GDD and the Microbiome
Over recent years the intestinal microbiome has become an important and fascinating subject of research in medicine and health. As I am an abdominal radiologist, I also love the concept of emphasizing the importance of the microbiome in health.
Scientific knowledge and learning is still early with the microbiome. Some aspects though are important:
1. the total cell mass of the microbiome is enormous: the number of bacteria that form important functions in our body appear to outnumber our host cells.
2. the microbiome serves as an important front line protection and is part of our immune system: like mercenaries.
3. there are extensive communications between the microbiome and many (perhaps all) body systems, including the neurological system.
4. appropriate balance of a mixed population of bacteria is crucial to health.
5. the most damaging injuries to the microbiome are from the use of antibiotics. This illustrates an important aspect of appropriate and indicated use of antibiotics. Indiscriminate and inappropriate use of antibiotics will kill off many of the helpful, protective bacteria, allowing their place to be taken by a smaller range of bacteria types, and those that are more likely to injure us. The classic is Clostridium difficile colitis arising from excess use of antibiotics. This can result in toxic colon and death.
6. there is likely a full range of different medications that can have a major adverse affect on the microbiome.
So what about GDD and the microbiome?
No doubt an imbalance of the microbiome, or related conditions: 'leaky bowel' interacts and creates fertile ground for GDD. A number of subjects with GDD had massive exposure to antibiotics, and following GBCA injection, they developed an aggressive form of GDD. Did destruction of the healthy microbiome by antibiotics create the environment to develop GDD following the GBCA. I am not sure but I believe probably yes. Treatment of the microbiome in addition to GDD is probably important in these individuals.
Fecal transplant to me make enormous sense in diseases which affect the bowel: such as C difficile colitis, Crohn's Disease, Ulcerative Colitis. Recently fecal transplant has been described to treat fibromyalgia. If this is to be tried in GDD, clearly the subjects who should be considered for this should have had a massive antibiotic exposure shortly before the disease developed., and/or GDD that involves bowel stasis. Fungi, such as candida, may be part of the bowel stasis picture, as fungi thrive in the setting of metals.