Microbiome Optimization for IBD

Small Intestinal Bacterial Overgrowth (SIBO) and IBD

Alyssa Luck · Mar 14, 2022 · Leave a Comment

This article is part of the IBD Index. Last updated on March 14, 2022.

Small intestinal bacterial overgrowth, or SIBO, is one area of research in the field of intestinal health that has gone from relative obscurity to almost totally mainstream just in the past decade. As research has progressed, the name “overgrowth” has become a bit of a misnomer, with recent evidence indicating that the issue isn’t bacterial overgrowth per se, but rather bacterial dysbiosis in the small intestine.

In any case, SIBO is often identified in patients with IBD*, and can both affect and be affected by other IBD-related disease processes. Therefore, the question of whether and how to treat it is highly relevant. While treatment of SIBO is certainly a lever one can pull that may affect symptoms and overall disease state, SIBO is also often a symptom of other dysfuctions and environmental factors, such that addressing those other factors could resolve the SIBO without explicit treatment. And because testing for and treating SIBO is often quite complicated, it’s best to take it in context and consider whether there are other “no-brainer” levers that could be pulled first.

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Akkermansia Muciniphila: Bane or Boon for IBD?

Alyssa Luck · Mar 21, 2021 · Leave a Comment

Summary: Akkermansia muciniphila is a commensal bacteria found in healthy human colons that is widely regarded as a promising next-generation probiotic. Researchers have mainly focused on therapeutic potential for obesity and diabetes, but there’s also substantial interest in the field of IBD, particularly for its beneficial effects on gut barrier function. However, a minority of researchers have suggested that Akkermansia muciniphila could worsen colitis. Despite that, most of the evidence thus far suggests that A. muciniphila could potentially be leveraged as a beneficial therapy for IBD and gut health in general once more research has been done.

This post is part of the IBD Index.

Lactobacillus and Bifidobacteria species may still be the darlings of the probiotic world, but there’s a new kid on the block: Akkermansia muciniphila.

This bacteria was isolated for the first time in 2004 (1) so it’s still relatively new to the game, but you can see from this fun trend analysis (2) that research has exploded, especially in the last couple years.

Source: Hojat et al., Global scientific output trend for *Akkermansia muciniphila* research: a bibliometric and scientometric analysis, 2020

So what is Akkermansia muciniphila, and why the interest all of a sudden?

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Fecal Microbiota Transplant (FMT) for Pouchitis – My Experience

Alyssa Luck · Dec 7, 2018 · 3 Comments

Last updated April 23, 2022.

It has now been over two years since my experience with FMT, and I have still neglected to document it in any way. This is just atrociously bad n=1 experimentation protocol on my part, and kind of speaks to how tapped out I was by The Great Search for Answers. I think the effort I went through to find/secure a part in/complete the FMT trial was all I had left in me at the time, so after it was over, I entered a phase of Staunchly Ignoring The Problems. Which was honestly very necessary. Sometimes ya just gotta take a break, you know?

But I owe it to my future self and the general knowledge bank of the internet to document and share what I can, so here we are! If you just want the cliff notes/what I learned (there’s one exciting thing!), scroll to the bottom. Because per usual, this became way longer and more rambling than necessary.

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POW: Therapeutic Manipulation of the Microbiome in IBD

Alyssa Luck · Aug 11, 2015 · Leave a Comment

Hellooo, friends, and welcome to the first weekly installment of Paper of the Week (POW)! This delightful new feature of my blog is where I read a paper that I want to read, and then I tell you about it. That way you learn something (theoretically), and I actually remember what I read (theoretically).

This Week’s Paper

Title: Therapeutic Manipulation of the Microbiome in IBD: Current Results and Future Approaches

Authors: Jonathan Hansen and Balfour Sartor (gastroenterologists and researchers at UNC aka MY SCHOOL #represent)

Year: 2015

Type: Review paper

Abstract (partial):

Despite recent major strides in our understanding of the genetic and microbial influences that contribute to the development of the inflammatory bowel diseases (IBDs), their etiology continues to be enigmatic. Results from experiments in animal models of IBDs overwhelmingly support a causal role of the microbiota in these diseases, though whether such a cause-effect relationship exists in human IBDs is still uncertain. Therefore, virtually all currently approved and most often prescribed treatments for IBDs are directed toward the over-active immune response in these diseases rather than the intestinal bacteria. Nevertheless, there is an important need for non-immunosuppressive therapies that may present a more favorable risk-benefit profile such as those that selectively target the disruptions in gut microbiota that accompany IBDs. This need has led to clinical trials of various microbial-directed therapies including fecal microbial transplant, antibiotics, probiotics, and prebiotics. Unfortunately, these published studies, many of which are small, have generally failed to demonstrate a consistent benefit of these agents in IBDs, thus leading to slow acceptance of microbe-focused treatments for these conditions.”

Let’s go!