Healthy Living

New Crohn's and Colitis Treatment May Combine Antifungals and Probiotics

A recent review, published in the Digestive and Liver Disease journal, proposes that new types of IBD treatment can come from combining antifungals with probiotics. Probiotics are live microorganisms that are believed to offer health-related benefits when consumed and bacteria can contain probiotic properties.

The researchers describe how such a combination can help create a healthy balance of microorganisms within the gastrointestinal tract. “The human gastrointestinal (GI) tract is home to trillions of microorganisms, some beneficial and others potentially harmful. Recent advances in science have allowed us to identify the multitude of organisms inhabiting the GI tract and parse out those that play a role in IBD. Unfortunately, most research has focused on studying only the bacteria while overlooking a key player, fungus. In order to address this issue, we have focused our efforts on studying the fungal community in the GI tract known as the mycobiome” said Dr. Mahmoud A. Ghannoum, lead author from the University Hospitals Cleveland Medical Center in Ohio and Case Western Reserve University School of Medicine.

Countless discoveries within the gastrointestinal tract

For several years now, the researchers have been analyzing the activity of the microorganisms that live within the gastrointestinal tract. In their earlier research, Dr. Ghannoum and his fellow colleagues studied the genetics of the microorganisms within the mouth. They uncovered the presence of countless fungal species. Today, based on their earlier discovery, they suggest that certain bacteria and fungi work together to form biofilms, which are capable of irritating the gastrointestinal tract and triggering inflammation, thus leading to Crohn’s disease. “Our study adds significant new information to understanding why some people develop Crohn’s disease. Equally important, it can result in a new generation of treatments, including medications and probiotics, which hold the potential for making qualitative and quantitative differences in the lives of people suffering from Crohn’s” said Dr. Ghannoum.

The researchers uncovered that the gastrointestinal tract of patients with Crohn’s disease contains higher levels of one type of fungus (Candida tropicalis) and two types of bacteria (Serratia marcescens and Escherichia coli) in comparison to individuals in good health. Their laboratorial assessments showed that the three organisms work together to form biofilms, which are thin and sticky layers of microorganisms that latch themselves to the gastrointestinal tract and can activate a negative response from the immune system (inflammation). Although the study was not the first of its kind to identify a link between fungi and bacteria, it was the first to show a link between fungi, bacteria, and inflammation in Crohn’s disease.

Fungi’s essential role in gastrointestinal health

In their latest review, the researchers strive to combine their findings and propose new treatments for IBD using a combination of antifungals with probiotics. They discuss how fungi plays a vital role in the health of the gastrointestinal tract and any overgrowth can cause damage to the lining of the gut. The researchers suggest that by eliminating the overgrowth of the fungus and administering a beneficial probiotic, which combines both bacteria and fungus, balance within the gastrointestinal tract can be reinstated. “Our groundbreaking discovery that bacteria and fungi both play a critical role in health and disease has tremendous implications not only for understanding the disease process, but also for [the] development of potentially life-changing treatments for those who suffer from chronic digestive diseases” stated Dr. Ghannoum.

“Efforts directed at development of new probiotics should take into consideration the recent findings showing that both bacteria and fungi are implicated in IBD. These studies clearly demonstrate that mycobiome/bacteriome interactions play an important role in the perpetuation of GI inflammation. Not only have we shown that fungi are important for overall GI tract health, we have also shown that overgrowth of the fungus due to imbalance has deleterious effects on the gastric mucosa. Introducing an antifungal to eliminate this overgrowth, followed by administration of a probiotic containing both good bacteria and good fungus to restore the balance of beneficial organisms, could be a promising new approach to treat IBD” concluded the researchers.

Still, while probiotic research is breaking way for new promising approaches to treating IBD cases, clinical studies are limited because probiotics are considered to be food supplements as opposed to drugs regulated by the FDA. “Conducting such trials is challenging due to the lack of funding, leaving companies with very little impetus to perform long, expensive, placebo-controlled studies” stated the authors.

Is fungus the culprit?

For a while now, it was believed that a combination of stress, hereditary factors, exposure to certain viruses and infections, as well as other risk factors were at fault for a large percentage of IBD cases. However, through new discoveries relating to inflammatory bowel diseases, such as Crohn’s disease, researchers have been building on the idea that fungus may be the culprit that fuels inflammation and autoimmune symptoms. New treatment combining antifungals and probiotics may have the potential to influence the activity of IBD by:

  • Altering the structure of the gut microbiota to accommodate the beneficial bacteria
  • Lowering the levels of bacteria and fungi found in the gut lumen
  • Decreasing colonization of bacterial tissue
  • Decreasing systemic dissemination of bacteria
  • Decreasing bacterial translocation from the gastrointestinal tract
  • Treating microabscesses

While there is currently no cure for IBD, some individuals have found that certain probiotics can help alleviate symptoms associated with forms of the disease. It is important to remember that not all probiotics are the same. They do not comprise of the same strains of bacteria and they do not deliver bacteria to the gastrointestinal tract in the same way. If you wish to take a probiotic, it is necessary to discuss the benefits and risks with your doctor. Generally, he or she may start you off on a small dose to give your body some time to adjust to the probiotic before building up to a full dose.

Probiotics have reported a great percentage of success among individuals with chronic conditions, helping ease symptoms such as fatigue, diarrhea, and constipation. Still, the success rate of a probiotic varies greatly from individual to individual. If you experience persistent symptoms such as bloating, diarrhea, rashes and acne, it is imperative that you stop taking the probiotic and talk to your doctor. Keep in mind that if one type of probiotic does not help you, it does not mean that none of them will. There is no ‘one size fits all’ probiotic. Moreover, since probiotics are expensive, you may want to consider doing some research on specific types before deciding to make your purchase.

You may even find that forums discussing the latest information on probiotics, new IBD treatments, as well as the experiences of others with chronic conditions who use such products, can be useful. They can help you to make better-informed decisions when it comes to your health.