Microbiota in the etiopathogenesis and treatment of the symptomatic diverticular disease of the large bowel

Czech version

Authors: Gombošová L.
Authors‘ workplace: I. interná klinika LF UPJŠ a UNLP, Košice
Published in: Gastroent Hepatol 2019; 73(5): 418-422
Category: Clinical and Experimental Gastroenterology: Review Article
doi: https://doi.org/10.14735/amgh2019418

Overview

Pathological changes in microbiota play a key role in the etiopathogenesis of symptomatic diverticular disease (DD) of the large bowel, as well as in immune dysregulation and visceral hypersensitivity. The large bowel is a diverse ecosystem whose two dominant microbiota are members of the phyla Firmicutes and Bacteroidetes, as well as viruses and fungi. Firmicutes represent 60–80% of the bacteria of the large bowel; there are gram positive anaerobes and aerobes, some of which are spore forming, together with Faecalibacterium sp, Clostridium sp, Lactobacillacae, Biffidobacteria sp. Other than bacteria, the large bowel also contains fungi (referred to as mycobioma or fungoma) with massive representation of Candida sp. in adults. The types of fungi differ with age, environment, and stress. Large bowel microbiota are affected by many internal and external factors, such as stress, diseases, drugs, environment, and others. Metabolomic studies have shown that specific changes in microbiota characterize symptomatic DD. The management of symptomatic DD includes cyclic therapy with rifaximin, aimed at modulating gut microbiota and improving the symptom score of the disease.

Keywords:

dysbiosis – rifaximin – microbiota – symptomatic uncomplicated diverticular disease

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