Alterations to the duodenal microbiota are linked to gastric emptying and symptoms in functional dyspepsia

• Published in: Gut Vol. 72; no. 5; pp. 929 - 938
• Main Authors: Shanahan, Erin R, Kang, Seungha, Staudacher, Heidi, Shah, Ayesha, Do, Anh, Burns, Grace, Chachay, Veronique S, Koloski, Natasha A, Keely, Simon, Walker, Marjorie M, Talley, Nicholas J, Morrison, Mark, Holtmann, Gerald J
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and British Society of Gastroenterology 01.05.2023; BMJ Publishing Group LTD
• Subjects: Anemia; Biopsy; Body mass index; Brain research; DIET; Dietary intake; DUODENAL MUCOSA; Duodenum; Dyspepsia; Endoscopy; GASTRIC EMPTYING; Gastric Emptying - physiology; Humans; Hypersensitivity; Immune response; Infections; Inflammation; INTESTINAL MICROBIOLOGY; Microbiota; Motility; Neurogastroenterology; Patients; Permeability; Quality of life; Relative abundance; RNA, Ribosomal, 16S - genetics; rRNA 16S; Australia; INTESTINAL MICROBIOLOGY; DUODENAL MUCOSA; DIET; GASTRIC EMPTYING
• ISSN: 0017-5749; 1468-3288
• DOI: 10.1136/gutjnl-2021-326158

ObjectiveFunctional dyspepsia (FD) is a complex disorder, with debilitating epigastric symptoms. Evidence suggests alterations in gastrointestinal (GI) motility, visceral hypersensitivity, permeability and low-level immune activation in the duodenum may play a role. However, we still have a relatively poor understanding of how these factors interact to precipitate the onset of FD symptoms which are frequently meal related. The duodenal microbiota, in combination with specific dietary substrates, may be important mediators in disease pathophysiology; however, these interlinked factors have not been thoroughly investigated in FD.DesignEighty-six individuals (56 FD, 30 controls) undergoing endoscopy were consecutively recruited and underwent detailed clinical assessment, including upper GI symptoms, gastric emptying and dietary assessment. Duodenal biopsies were obtained aseptically, and the mucosa-associated microbiota (MAM) analysed via 16S rRNA gene amplicon sequencing.ResultsThe relative abundances of predominant members of the Firmicutes, Bacteroidota and Fusobacteriota phyla were linked to symptom burden in FD. Inverse relationships between the relative abundances of Streptococcus and Prevotella, and the relative abundance of Veillonella spp with gastric emptying time, were also observed. No significant differences in long-term nutrient intake or diet quality were found between FD and controls, and there appeared to be limited association between habitual diet and duodenal MAM profiles.ConclusionThis study suggests a link between the duodenal MAM, gastric emptying and FD symptoms, and this is largely independent of long-term dietary intake.