Dr. Starpoli blog on GI disorders

The War Against Our Internal Microbiolgy

Written by Rachel Jones | Apr 27, 2011 4:33:00 PM

Bacteria. Microbes. Germs. The words tend to make us squirm or draw back in fear. But are they really all that bad? Recently, researchers have been looking for ways to make the bacteria and microbes we have work for our immune system instead of against it.

While it is absolutely true that bacterial infections can be extremely dangerous and that antibiotics have assisted in the treatment of particularly virulent infections, there may be more effective ways to treat infections that don’t have the same detrimental effect on our bodies. Rob Jackson, a biologist working with Duke University Medical Center, puts it this way: “When you use antibiotics, you are essentially dropping a bomb on a microbial community, hoping that your explosion will not harm anything useful.” An experiment using antibiotics on healthy individuals yielded the result that while a person’s colonic flora recovers from the treatment, it never returns to its original state.

A new attitude toward our internal microbial ecology may be warranted. Jackson goes on to report that “there is staphylococcus and E. coli in all of us but they don’t always cause problems. It is the balance that is important. A more normal population of microbes in the gut can offset the bad players.” A more diverse eco-system in the colon may be important in countering pathogens and malignant bacteria. Richard Ostfeld, a disease ecologist at the Cary Institute of Ecosystem Studies in New York, states: “The greater the diversity, the lower the probability that pathogens can invade and persist. If all the niches are taken up in the gut, it might be hard for them to get hold.”

Some physicians have recommended the use of a probiotic to help balance the microbial flora in the digestive system. Researchers are not sure that taking a probiotic is helpful, because it is introducing a few billion organisms into a system of trillions of live organisms, so the ratio is quite high, but testing seems to indicate that the introduction of the new microbes might signal the existing community to become more active. These probiotics, however, are as yet unregulated by the FDA and any regimen should be discussed with your physician.

What about the treatment of severe and dangerous bacterial infections, such as Clostridium difficile, the number 1 cause of hospitalization for diarrheal illness in the US and Europe? Antibiotics have certainly been integral in treating and preventing the return of this type of infection, and in most cases, are still the most effective and safest way to treat them. However, as the disease becomes more prevalent, and people develop immunities to antibiotic treatments, more virulent strains become increasing difficult to cure. A team lead by University of Minnesota immunologist and gastroenterologist Alexander Khoruts has been producing excellent results with an obscure and poorly understood procedure: fecal transplants. In life-threatening cases of bacterial infection, Dr. Khoruts has found that transplanting a small amount of healthy stool from a donor balances the flora in the patients colon, with spectacular success. This procedure has been around since the 1950’s, but Dr. Khoruts team is the first to explore the effect on the microbial community of the patients.

It is exciting and fascinating to see the treatment options available today, and the implications of this type of research on the medical community.

All symptoms and treatment regimens should be discussed with your physician.

Sources: Discover Magazine 35 03.2011 "The Ecosystem Inside"; Medscape.com 4/7/11 C difficile: New Therapy for a Dangerous Disease