Washington, Microbiome research to date has largely resembled the parable of the blind man and the elephant. How much can be said about an elephant just by looking at its tail? Researchers have studied what's most readily available—feces left over from flushing the toilet—but are missing the microbial masterminds higher up in the small intestine. until recently.
Compared by some scientists to any other human organ, your microbiome is collectively the tens of trillions of microorganisms that live in interconnected populations in and on your body. They serve as miniature sentinels that help protect your body's surfaces from pathogenic invaders.In the upper intestine, specific microbial populations aid in digestion, metabolism, and even immunity.
I'm a gastroenterologist who has spent the last 20 years studying the role of the microbiome in health and disease. Advances in technology are helping scientists investigate the microbiome of the small intestine and hold promise for better understanding and treating many diseases. Big changes come from small places
Some members of the small intestinal microbiome are associated with obesity and overweight, while other microbial members are associated with a healthy metabolic state. In fact, small intestine microbes aid digestion by converting certain simple carbohydrates into molecular building blocks of a healthy gut and body.While consistent with the function of the colon, the metabolites of the small intestine may differ significantly from the fiber-derived metabolites of the large intestine microbiome. Certain metabolites in the small intestine help regulate the production of GIP in the upper intestine, a cognate molecule of the lower intestinal hormone GLP-1, which produces the weight loss and type 2 diabetes drugs Vegov and Ozempic. Together with another lower gut hormone called PYY, this trio is important for coordinating your body's response to food by controlling your appetite and blood sugar. Monjaro has a higher concentration of GIP and GLP-1 than Vegov and Ozempic. It's a powerful combination. The full complement of these hormones is naturally induced by the breakdown of products from the microbiome of both the large and small intestines.Research has linked a disrupted microbiome of the small intestine to gut diseases. These include irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), Crohn's disease, and celiac disease.
These diseases are thought to arise in part from disturbances in the way the microbiome breaks down food. Celiac disease, for example, is associated with a reduced ability of the small intestinal microbiome to digest gluten. IBS and SIBO are linked by the opposite: the ability of the small intestine microbiome to ferment fiber and sugars too easily.Foods such as wheat, garlic, onions, beans and some processed products that are high in FODMAPs – a set of fermentable short-chain carbohydrates – have been shown to contribute to symptoms in individuals with SIBO and IBS. Lactose-rich dairy is a high FODMAP food group that has been implicated in lactose intolerance and is linked to an overactive small intestine microbiome.
Diseases associated with the small intestinal microbiome are not limited to metabolism and the gut. The lining of the gut houses a virtual embassy of immune cells that are always on alert, surveying the diverse stream of microbial and nutritional antigens passing through your gut.
Compromises in the protective systems that separate the stool flow from the rest of the body and the processes that keep immune responses in check are hypothesized to play a role in triggering various autoimmune conditions in which the body becomes confused about which is friend. Who else is the enemy?Studies have linked inflammatory changes in the small intestine microbiome to type 1 diabetes, where the body's circulating immune cells attack insulin-producing cells in the pancreas, and to extra-intestinal symptoms of celiac disease, where immune cells attack insulin-producing cells in the pancreas. Can give rise to processes. The eyes, skin and joints of the body.
Until recently, research on the small intestine has progressed slowly. Scientists relied on upper endoscopy procedures, which involve sedation and inserting a tiny camera on the end of pinky-thick tubes through the mouth into the first part of the small intestine.
One of the few alternatives to endoscopy is being studied for patients who have had intestinal surgery that leaves a portal directly into their small intestine through a hole in their abdominal wall.Newly developed technologies are removing the need for sedation and unique physiological conditions by allowing scientists to more easily sample the furthest reaches of the intestine. Such technologies include camera capsules attached to angel-hair-thin filaments and other even more streamlined devices that create minimally invasive direct lines of access to the small intestine. Researchers have also developed capsules with sample compartments that open when certain acidity levels are reached in the body.
These new sampling techniques have opened unprecedented access to the upper intestine, paving the way for new insights and treatments. In a real-life parallel to the childhood favorite "The Magic School Bus, Inside the Human Body," researchers can now travel through the gut like Ms. Frizzle and her class, shedding light on the microbial mysteries that lie within.Treatments based on an early understanding of the gut microbiome include approaches ranging from probiotics to fecal transplants and prebiotics to fermented foods. But new treatments for gut health are still in their early stages. Studying the small intestine may provide insights to improve therapeutic development. Some promising future possibilities include partnering small intestine bacteria with their preferred prebiotics and personalized combinations of low FODMAP prebiotics designed to avoid small intestine fermentation.
