You will surely be surprised to know that your gut, a big long muscle, more than six meters long, is home to trillions of microorganisms such as bacteria, archaea, viruses, fungi, metazoa, and protozoa. Each of the microbes has more than 1000 different species in there. These communities of gut microbes work in harmony with the human body and evolve continually. The microbes come together to work in cooperation and competition and maintain balance in microbiome. Nevertheless, some of them can be harmful too.
This vast array of gut-harbouring micro-organisms is exposed to the food you eat on a day-to-day basis. Thus, the food essentially has a far-reaching influence on the gut microbiome harmony and functioning4. Increased use of antibiotics, drugs, probiotics, and dietary changes disrupts the delicate balance of the gut microbiome. This imbalance further enhances vulnerability to infections, gastrointestinal tract inflammation and chronic illnesses ranging from metabolic diseases to gastrointestinal disorders.
The discussion on gastrointestinal disorders evokes the most common issue of constipation. What you eat reaches the large intestine in a couple of hours and exits body the next morning. However, the process can, at times, take up to a week, and the result is a constipated stomach. It’s a sort of little awkward topic that no one wants to discuss openly, yet many suffer. A gut health survey conducted by Abbott Healthcare in 2018 showed that 22% of the country's adults suffer from constipation. Interestingly constipation shows higher prevalence in metro cities believed to be mostly due to urban diet and lifestyle. Additionally, one-fourth of constipated individuals suffer from severe pain.
Constipation is clinically defined by difficult, infrequent, or inadequate bowel movements. It is one of the most common gastrointestinal diseases, which may result from a variety of reasons. Continued research shows altered gut flora as one of the primary causes of constipation. For example, the number of certain bacterial species like Bifidobacteria, Lactobacilli, and Bacteroides decrease in constipated adults. Lower levels of Bifidobacteria and high level of Bacteroidetes cause both functional constipation and constipation type irritable bowel syndrome. Also, the numbers of potentially pathogenic microorganisms like Pseudomonas aeruginosa and Campylobacter jejuni increase in people suffering from constipation. Such alteration in microbiome populations disrupts several metabolic processes causing constipation.
Studies show that gut microbiota helps metabolize substances using special enzymes which are not available in humans. Thereby, they help metabolize cholesterol, bile acid, and hormones. Moreover, gut microbes also produce short-chain fatty acids that prove beneficial in numerous ways. For example, bacteria produce short-chain fatty acids like butyrate, acetate, and propionate to carbohydrates in the absence of oxygen. A high concentration of butyrate inhibits mucin secretion and stimulates water and electrolyte absorption in the large intestine. The absence of mucin and water retention reduces the stool volume and increases hardness leading to constipation. Correspondingly, research findings support an increase in butyrate-producing genera in constipated patients.
Gut microbiome also concerns immunity as a huge proportion of the immune system finds an association with gut health. For example, Clostridial species, Bacteroidetes species, and Candidatus svagella are found to disrupt colonic immunity. Colonic immunity ultimately causes the development of colonic motility disorder and chronic constipation. They act through the secretion of anti-inflammatory molecules and through function modulation of immune cells. These changes further impact the motility and secretory functions of intestine by altering the amount of physiologically active substances and gut’s metabolic environment.
Thus, intestinal flora modulates gut mobility by altering bacterial metabolites (such as SCFAs) or bacterial cell components (such as lipopolysaccharide) or through interactions between bacterial cells and the host immune system. Consequently, showing a crucial role in the pathology of constipation.
Another microbe, Methanobrevibacter smithii, in concert with gut bacteria produces methane from dietary carbohydrates. The methane produced slows down gastric transit. Research supports its role in constipation as these micro-organisms remain abundant in constipated individuals. Some indirect evidence also shows that gut microbiota regulates endocrine cells to secrete hormones like somatostatin and Neuropeptide Y, which finally modulate the gut motility and constipation1.
Further, saturated long-chain fatty acid (SLCFA) generated by gut bacteria enhances colonic contraction and increases stool frequency in rat models. Thus, low abundance or absence of bacteria producing SLCFA may play role constipation. Moreover, the bacterial endotoxin lipopolysaccharide influences intestinal motility by delaying gastric emptying and inducing sphincteric dysfunction. Hence over-population of bacteria producing lipopolysaccharide in the gut can be a reason for developing constipation.
For decades, people with constipation receive advise to change their diets, consume a fibre-rich diet with plenty of probiotics, and indulge in regular physical exercise. However, one size does not fit all, nor do these recommendations. The bacterial community within the stomach and intestines in each and every person remains unique. Thus, a tailor-made plan is needed for every constipated gut.
So, if you really want to build a diet that promotes your gut health, the ‘Gut Microbiome Test’ may be your saviour. Using DNA sequencing technology and advance bio-informatics algorithm, the test maps the array of micro-organisms present in your gut. With the help of an advanced artificial intelligence algorithm based on the nutrient database and disease susceptibility index, the BugSpeaks test provides a customized dietary recommendation. This diet targets the root cause of constipation and helps the bowels move freely.