Do you often experience bloating, abdominal pain or irregular bowel movements? You may well have wondered whether these unpleasant symptoms are caused by an imbalance in your gut flora. These days, we hear more and more about the importance of gut flora, but many people are unsure exactly what this means and how to maintain a healthy gut. In this article, we explain in detail what gut flora is, what symptoms may indicate an imbalance, and what diagnostic and treatment options are available. Our aim is to help you navigate this seemingly complex topic with clear and reliable information.
What is gut flora and why is it important for our health?
The gut flora, also known as the gut microbiome, is the collective term for the microorganisms – bacteria, fungi and viruses – that live in our digestive system, primarily in the large intestine. This microscopic community plays a key role in maintaining our health. Under normal circumstances, beneficial bacteria predominate and suppress the proliferation of harmful microbes.
The main functions of healthy gut flora:
- Digestive support: They help break down the complex carbohydrates (fibre) that our bodies cannot digest on their own.
- Vitamin production: They produce vitamin K and certain B vitamins.
- Boosting the immune system: The gut flora educates and regulates the immune system, helping the body to defend itself against pathogens.
- Protection against pathogens: They prevent harmful bacteria from colonising and multiplying in the gut.
The small intestine normally contains relatively few bacteria, mainly aerobic (oxygen-requiring) species. In contrast, the large intestine is home to an extremely dense population of anaerobic (oxygen-free environment-preferring) bacteria. The transition between the two and the prevention of bacteria returning to the Bauhin key regulates.
Forms of gut flora imbalance
An imbalance in the gut flora dysbiosis Let’s call it that. Two common forms of this are SIBO and IMO.
- SIBO (Small Intestinal Bacterial Overgrowth): This condition occurs when there is an abnormal proliferation of bacteria in the small intestine, typically of the type that would normally be found in the large intestine.
- IMO (Intestinal Metanogenic Overgrowth): In this case, it is not bacteria but methane-producing microorganisms (archaea) that proliferate excessively in the small or large intestine.
Symptoms and causes of an imbalance in the gut microbiota
An imbalance in the gut flora can cause a number of unpleasant symptoms that often seem quite common. It is important to recognise these signs so that we can seek professional help in good time.
Characteristic symptoms
The most common symptoms of SIBO and IMO are as follows:
- Bloating and flatulence: The gases produced by bacteria (hydrogen, methane) cause distension of the intestinal wall.
- Abdominal pain and discomfort: You may experience cramping, stabbing or dull pain.
- Changes in bowel habits: Diarrhoea (particularly in cases of hydrogen-dominant SIBO) or constipation (often in cases of methane-dominant IMO) may be characteristic, but an alternation between the two may also occur.
- Nausea, an urgent need to go to the toilet.
More severe cases (malabsorption)
When absorption is also impaired, further symptoms may appear:
- Weight loss: Due to inadequate absorption of nutrients.
- Deficiencies: Bacteria can deplete vitamin B12, which can lead to anaemia. At the same time, folic acid levels may rise, as certain bacteria produce it.
- Vitamin deficiency: Deficiency of fat-soluble vitamins (A, D, E, K) due to impaired fat digestion.
- Steatorrhoea: The stools are pale, foul-smelling and difficult to flush away.
Possible causes of an imbalance in the gut flora
- Reduced stomach acid production: Stomach acid destroys any pathogens that are swallowed. Taking proton pump inhibitors (PPIs) or having a Helicobacter pylori infection may help the bacteria reach the small intestine.
- Intestinal motility disorders: Conditions such as diabetes, an underactive thyroid or certain medicines can slow down peristalsis, leading to constipation.
- Anatomical differences: Previous abdominal surgery, scarring, strictures (e.g. Crohn’s disease) or the removal of the Bauhin’s valve also favour the colonisation of bacteria.
- Weakened immune system: Localised or generalised weakness (e.g. IgA deficiency).
How can an imbalance in the gut microbiota be diagnosed?
As the symptoms may also indicate a number of other conditions (e.g. IBS), an accurate diagnosis is essential. The Endomedix Gastroenterology Centre Using its modern equipment, the following tests can be carried out:
Breath tests (H₂/CH₄)
This is the most commonly used, painless method. The patient drinks a sugar solution, and the device then measures the hydrogen and methane levels in their exhaled breath.
- An early rise in gas levels (within 90–120 minutes) is indicative of SIBO.
- Measuring methane production is necessary for the IMO diagnosis.
Culture of small bowel aspirate
This is the „gold standard” (most accurate) method. During an endoscopy, a sample is taken from the fluid in the small intestine. If the bacterial count exceeds 10³ CFU/ml, this confirms SIBO.
Other supplementary tests
Laboratory tests to identify any deficiencies, as well as an abdominal ultrasound or endoscopy to rule out any anatomical causes.
Treatment of an imbalance in the gut flora
The aim of the treatment is to eliminate the microbes, address the underlying cause and maintain balance.
- Antibiotic treatment: Drugs that act specifically in the gut and are poorly absorbed are used. In cases of SIBO, typically rifaximin, in the case of IMO, rifaximin is often used and neomycin combination of.
- Dietary therapy: with low-FODMAP diet It deprives harmful bacteria of their food source. It is advisable to follow this diet under the supervision of a specialist.
- Treating the underlying cause: Surgical treatment for anatomical abnormalities, the use of prokinetic agents for motility disorders, or the discontinuation of antacids under medical supervision.
- Probiotics and prebiotics: They may be helpful during the recovery phase following a course of antibiotics, but they may also worsen symptoms during the active phase of SIBO.
What next?
An imbalance in the gut flora reduces quality of life, but an accurate diagnosis and appropriate treatment are essential for recovery. The Endomedix Gastroenterology Centre Our experienced specialists will help you identify the cause of your symptoms. Don’t just put up with these unpleasant symptoms – book an appointment for a consultation!