Treatments that partner food and the microbiome are perhaps early harbingers of what is to come in the rapidly growing field of microbiome medicine.Researching the small intestine – and not just the last end of the gut – could be the most pioneering upstream start for microbiome medicine. (Conversation)
RUP
Compared by some scientists to any other human organ, your microbiome is collectively the tens of trillions of microorganisms that live in interconnected populations in and on your body. They serve as miniature sentinels that help protect your body's surfaces from pathogenic invaders.In the upper intestine, specific microbial populations aid in digestion, metabolism, and even immunity.
I'm a gastroenterologist who has spent the last 20 years studying the role of the microbiome in health and disease. Advances in technology are helping scientists investigate the microbiome of the small intestine and hold promise for better understanding and treating many diseases. Big changes come from small places
Some members of the small intestinal microbiome are associated with obesity and overweight, while other microbial members are associated with a healthy metabolic state. In fact, small intestine microbes aid digestion by converting certain simple carbohydrates into molecular building blocks of a healthy gut and body.While consistent with the function of the colon, the metabolites of the small intestine may differ significantly from the fiber-derived metabolites of the large intestine microbiome. Certain metabolites in the small intestine help regulate the production of GIP in the upper intestine, a cognate molecule of the lower intestinal hormone GLP-1, which produces the weight loss and type 2 diabetes drugs Vegov and Ozempic. Together with another lower gut hormone called PYY, this trio is important for coordinating your body's response to food by controlling your appetite and blood sugar. Monjaro has a higher concentration of GIP and GLP-1 than Vegov and Ozempic. It's a powerful combination. The full complement of these hormones is naturally induced by the breakdown of products from the microbiome of both the large and small intestines.Research has linked a disrupted microbiome of the small intestine to gut diseases. These include irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), Crohn's disease, and celiac disease.
These diseases are thought to arise in part from disturbances in the way the microbiome breaks down food. Celiac disease, for example, is associated with a reduced ability of the small intestinal microbiome to digest gluten. IBS and SIBO are linked by the opposite: the ability of the small intestine microbiome to ferment fiber and sugars too easily.Foods such as wheat, garlic, onions, beans and some processed products that are high in FODMAPs – a set of fermentable short-chain carbohydrates – have been shown to contribute to symptoms in individuals with SIBO and IBS. Lactose-rich dairy is a high FODMAP food group that has been implicated in lactose intolerance and is linked to an overactive small intestine microbiome.
Diseases associated with the small intestinal microbiome are not limited to metabolism and the gut. The lining of the gut houses a virtual embassy of immune cells that are always on alert, surveying the diverse stream of microbial and nutritional antigens passing through your gut.
Compromises in the protective systems that separate the stool flow from the rest of the body and the processes that keep immune responses in check are hypothesized to play a role in triggering various autoimmune conditions in which the body becomes confused about which is friend. Who else is the enemy?Studies have linked inflammatory changes in the small intestine microbiome to type 1 diabetes, where the body's circulating immune cells attack insulin-producing cells in the pancreas, and to extra-intestinal symptoms of celiac disease, where immune cells attack insulin-producing cells in the pancreas. Can give rise to processes. The eyes, skin and joints of the body.
Until recently, research on the small intestine has progressed slowly. Scientists relied on upper endoscopy procedures, which involve sedation and inserting a tiny camera on the end of pinky-thick tubes through the mouth into the first part of the small intestine.
One of the few alternatives to endoscopy is being studied for patients who have had intestinal surgery that leaves a portal directly into their small intestine through a hole in their abdominal wall.Newly developed technologies are removing the need for sedation and unique physiological conditions by allowing scientists to more easily sample the furthest reaches of the intestine. Such technologies include camera capsules attached to angel-hair-thin filaments and other even more streamlined devices that create minimally invasive direct lines of access to the small intestine. Researchers have also developed capsules with sample compartments that open when certain acidity levels are reached in the body.
These new sampling techniques have opened unprecedented access to the upper intestine, paving the way for new insights and treatments. In a real-life parallel to the childhood favorite "The Magic School Bus, Inside the Human Body," researchers can now travel through the gut like Ms. Frizzle and her class, shedding light on the microbial mysteries that lie within.Treatments based on an early understanding of the gut microbiome include approaches ranging from probiotics to fecal transplants and prebiotics to fermented foods. But new treatments for gut health are still in their early stages. Studying the small intestine may provide insights to improve therapeutic development. Some promising future possibilities include partnering small intestine bacteria with their preferred prebiotics and personalized combinations of low FODMAP prebiotics designed to avoid small intestine fermentation.
Treatments that partner food and the microbiome are perhaps early harbingers of what is to come in the rapidly growing field of microbiome medicine.Researching the small intestine – and not just the last end of the gut – could be the most pioneering upstream start for microbiome medicine. (Conversation)
RUP
