The alterations in the microbiota, bacterial communities that populate the skin and mucosal surfaces, both respiratory and intestinal or genital, greatly affect health. They are behind infectious and non-infectious processes, and the latest research links the disorders in the flora microbial to tumors, diabetes, circulatory and neurological problems. In fact, a study led by the Higher Council for Scientific Research (CSIC) has discovered the presence of bacterial amyloids – protein aggregates inside a cell present in certain bacteria– associated with the disease of Parkinson’s.
The CSIC discovers the presence of proteins with malformations in the intestinal microbiota associated with Parkinson’s
These disorders have become the main reason for consultation to Digestive doctors by affecting more than half of the patients. These cases fall into the so-called functional disorders and the alteration of the microbiota is usually achieved by progressing in the study of the affected people. The Alicante General Hospital has a reference unit in the province for microbiota disorder tests, to which other hospital centers in the province refer the most complicated patients; although most of them have resources to handle some cases.
Sugars and processed
The microbiota is what the organisms are scientifically called. bacteria that we have in the intestine, a flora that is harmed by current life habits such as eating with a lot of sugars and processed foods, as well as the stress.
“To put it very simply, it is not a ‘plumbing’ problem, there is nothing closed or perforated in the intestine but rather it affects its functioning”
Doctor José Ignacio Cameo. Deputy of the Digestive Service of the General Hospital of Alicante
“The bad life we lead can ultimately have a negative influence and lead us to this type of disorder,” explains Dr. José Ignacio Cameo, assistant to the Digestive Service at the General Hospital of Alicante, who emphasizes that there has been a noticeable significant increase of people with altered microbiota in recent years. “To put it very simply, it is not a ‘plumbing’ problem, there is nothing closed or perforated in the intestine but rather it affects its functioning. In reality, before we did not have options to assess this because they are relatively modern tests, but it is true It is progressively giving the impression that demand for assessments of these types of problems is growing.
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This disorder, rather than being influenced by age, also depends on risk factors such as having a delicate intestine due to an inflammatory disease or cancer surgery.
Alimentary intolerance
The most common thing in patients with altered flora is to suffer Alimentary intolerance, especially to certain carbohydrates and sugars, lactose, fructose, fructans, gluten or sorbitol. “There may be several possibilities and by ingesting these nutrients through vegetables, sweets or legumes, it generates a reaction in the intestine that makes gaswhich sometimes even irritates.”
The imbalance manifests itself, as the most common symptoms, with “abdominal swelling especially after eating, sometimes accompanied by cramps and change is the way of having a bowel movement that, depending on the type of bacterial overgrowth, can cause diarrhea or rather constipation.” There are also a few people who suffer from headaches, fatigue and alterations in menstrual rhythm but it is not so common.
Specialist
In these cases, patients are referred to specialist Digestive care by the Primary Care doctor, who you go to when your stomach hurts or suffers certain alterations. The doctor points out that Women tend to suffer more problems from altered microbiota because historically it has been considered that functional disorders affect the female sex more. “Sometimes there may be certain biases in these studies, but at least that is what is considered good.”
“The bad life we lead can ultimately have a negative influence and lead us to this type of disorder”
Doctor José Ignacio Cameo. Deputy of the Digestive Service of the General Hospital of Alicante
Regarding his possible relationship with the irritable bowel syndromethis doctor remembers that this last pathology “is what we call a mixed bag where there are many things inside. In the end it is a description of symptoms and within that there can be many causes. One of them can be a microbiota disorder, Not the only one, sometimes there are disorders in the digestion of, for example, bile salts or a problem with the enzymes that contain some sugars. There are more possibilities, but this is one of them and it is relatively common.
Evidence
Patients can undergo various types of microbiota tests. First of all, a study through feces which is little used because, he states, we do not yet know how to interpret the results very well apart from the fact that it extrapolates results from very basic laboratory tests that are not always applicable to the clinical reality of the patient.
What is SIBO, a newly diagnosed syndrome that already affects 22% of the population?
Yes, it is used more in daily clinical practice.test for bacterial overgrowth in the small intestine, which is known as SIBO, for its acronym in English. When the patient presents certain risk factors such as intestinal surgeries or disorders caused by bacteria from the colon or mouth that appear in the small intestine, fermenting some foods, which produces swelling and a change in the way the stomach moves.
These tests are of two types. One of them is done through a endoscopy and an aspiration of the fluid in the duodenum but it is more expensive and not simple, so it is not common.
The one usually used is breath testwhich consists of “the person takes a little bit of a certain sugar that we think is going to react, which can be lactulose, lactose, fructose, it can be several, and we measure the gases in the breath for the next three hours, especially the CO2, hydrogen and methane. Depending on how these gases move, we can interpret whether the proposal is basically positive or negative.”
These can be made in two formats. In the hospital there is a fixed machine with capacity to do 15 tests at the same time; and the tests laptops to take home, which consist of boxes with tubes in which the patient blows every certain interval of time and closes, and then that air is analyzed, which allows duplication of tests that are made with the static machine. Between both formats, there are more than a hundred tests per month. These require a strict diet the days before and many people fail to comply, so the at-home test loses quality and gives dubious results. The percentage of positives in bacterial overgrowth exceeds 30% while in intolerances it is lower.
Antibiotics or probiotics
If the test is positive, some type of treatment is offered, usually through antibiotics, but it can be accompanied by probiotics and other types of supplements that can help, “we do that relatively often. It is the most visible part of this topic of the microbiota for our daily reality.”
The fact that the test is positive means that Bacteria from the colon or mouth are in the small intestine. “Sometimes you have to find out why this is happening because it is interpreted that it should not be something completely normal and give it appropriate treatment.”
In the most serious cases, always in very selected patients, microbiota transplant, which consists of choosing a feces donor, purifying them and, through colonoscopy, irrigating the intestine of the recipient patient with them. It is a procedure that It is only carried out in the province at the Alicante General Hospital.