‘Does any good thing proceed from the gut?’
Who would believe it, that in the gut lies an indispensable tool for transforming and retelling the 21st Century health narrative? How on earth would one convince you that ‘poop’ is not a complete waste? Why should one even care to believe such a seeming ‘cock and bull’ story?
Several centuries ago, the Chinese ‘yellow soup’ was used to treat diarrhoea and bowel diseases. This so-called ‘colourful soup’ was prepared from the poop of a healthy individual, and used as a therapeutic for the patient. Well, that’s an old story (probably a folktale), one may quickly infer; it could only have been possible with the prevalent dark clouds of ignorance and illiteracy. So, what ‘new things’ would the education and enlightenment of the 21st Century offer?
Meet ‘Gut Microbiota’; the 21st Century Health Specialists. Gut microbiota refer to the diverse micro-organisms that inhabit the gut. Gut, here refers to the digested system, especially the intestines – the site containing foods undergoing digestion and ‘poop’. This microbial community, which encompasses a rich diversity of trillions of micro-organisms, has all it takes to chart the course and predict the pace for health-related research, especially in the nearest future. This is no doubt because of the overlapping beneficial and detrimental roles they play in health and in the incidence of diseases. Gut microbiota, provide a major link between genetics, diet, health and diseases.
They include bacteria, archaea, viruses, fungi and protozoan which fall into different classes – the beneficial symbionts, the harmless commensals and the detrimental pathogens – depending on how they influence health and diseases. All of these microbes are inter-dependently and differentially expressed in response to diet, disease, aging, location, lifestyle changes, as well as in health and diseases.
In the past decade, several studies have identified or suggested possible links between changes in gut microbiota and the incidence or severity of certain disorders; obesity, type 2 diabetes, allergies, inflammatory bowel disease, schizophrenia and colorectal cancer – some of which were barely understood, previously.
Gut dysbiosis, an alteration of the normal microbial community in the gut; and gut permeabilty compromise, are the major links between gut microbiota and the incidence of most of these diseases. However it is yet unclear whether these observed links cause, or alarm us of the diseases. In other studies, gut microbiota have been found to interact with drug metabolism and bioavailabilty; they modify drugs to yield metabolites that affect a patient’s response to the drugs. They are also known to interact with and influence immune development and function, mediating diverse roles, that span susceptibility to infections, hypersensitivity, allergies, inflammation and autoimmunity (some of these conditions have been discussed extensively in previous articles on the ‘Immune System’).
With the gut and its pristine citizens, one can never stop discovering and developing – ‘the more you dig, the more there is to dig’.
Being home to over 1000 species of bacteria (and several other microbial families), which account for at least 3 million genes – many times more than human genes – the gut is no doubt a world of its own. The common bacteria species inhabiting the gut include those belonging to the genera; Bacteroides, Clostridium, Eubacterium, Fusobacterium, Ruminococcus, Bifidobacterium, Peptococcus, Peptostreptococcus, Lactobacillus and Escherichia. This potpourri of diverse microbes, in addition to their associated biochemical processes, products, interactions and transitions enlightens the layman’s perspective of the gut – its microbiota and their operations – as a lively scenery of ‘colourful’ species. But, such a perspective comes no where close to describing the reality of the gut; because for researchers, it is a whole lot more, than just ‘colours’, beauty and admirations. The fact that the interactions amongst gut microbiota and the transitions in their composition and function are neither simplistic nor readily predictable complicates the whole process of analysing and understanding them. For example, gut microbiota composition and function is known to differ with respect to one’s genetics, geographical origin, age, diet, disease, location and lifestyle. Moreover, apart from its role in the incidence of psychiatric disorders – schizophrenia and anorexia, colorectal cancer, obesity and diabetes (type 2); the gut microbiome has also been suggested to influence fetal development and certain pregnancy-associated complications, in such a way that places individuals at risk of allergies and autoimmune conditions in their lifetime.
In harnessing these features and functions of the gut microbiome, researchers have embarked on a number of ‘discover-predict-design’ cycles that have yielded positive results. Some of the current techniques which target, influence or employ gut microbiota in healthcare include;
| Fecal Microbiota Transplant (FMT) (Stool Substitute Transfer Therapy – SSTT): This therapeutic advance in gut microbiota application, is the 21st Century modification of the 4th Century ‘Chinese yellow soup’, which was used to transfer gut microbiota from a healthy individual to a patient via ‘poop’. FMT uses ‘poop capsules’, and has been utilised in the treatment of Clostridium difficile infections and inflammatory bowel disease (IBD). Although, it does have its limitations (may not yield favourable results in every patient), it foretells a promising future for disease prevention and treatment using gut microbiota.
| Probiotics, Prebiotics and Antibiotics Administration: Probiotics refer to live microbes that confer health benefits when consumed; prebiotics are the often ‘undigestible’ foods that influence the growth and development of the gut microbiome; while antibiotics are drugs taken to kill microorganisms. These (especially when targeted at specific microbes) may be used independently or in concert, to influence gut microbiome composition and function, and to reverse dysbiosis and disease conditions. For example, ‘probiotic cocktails’ have been suggested to aid in the treatment of food allergies and reversal of dysbiosis.
| Modified Diets: Dieticians are able to modify one’s diet, taking into cognizance his genetic predispositions and other factors, to promote ‘stable’ or ‘ideal’ gut microbiota-host interactions in healthy individuals and to prevent or treat diseases in unhealthy individuals.
It is obvious that the complex interactions, transitions and diversity of the gut microbiota have not in any way deterred researchers in their quest to explore and certify them as ‘the 21st Century Health Specialists’. With the current improved interest in ‘gut research’ and the spate of newer discoveries, inventions and connections coming into the big-picture, it would not be unsafe to infer that these ‘aged, re-discovered, novel health influencers’ have come to stay – to rescript our current understanding of and approach to predicting, diagnosing, preventing and treating diseases and disorders in healthcare – and would definitely outlive their contemporaries.
LEARN A NEW TERM
INFLAMMATORY BOWEL DISEASE (IBD): This is a group of disorders marked by an inflamed intestine or gastrointestinal tract (GIT). IBD was thought to be an autoimmune condition – resulting from a ‘self attack’ of the body’s protective machinery (immune system) on its own cells. But, in more recent times, it has been linked to dysbiosis – an alteration of the gut microbiota in composition and function. There are two major forms of this disease; Crohn’s disease (which may affect any portion of the gastrointestinal tract – GIT, from the mouth to the anus) and Ulcerative colitis (which is limited to the colon or large intestine).
THE GUT-BRAIN AXIS: The gut-brain axis serves as a link between the central nervous system (CNS) of the brain and the enteric nervous system (ENS) of the gastrointestinal tract (GIT). It allows for gut-brain communication; the bi-directional migration of gut microbes and their metabolic products between the gut and the brain. In addition to being independent, the ENS of the gut is often referred to as ‘the second brain’ due to this special communication link. The gut-brain axis has been identified to play a key role in the incidence of neurological disorders such as anxiety and schizophrenia; in mediating one’s feeding habits; as well as in diet-linked health disorders such as, obesity and anorexia.
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