New Research Shows Which Microbes Cause IBS Subtypes

A recent study could change the way doctors see IBS subtypes. This breaking research was done by Dr. Maria Villanueva-Millan et. al and published in The American Journal of Gastroenterology.

We know about the different subtypes of IBS: constipation-predominant, diarrhea-predominant, and mixed. However, until this study was released, it was difficult to pinpoint the cause of each specific subtype. 

What we knew leading up to this study to forge the way for new findings

We knew that there were subtypes of IBS leading to different avenues of treatment. Considering our clients’ symptoms, we knew that the gut microbiome had a large hand in symptom and syndrome development. However, we didn’t know which microbes contributed to the symptom/syndrome onset. 

Hydrogen breath tests are a common test when it comes to diagnosing gastrointestinal issues. IBS, SIBO, lactose intolerance, and other food sensitivities are commonly diagnosed after these tests are done. 

The bacteria in our guts ferment foods that aren’t broken down by digestive enzymes. This allows our body to get more from the foods we eat. However, these anaerobic bacteria that do the fermenting give off gases when they’re fermenting certain foods. Then we experience bloating, belching, and flatulence as a result. We also give these gases off from our breath which is why that test is a good indicator of a gastrointestinal disturbance. 

Methane production (found by doing methane breath tests) is known to be associated with IBS-C, constipation-predominant IBS. 

There was speculation that hydrogen production was more common in IBS-D, diarrhea-predominant IBS but it’s actually hydrogen sulfide.

So this is a lot of information that we did already know. But our patients were still suffering from flare-ups because we couldn’t get to the root source of their problems. 

What was done during the study?

Only specific patients were able to participate in the study. Anyone who had any of the following was excluded to ensure the variables were consistent among all participants:

• Recent use of antibiotics
• History of an enema or laxative abuse
• Pelvic floor dysfunction
• Bariatric surgery
• Surgery to remove any part of the digestive tract

Patients were separated into two groups: IBS-C and IBS-D predominant subtypes.

These patients then took breath tests and provided stool samples that went through a series of tests. 

The goal of these tests was to determine what micro types are associated with the exhaled gas and IBS phenotype.

New findings in IBS subtypes and the microbes that cause their symptoms

IBS-D has a higher association with SIBO prevalence. This study confirmed that both SIBO and IBS-D have positive hydrogen breath test results with hydrogen sulfide. This group also experienced a lower microdiversity in their stool samples. 

The IBS-D group had higher quantities of the bacteria:

• Bacteroidetes (phylum)
• Proteobacteria (phylum)
• Epsilonbacteraeota (phylum)
• Fusobacteria (phylum)
• Spirochaetes (phylum)
• Pseudomonadaceae (family)

Both Spirochaetaceae and Fusobacteriaceae were especially common with higher hydrogen sulfide breath levels. 

Where IBS-D is commonly correlated with SIBO, IBS-C is now correlated with IMO intestinal methanogen overgrowth (IMO). And the findings in this study helped link them together. 

The IBS-C group was found to have higher quantities of methanogens and methane-producing microbes. IBS-C patients had higher microdiversity and a more rich abundance of microbiota. 

The specific microbes that seemed to be unique to the microbiomes of those with IBS-C were:

• Methanobrevibacter smithii (species)
• Firmicutes (phylum)
• Tenericutes (phylum)
• Lentisphaerae (family)
• Synergistetes (family)
• Anaeroplasmataceae (family)
• Flavobacteriaceae (family)
• Christensenellaceae (family)
• Enterococcaceae (family)
• Ruminococcaceae (family)
• Methanobacteriaceae (family)

What these findings mean for the future of IBS treatment

Looking at the different types of bacteria and archaea allows us to understand why IBS presents in different ways. When we learn which microbes are specific to a particular condition, it helps us understand:

• What microbes need to be studied to better understand that condition
• How those specific microbes affect our health on a general and disease-specific basis
• How we can control the populations of these microbes within our body
• How do they respond to different treatment methods in vitro and then in in-vivo studies
• What other conditions might have a similar microbial profile and how this affects patient health and healthcare for them
• If researchers were on the right path for figuring out a treatment or if one of the links found created a novel path for symptom and condition management

So if we look at these profiles, we know that the methanogens in IBS-C patients correlated with more breath methane output. This also correlated with worsened symptoms. 

This information also helped to link IMO and IBS-C. This can help doctors treat their patients better by understanding that link in case a patient had a misdiagnosis. 

The species we see predominantly in IBS-C aren’t actually bacteria. They are methanogenic Archaea. These microorganisms behave differently than the bacteria we are used to dealing with. Archaea are more difficult to control because they are resistant to the antibiotics doctors typically prescribe to control these conditions. 

Archaea will go into a type of “hiding” when antibiotics are in the body with them. Then once the antibiotics have run their course, the archaea come out and cause the problems they were causing before. This is why antibiotics were used as treatment for these conditions because they seemingly work for a short period of time. But they don’t really get to the root of the problem. 

Knowing that we are dealing with archaea strains and not bacterial strains helps to find better treatments to erradicate the problem instead of masking it temporarily. Especially since antibiotics kill off healthy bacterial strains causing future problems. 

We also know that these type of archaea affect the smooth muscles of our intestinal tract. This causes the slowed motility and constipation seen in these patients. Knowing this information helps mold a better form of treatment for these patients.

The microbes in IBS-D and SIBO patients are more commonly bacterial strains. The bacteria seen in these microbial profiles give off hydrogen sulfide and not methane. Knowing this information allows for a quicker diagnosis based on the outcome of the breath tests. 

Sometimes archaea are the problem in SIBO as well. But knowing the bacterial profile of IBS-D and SIBO can help us determine which one our patient is experiencing for better treatment protocol.

We can now look at these microbial profiles and better create a treatment plan for our patients depending on what they are presenting with. Although this is still novel research, it is a huge step in the right direction for treating our patients with IBS in any form, SIBO, and IMO. 

If you’re experiencing any of these diagnoses, there is hope for treatments. Now that they can be separated more than just based on symptoms, treatment plans can be created much easier. There might still be some time before exact protocols are created, but we are absolutely closer than before this research was done. 

Atrantil was created to help balance the microbiome and the polyphenols used in it are able to attack archaebacteria. Ask your doctor if, regardless of your diagnosis, Atrantil is right for you. You can get yours at this link.