Interstitial cystitis and the Microbiome

According to the wonderful article, The DIPP Mystery – Why are IC patients deficient in some good bacteria?:

IC Patients Found Deficient in Gut Bacteria

While they have NOT found bacteria in the urinary tract and urine distinctive to IC (i.e. such as an elusive infection), they have found significant differences in the gut. They isolated bacteria from the stool of women with interstitial cystitis as well as normal controls. IC patients had significantly lower levels of five species of bacteria – O. splanchnicus, F. prausnitzii, C. aerofaciens, E. sinensis, and L. longoviformis. They’ve dubbed this group as “deficient in interstitial cystitis pelvic pain (DIPP).”

They also found higher than normal levels of other bacteria that could, perhaps, increase pelvic pain. Researchers have labelled this population of bacteria as “increased in IC pelvic pain (IIPP).” One bacterial species, E. lenta, as well as several bacterial families were found to be elevated in the IC patient.

A closer look at these bacteria reveal new, potential insights into IC and its related conditions:

  • L. longoviformis –  metabolizes phytoestrogens, perhaps contributing to the higher number of women with IC.
  • E. sinensis – may contribute to alterations in the gut-brain axis or pelvic organ crosstalk.
  • F. prausnitzii – is highly abundant in the human GI tract and produces critical fatty acids.
  • C. aerofaciens –  is significantly associated with symptoms in IBS patients.
  • O. splanchnicus – a bacterial mystery, very little is known about it.
  • E. lenta – associated with the bacteria in the blood stream

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PPIs Diminish Gut Microbiome Diversity

“PPIs may limit the gut’s diversity by reducing its acidity and thus creating an environment that is more or less amenable to certain microbes. And that imbalance could then lead to infection, says Rinse Weersma, a gastroenterologist at the University of Groningen. The drugs may induce “a change in the microbiome that creates a niche where Salmonella or C. difficile can grow,” he explains.”

From Heartburn Meds Alter the Gut: Acid blockers reduce the diversity of bacteria in the intestines—and that could lead to trouble, published in Scientific American.

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