearrangements of the microbiota are as diverse as the cases of dysbiosis.

For each patient a “different” dysbiosis

Characterization of dysbiosis: is it possible?

It is important to highlight here how much science has advanced in terms of knowledge of the microbiota in recent decades. However, this knowledge is still very superficial. Many mechanisms remain unknown and the dynamics linked to eubiosis and dysbiosis of the microbiota are so variable and individual (for the reasons described above) that there is currently no reliable possibility to clearly assess the characteristics of dysbiosis.

Although it is legitimate and coherent to investigate in this direction to know “what exactly we have” and although the diagnosis of “dysbiosis” is a kind of big drawer, this is very frustrating for the patient who, not having a “final” diagnosis, does not feel taken seriously; the path to diagnosis is currently not a desirable path.

In fact, the available tests and examinations (blood, urine, stool tests) are unreliable, non-reimbursable assessments whose interpretation often remains in the hands of the professional who (pardon the expression) does what he wants with it…

How to act without diagnosis then?

For the reasons mentioned above, a “good” advice in case of Irritable Bowel Syndrome/digestive dysbiosis would simply be to work individually and personalized in the following directions:

– symptom management

– restoration of regular transit

– reduction of inflammation of the intestinal wall

– prevention of intestinal hyperpermeability

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