What is microflora and why does it change?
The intestines contain trillions of bacteria involved in the digestion of fiber, the synthesis of certain vitamins and the functioning of the immune system. The composition of the microflora is individual for each person and changes depending on nutrition, age, medications and diseases. “Norms for dysbacteriosis” in the usual sense do not exist: in healthy people, the number of individual bacteria can differ tens of times. When the factor that disturbed the balance disappears, the microflora, as a rule, restores itself.
- Antibiotic courses
- Acute intestinal infections and parasitoses
- Irritable bowel syndrome, SIBO
- Inflammatory bowel disease, celiac disease
- Diseases of the pancreas and liver
- Low fiber diet
Symptoms that are attributed to dysbiosis
The complaints with which people come to “treat dysbiosis” are nonspecific and occur in many diseases. That is why it is important not to attribute them to microflora, but to get examined.
- Bloating and increased gas production
- Loose stools—diarrhea or constipation
- Rumbling, discomfort and pain in the abdomen
- Bad breath, coating on the tongue
- Skin rashes that actually usually have another cause
Do I need a stool test for dysbacteriosis?
Stool culture for dysbacteriosis shows only bacteria from the lumen of the colon that were able to grow on a nutrient medium - and this is a small part of the real microflora. The result depends on the conditions of collection and delivery of the material and does not correlate well with symptoms. Therefore, evidence-based medicine does not recommend making a diagnosis and prescribing treatment based on this analysis. Much more useful is an examination aimed at finding the cause of complaints.
- Coprogram - evaluates food digestion
- Fecal calprotectin - detects inflammation in the intestines
- Fecal tests for Giardia, helminth eggs and intestinal infections
- C. difficile toxins in diarrhea after antibiotics
- Hydrogen breath test - if you suspect SIBO and lactase deficiency
What diseases should be excluded
Depending on the complaints and age, the gastroenterologist may prescribe blood tests, ultrasound of the abdominal organs, gastroscopy or colonoscopy. Often, “dysbacteriosis” reveals very specific and treatable conditions.
- Irritable bowel syndrome
- Lactase deficiency and celiac disease
- Giardiasis and helminthiases
- Chronic pancreatitis
- Inflammatory bowel diseases and polyps
- Antibiotic-associated diarrhea and clostridial colitis
Treatment and prevention
The main thing is to treat the identified disease. A doctor may prescribe probiotics with proven effectiveness in specific situations: for the prevention of diarrhea due to antibiotics, for certain intestinal infections in children, as an addition to the treatment of SIBO or H. pylori. There is no point in taking them for years “for microflora” without indications. The best thing you can do for your gut bacteria is to eat a varied diet with plenty of plant fiber and avoid unnecessary antibiotic use.
- Eat more vegetables, fruits, legumes, whole grains
- Include dairy products
- Take antibiotics only as prescribed by your doctor
- Wash your hands and practice good food hygiene
- Be examined for persistent complaints, and not be treated at random