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