Gastrointestinal discomforts such as stomach pain and bloating are common urban diseases. If the feeling of "heartburn" frequently occurs after a meal, it may be a tell-tale sign of gastroesophageal reflux disease (GERD), commonly known as acid reflux. GERD is a common digestive disorder that will affect both the oesophagus and duodenum.
According to a study by the University of Texas Medical Branch, microbiota dysbiosis could be a side effect of the highly acidic environment created from GERD. Chronic inflammation has also been shown to create systemic immune responses that can alter natural microbiota, which further promotes the advancement of Barrett’s oesophagus.
A recent study examined the efficacy of probiotics in alleviating the frequency and severity of symptoms in GERD in the general adult population, and concluded that probiotics (e.g., Lactobacillus and Bifidobacterium) can help reduce nausea, alleviate acid reflux and heartburn.
It is widely believed that acid reflux is caused by excessive stomach acid, but it is actually caused by the relaxation of the lower oesophageal sphincter (valve) between the stomach and the oesophagus fails to function properly. Normally this valve closes tightly after food enters our stomach, but if it relaxes and does not close, your stomach contents and stomach acid may flow back into the oesophagus, causing bad breath, oesophageal inflammation, bleeding, or in extreme cases oesophageal cancer. Obesity and pregnancy also increase the risk of GERD as the excess belly fat or an enlarged uterus can crowd the abdomen, pushing stomach acids upward into the oesophagus.
Common symptoms of GERD includes:
- Heart burn
- Chest pain
- Sore throat
- Sensation of a lump in the throat
A recent study in the United States revealed that gut dysbiosis has been associated with several oesophageal disease processes, such as Barrett’s esophagus (BE) and gastroesophageal reflux disease (GERD). The microbiota dysbiosis could be a side effect of the highly acidic environment created from GERD. The lower oesophageal tract microbiome is unique for patients with GERD, showing high levels of gram-negative species such as Proteobacteria, Fusobacteria, Spirochaetes, Rothia, and Campylobacter. This bacterial shift can be a vicious cycle of dysbiosis.
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Okereke, I., Hamilton, C., Wenholz, A., Jala, V., Giang, T., Reynolds, S., Miller, A., & Pyles, R. (2019). Associations of the microbiome and esophageal disease. Journal of thoracic disease, 11(Suppl 12), S1588–S1593. https://doi.org/10.21037/jtd.2019.05.82
Tian, Z., Yang, Z., Gao, J., Zhu, L., Jiang, R., & Jiang, Y. (2015). Lower esophageal microbiota species are affected by the eradication of Helicobacter pylori infection using antibiotics. Experimental and therapeutic medicine, 9(3), 685–692. https://doi.org/10.3892/etm.2015.2169
Amir, I., Konikoff, F. M., Oppenheim, M., Gophna, U., & Half, E. E. (2014). Gastric microbiota is altered in oesophagitis and Barrett's oesophagus and further modified by proton pump inhibitors. Environmental microbiology, 16(9), 2905–2914. https://doi.org/10.1111/1462-2920.12285
Cheng, J., & Ouwehand, A. C. (2020). Gastroesophageal Reflux Disease and Probiotics: A Systematic Review. Nutrients, 12(1), 132. https://doi.org/10.3390/nu12010132