Exposure to environmental microbiota explains persistent abdominal pain and irritable bowel syndrome after a major flood

NurFadhilah Yusof, Universiti Sains Malaysia, Kota Bharu
Nurhazwani Hamid, Universiti Sains Malaysia, Kota Bharu
Zheng Feei Ma, Universiti Sains Malaysia, Kota Bharu
Rona Marie Lawenko, De La Salle Health Sciences Institute
Wan Mohd Zahiruddin Wan Mohammad, Universiti Sains Malaysia, Kota Bharu
Deirdre A. Collins, Edith Cowan University
Min Tze Liong, Universiti Sains Malaysia
Toshitaka Odamaki, 6 Next Generation Science Institute
Jinzhong Xiao, Next Generation Science Institute
Yeong Yeh Lee, Universiti Sains Malaysia, Kota Bharu


Background: After an environmental disaster, the afected community is at increased risk for persistent abdominal pain but mechanisms are unclear. Therefore, our study aimed to determine association between abdominal pain and poor water, sanitation and hygiene (WaSH) practices, and if small intestinal bacterial overgrowth (SIBO) and/or gut dysbiosis explain IBS, impaired quality of life (QOL), anxiety and/or depression after a major food.

Results: New onset abdominal pain, IBS based on the Rome III criteria, WaSH practices, QOL, anxiety and/or depression, SIBO (hydrogen breath testing) and stools for metagenomic sequencing were assessed in food victims. Of 211 participants, 37.9% (n = 80) had abdominal pain and 17% (n = 36) with IBS subtyped diarrhea and/or mixed type (n = 27 or 12.8%) being the most common. Poor WaSH practices and impaired quality of life during food were signifcantly associated with IBS. Using linear discriminant analysis efect size method, gut dysbiosis was observed in those with anxiety (Bacteroidetes and Proteobacteria, efect size 4.8), abdominal pain (Fusobacteria, Staphylococcus, Megamonas and Plesiomonas, efect size 4.0) and IBS (Plesiomonas and Trabulsiella, efect size 3.0).

Conclusion: Disturbed gut microbiota because of environmentally-derived organisms may explain persistent abdominal pain and IBS after a major environmental disaster in the presence of poor WaSH practices.