Role of the duodenal microbiota in functional dyspepsia

BACKGROUND: Functional dyspepsia (FD) is a common and debilitating gastrointestinal disorder attributed to altered gut‐brain interactions. While the etiology of FD remains unknown, emerging research suggests the mechanisms are likely multifactorial and heterogenous among patient subgroups. Small bow...

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Autores principales: Brown, Georgia, Hoedt, Emily C., Keely, Simon, Shah, Ayesha, Walker, Marjorie M., Holtmann, Gerald, Talley, Nicholas J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9786680/
https://www.ncbi.nlm.nih.gov/pubmed/35403776
http://dx.doi.org/10.1111/nmo.14372
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author Brown, Georgia
Hoedt, Emily C.
Keely, Simon
Shah, Ayesha
Walker, Marjorie M.
Holtmann, Gerald
Talley, Nicholas J.
author_facet Brown, Georgia
Hoedt, Emily C.
Keely, Simon
Shah, Ayesha
Walker, Marjorie M.
Holtmann, Gerald
Talley, Nicholas J.
author_sort Brown, Georgia
collection PubMed
description BACKGROUND: Functional dyspepsia (FD) is a common and debilitating gastrointestinal disorder attributed to altered gut‐brain interactions. While the etiology of FD remains unknown, emerging research suggests the mechanisms are likely multifactorial and heterogenous among patient subgroups. Small bowel motor disturbances, visceral hypersensitivity, chronic microinflammation, and increased intestinal tract permeability have all been linked to the pathogenesis of FD. Recently, alterations to the gut microbiome have also been implicated to play an important role in the disease. Changes to the duodenal microbiota may either trigger or be a consequence of immune and neuronal disturbances observed in the disease, but the mechanisms of influence of small intestinal flora on gastrointestinal function and symptomatology are unknown. PURPOSE: This review summarizes and synthesizes the literature on the link between the microbiota, low‐grade inflammatory changes in the duodenum and FD. This review is not intended to provide a complete overview of FD or the small intestinal microbiota, but instead outline some of the key conceptual advances in understanding the interactions between altered gastrointestinal bacterial communities; dietary factors; host immune activation; and stimulation of the gut–brain axes in patients with FD versus controls. Current and emerging treatment approaches such as dietary interventions and antibiotic or probiotic use that have demonstrated symptom benefits for patients are reviewed, and their role in modulating the host–microbiota is discussed. Finally, suggested opportunities for diagnostic and therapeutic improvements for patients with this condition are presented.
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spelling pubmed-97866802022-12-27 Role of the duodenal microbiota in functional dyspepsia Brown, Georgia Hoedt, Emily C. Keely, Simon Shah, Ayesha Walker, Marjorie M. Holtmann, Gerald Talley, Nicholas J. Neurogastroenterol Motil Review BACKGROUND: Functional dyspepsia (FD) is a common and debilitating gastrointestinal disorder attributed to altered gut‐brain interactions. While the etiology of FD remains unknown, emerging research suggests the mechanisms are likely multifactorial and heterogenous among patient subgroups. Small bowel motor disturbances, visceral hypersensitivity, chronic microinflammation, and increased intestinal tract permeability have all been linked to the pathogenesis of FD. Recently, alterations to the gut microbiome have also been implicated to play an important role in the disease. Changes to the duodenal microbiota may either trigger or be a consequence of immune and neuronal disturbances observed in the disease, but the mechanisms of influence of small intestinal flora on gastrointestinal function and symptomatology are unknown. PURPOSE: This review summarizes and synthesizes the literature on the link between the microbiota, low‐grade inflammatory changes in the duodenum and FD. This review is not intended to provide a complete overview of FD or the small intestinal microbiota, but instead outline some of the key conceptual advances in understanding the interactions between altered gastrointestinal bacterial communities; dietary factors; host immune activation; and stimulation of the gut–brain axes in patients with FD versus controls. Current and emerging treatment approaches such as dietary interventions and antibiotic or probiotic use that have demonstrated symptom benefits for patients are reviewed, and their role in modulating the host–microbiota is discussed. Finally, suggested opportunities for diagnostic and therapeutic improvements for patients with this condition are presented. John Wiley and Sons Inc. 2022-04-11 2022-11 /pmc/articles/PMC9786680/ /pubmed/35403776 http://dx.doi.org/10.1111/nmo.14372 Text en © 2022 The Authors. Neurogastroenterology & Motility published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Review
Brown, Georgia
Hoedt, Emily C.
Keely, Simon
Shah, Ayesha
Walker, Marjorie M.
Holtmann, Gerald
Talley, Nicholas J.
Role of the duodenal microbiota in functional dyspepsia
title Role of the duodenal microbiota in functional dyspepsia
title_full Role of the duodenal microbiota in functional dyspepsia
title_fullStr Role of the duodenal microbiota in functional dyspepsia
title_full_unstemmed Role of the duodenal microbiota in functional dyspepsia
title_short Role of the duodenal microbiota in functional dyspepsia
title_sort role of the duodenal microbiota in functional dyspepsia
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9786680/
https://www.ncbi.nlm.nih.gov/pubmed/35403776
http://dx.doi.org/10.1111/nmo.14372
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