Early IBD shows clear gut bacteria changes before treatment begins.
People who develop inflammatory bowel disease often experience these symptoms long before a clear diagnosis is made. New research suggests that important changes inside the gut may already be underway at the very start of the illness, leading to the potential for an early IBD diagnosis and prompt treatment. An international study led by researchers at the University of Birmingham found that major shifts in gut bacteria occur right when inflammatory bowel disease first appears, even before any treatment begins. These findings may help doctors identify the disease earlier and guide future care.
Inflammatory bowel disease, often shortened to IBD, mainly includes Crohn’s disease and ulcerative colitis. Both conditions involve ongoing inflammation in the digestive tract and can cause pain, diarrhea, weight loss, and fatigue. Although IBD has been studied for many years, it has remained difficult to pinpoint what happens in the gut at the moment the disease begins. Most earlier studies looked at people who had already been living with IBD and taking medications, which can change gut bacteria on their own.
This new study took a different approach. Researchers combined raw microbiome data from several earlier studies around the world. In total, they analyzed information from more than 1,700 children and adults in 11 countries. All participants had recently been diagnosed with IBD and had not yet started treatment. This allowed the research team to see clearer patterns linked to the disease itself rather than medication effects.
The results showed a consistent loss of helpful gut bacteria that thrive without oxygen. These bacteria play an important role in breaking down complex carbohydrates and supporting gut health. At the same time, there was an increase in bacteria that tolerate oxygen, many of which are usually found in the mouth rather than the intestines. This shift suggests that the gut environment becomes more oxygen-rich at disease onset, making it harder for beneficial bacteria to survive.
Scientists refer to this idea as the oxygen hypothesis. According to this view, inflammation in the gut lining allows more oxygen to enter areas that are normally low in oxygen. This change disrupts the balance of bacteria and favors microbes that are less helpful or even harmful. The study found clear support for this theory, showing that these changes appear very early in the disease process.
The presence of oral bacteria in the gut was another striking finding. Species such as Granulicatella and Haemophilus were more common in people with newly diagnosed IBD. These bacteria are not typically part of a healthy gut community. Their movement from the mouth into the intestines may add to inflammation and worsen symptoms.
The study also revealed differences based on age, sample type, and location. Patterns in children were not always the same as those seen in adults. Stool samples sometimes showed different bacterial changes than tissue samples taken during medical procedures. In addition, microbiome patterns varied across regions of the world, highlighting the need for global data when studying gut health.
Another important finding involved how microbiome data are studied. The researchers noted wide variation in testing and analysis methods across the studies they reviewed. This lack of standard methods can make results harder to compare and slow progress in the field. The study adds to calls for more consistent approaches when examining gut bacteria.
Overall, the findings point to new possibilities for earlier diagnosis. If these bacterial changes can be detected before symptoms become severe, doctors may be able to identify people at risk sooner. The results also suggest that future treatments might focus on restoring healthy gut bacteria or adjusting oxygen levels in the gut rather than relying only on traditional drugs.
By focusing on the earliest stages of inflammatory bowel disease, this research offers a clearer view of how the condition begins. Understanding these early changes may lead to better outcomes for people facing a lifelong digestive illness.
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Study demonstrates significant changes in gut bacteria at the onset of IBD
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