Systematic Review: Gastrointestinal Infection and Incidence of Inflammatory Bowel Disease

This is part two of the series where we examine scientific papers studying helminthic therapy.  I have had a lot of anxiety lately about whether or not helminthic therapy is going to work for me.  I have found that looking into the research of helminthic therapy and IBD has really helped calm my anxieties.  

To read part one of the series Advances in the Use of Parasitic Worms click here.

We will examine, 

• What the paper is about
• Quotes from the paper
• Highlights from the paper

I hope to only summarize the amazing work of the authors here.  I strongly encourage you to read the entire research paper here. 

 

What is the Paper Gastrointestinal Infection and Incidence of Inflammatory Bowel Disease About?

This paper is a systematic review of the research discussing certain gastrointestinal infections increasing the risk and burden of IBD.  While other gastrointestinal infections reducing the risk and burden of IBD.

Although no one bacteria has been discovered to cause IBD.  There seem to be a few contributing factors.  One of these being a genetic predisposition for IBD.  As well as overall gut health and gut dysbiosis.  

While we cannot know or discuss all infections that promote and protect against IBD, the authors do name a few.

Gastrointestinal Infection and Incidence of Inflammatory Bowel Disease discuss the following infections as having a consistent, positive association with the risk and incidence of IBD.

• Campylobacter species (bacteria)
• Salmonella species (bacteria)
• Clostridium difficile species (bacteria)
• Norovirus (virus)
• Mycobacterium Avium Paratuberculosis (MAP) (bacteria)

All of these infections have been strongly associated with IBD pathology.

Of the beneficial, protective gut infections the authors discussed two types.  Helicobacter Pylori, and helminths were shown to have consistent reduced risk of IBD.  H. Pylori is the most common chronic bacterial infection worldwide.  But with the spread of total hygiene, it is at risk of being eradicated.

 

Quotes from the Paper

Gastrointestinal Infection and Incidence of Inflammatory Bowel Disease is full of amazing quotes about the science of the gut microbiota and the risk of IBD.  The authors explain that the gut microbiota is extremely complex.  And that any disturbance to this complex network may result in disease.  Unfortunately, presently, we know so little about the gut microbiome in relation to complex diseases.

Some of my favourite quotes from the paper are below.  They are kept in sequential order, and were selected to summarize the paper.  My personal thoughts are below each quote.

• “GI infection is a common cause of gut dysbiosis, and several studies have reported an association between enteric infection, functionally altered commensal bacteria, and IBD.  By contrast, some microbes such as Helicobacter pylori (H pylori) and helminths, are inversely associated with IBD, particularly CD.”
• • • This pretty much summarizes the paper.  Some infections are harmful, some are helpful.  We have been led to believe all infections are harmful, but that is not the case.  Our gut is a complex network of microorganisms.

• “In a nationwide cohort study of 94,013 patients from the United Kingdom, a diagnosis of any gastroenteritis (bacterial or viral infection) was associated with a greater than 3-fold increased risk of CD” 

• • • Some infections have been strongly, and consistently associated with the onset of IBD.

• “Certain helminths might prevent or mitigate underlying dysbiosis and or suppress pro-inflammatory products and pathways.”

• • • They may have protective qualities so that when we are infected with harmful infections, we have some good guys (bacteria) on our side

• “In general, a diverse body of literature comprising population-based, observational, cross-sectional, and retrospective studies consistently demonstrates an inverse relationship between H. pylori and intestinal helminths and IBD.”

• • • These are the good guys that we want on our side.

• “Studies often analyze subset species as a composite genus, and there is the possibility of diluted effect for species-specific or strain level differences.”

• • • This is why it is super important to get the right species from a reputable source.  Not all helminths, bacteria or parasites are created equal.

• “Broadly, helminths play an important immunoregulatory role in the intestinal microbiome, and the lack of identifiable exposure to intestinal helminths has been associated with the development of IBD”

• • These are our old friends.  We have co-evolved to have these helminths inside our body.  And we each mutually benefit from the relationship.

Highlights of the Paper

One of the most interesting parts of Gastrointestinal Infection and Incidence of Inflammatory Bowel Disease for me personally was that it discussed what I believe was the onset of my own personal IBD infection.

I experienced my first IBD symptoms shortly after a very bad salmonella infection.  Before I had this salmonella infection, I think I had mild IBS, but after the salmonella I definitely had IBD.  Although I was not diagnosed until a few years later.

The information in this article solidified my belief that the salmonella infection in 2010 was the environmental trigger that set off my IBD.

Another highlight of this article is Table 3.  

Table 3 is a great summary of all of the bacteria, viruses, fungi, and parasites discussed in the paper.  It has broken them down into those that reduce your risk of IBD.  And those that increase your risk of IBD.

 

Gastrointestinal Infection and Incidence of Inflammatory Bowel Disease is a great article to read if you want to learn more about helminthic therapy, the gut microbiome, and IBD.  It discusses the many harmful, and a select few beneficial infections in relation to the onset of IBD.