What’s New in Gastroenterology: Microbiome + FODMAP + Autism + Celiac Disease Pathology
You rarely get the chance to meet 15,000 gastroenterologists, all together in one place. So, when BMC Medicine joined Digestive Disease Week 2015 in Washington DC last month, celiacs in Victoria, Vancouver Island and the Gulf Islands got a glimpse into what’s new in the fields of gastroenterology and hepatology.
You and your microbiome
The human microbiome was one of the main themes at DDW 2015. In a talk about gut microbiome markers and clinical response to diet, Bruno Chumpitazi focused on the efficacy of a low fermentable saccharides and polyoils diet (FODMAP) to decrease gastrointestinal disease symptom frequency and severity.
Such a diet is effective in many children and adults, but its effectiveness is still under debate. Chumpitazi highlighted that a number of specific gut biomarkers increased, such as Bacteroides, Ruminococcaceae and Faecalibacterium prausnitzii, which can be associated with the clinical response to low FODMAP diet in 33 children with IBS.
Alain Benitez described how the microbiome is also distinct in children with and without eosinophilic esophagitis, an allergic disorder featured by inflammation of the esophagus. With the aid of gene sequencing, he concluded that introducing allergenic foods caused the increase of specific bacterial species like firmicutes, which reach their highest diversity during active allergic inflammation.
The principal aim of our studies was to provide rationale basis to a possible specific therapeutic intervention in restoring a balanced gut microflora in autism spectrum disorder patients
Finally, Anna Sapone gave a talk on the microbiome signature of autistic children, highlighting that an individual’s microbiome is not only dynamic, but can be specific to certain conditions. In their unpublished study on 47 autistic children, they found a specific microbiome signature exhibiting lower diversity and distinct representation of specific phyla. Dr Sapone explained that “The principal aim of our studies was to provide rationale basis to a possible specific therapeutic intervention in restoring a balanced gut microflora in autism spectrum disorder patients.”
Celiac disease is seldom alone
Celiac disease (CD) and its related pathologies are rising worldwide, but the mechanisms and prevalence estimates are still uncertain. For example, lymphocytic gastritis (LG) has an uncommon histologic entity with different symptoms and endoscopic appearances. Benjamin Lebwohl argued that there’s a probable association between LG and CD.
To test this, Lebwohl and colleagues measured the prevalence of LG in people with and without CD, by analyzing concurrent gastric and duodenal biopsy specimens, concluding that LG is associated with CD. These results add to the knowledge of celiac disease, and it is vital to assess the clinical significance of this association. Celiac disease diagnostic techniques are still very much under debate, and the focus is now on developing less invasive methods.
Gastrointestinal diseases are extremely varied and complex, and so it’s great that meetings like DDW exist to allow researchers to share their latest findings and hypotheses, encouraging constant innovation. We really look forward to seeing the results of so much hard work translated into clinical practice.