Doing better with functional gastrointestinal disorders? Profiling gut microbiota and circulating antibodies to CdtB and vinculin

Functional gastrointestinal disorders (FGIDs) or disorders of gut-brain interaction affect up to 40% of the general population, have significant healthcare costs and have a negative impact on health-related quality of life. According to Rome IV criteria, FGIDs do not recognize the underlying structural abnormalities, and the multifactorial pathogenesis contributes to the onset and exacerbation of symptoms (i.e., abdominal pain, burning, nausea, fullness, vomiting, bloating and altered bowel habits). Irritable bowel syndrome (IBS) and functional dyspepsia (FD) are among the most prevalent FGIDs. A better understanding of the pathogenesis of FGIDs must include the detection of distinct intestinal microbiota profiles and associated circulating antibodies as more specific biomarkers of disease. The role of the microbiota in the pathogenesis of FGIDs is supported by the onset of IBS-D after an episode of acute gastroenteritis, on a background of gut dysbiosis. In addition, FD can result from a previous Helicobacter Pylori infection, and the eradication of infection produces a small but statistically significant improvement of dyspepsia in patients with nonulcer dyspepsia.