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DIG E > E6 Gut dysbiosis and disease > Flashcards

E6 Gut dysbiosis and disease Flashcards

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1
Q

what is dysbiosis?

A

an imbalance of microbial species within a microbiome

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2
Q

what happens in dysbiosis?

A
  • beneficial bacteria usually decrease in number and diversity
  • other bacteria that may be harmful ten to increase in number
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3
Q

how can dysbiosis occur?

A
  • medications (eg. antibiotics)
  • dietary changes
  • psychological and physical stress
  • age
  • puberty
  • biological sex
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4
Q

how can antibiotics cause dysbiosis?

A

they can kill bad bacteria but Aldo good bacteria which can cause gut dysbiosis

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5
Q

why does gut dysbiosis matter?

A

linked to a range of illnesses and diseases

  • obesity
  • diabetes
  • cancer
  • gastric ulcers
  • depression
  • asthma
  • IBD
  • arthritis
  • autoimmune disorders
  • eczema
  • dental cavities
  • acne
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6
Q

what is Clostridium difficile?

A

a type of bacteria that can cause diarrhoea

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7
Q

where is Clostridium difficile located and how can it cause infection?

A
  • Clostridium difficile usually lives harmlessly in your colon
  • if the balance of bacteria in the gut changes (dysbiosis), Clostridium difficile can cause infection
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8
Q

what kind of pathogen is Clostridium difficile?

A

opportunistic pathogen (pathobiont)

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9
Q

risk factors for Clostridium difficile

A
  • antibiotic exposure
  • older age (over 65)
  • previous history of Clostridium difficile
  • weakened immune system
  • recent stay at a hospital or nursing home
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10
Q

how do we treat Clostridium difficile infection?

A
  1. stop any antibiotics use if possible
  2. taking course of another antibiotic to treat the Clostridium difficile infection

(and stay hydrated)

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11
Q

what is metabolic syndrome and who does it affect?

A

combination of linked conditions:
- type II diabetes
- high blood pressure
- obesity

  • affects 1 in 3 older adults aged 50 or over in the UK
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12
Q

how can metabolic syndrome occur?

A

underlying aetiology is complex but is associated with gut dysbiosis

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13
Q

why does metabolic syndrome matter?

A

research shows the gut microbiome is linked to disease and there is evidence it has a role in obesity

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14
Q

what is the microbiome-gut-brain concept?

A
  • evidence the gut microbiome influences the brain led to this concept
  • gut microbiome is involved involved in the modulation of neurochemical pathways between GIT and CNS
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15
Q

short-chain fatty acids produced by bacterial fermentation of dietary fibre in the colon have many benefits. state some.

A
  • influence intestinal mucosal integrity and function
  • can cross BBB, neuroactive properties that directly influence the brain
  • secretion of gut hormones (eg. glucagon-like peptide 1)
  • brown adipose tissue activation
  • regulation of liver function
  • increased insulin secretion from pancreas
  • immune regulation
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16
Q

what is the disruption in balance of SCFA linked to?

A

mood changes
mood disorders
overall health

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17
Q

what does FMT stand for?

A

faecal microbiota transplants

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18
Q

where can FMT be administered via?

A

upper GIT
- endoscopy (tube down throat)
- nasogastric tube (tube down nose into throat and oesophagus)
- freeze-dried capsules

lower GIT
- enema
- colonoscopy

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19
Q

compare the cure rates of C. diff infection with faecal microbiota transplants vs. vancomycin

A
  • 90% cure rate after single FMT treatment
  • 25% cure rate for vancomycin
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20
Q

who has NICE approved FMT treatment for?

A

adults who had had 2 or more episodes of C. diff infection that have not resolved with antibiotics

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21
Q

describe the improvement of C. diff infection in those with autism spectrum disorder with FMT

A

40% improvement after 1 month of capsules, sustained after 2 years

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22
Q

what are the 2 types of irritable bowel disease? what types of condition are they?

A
  • ulcerative colitis
  • Crohn’s disease

both autoimmune diseases

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23
Q

describe the use and effectiveness of FMT treatment in those with either type of IBS

A

ulcerative colitis
- 40% showed positive response after 1 month of treatment

Crohn’s disease
- preliminary studies suggest FMT may be effective

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24
Q

what is gastroenteritis?

A
  • inflammation of the lining of the stomach and intestines
  • acute condition typically lasting a few days to 1 week
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25
symptoms of gastroenteritis
- nausea - vomiting (for 1-2 days) - diarrhoea (for up to 5 days) - abdominal cramps - fever - fatigue
26
causes of gastroenteritis
- infection - allergic reactions to medications or food - stress - diet - underlying conditions
27
describe the transmission of gastroenteritis
- typically faecal-oral route - contaminated water / food - travel history is useful to explore
28
describe the treatment and management of gastroenteritis
- ORT - paracetamol - stay home for 48 hours - good hygiene practices - antidiarrheals and / or antibiotics
29
are antidiarrheals and / or antibiotics always used to treat and manage gastroenteritis?
- no - they are severity and cause-dependent - if it is caused by infection, want to expel infection asap so diarrhoea must occur and not be stopped
30
in gastroenteritis (and generally), what can diarrhoea cause?
- disturbance of water and electrolyte reabsorption in gut - moderate to severe dehydration - risk of infection spreading
31
give some statistics surrounding diarrhoea (eg. from gastroenteritis) disturbing water and electrolyte reabsorption in the gut
- a leading cause of child mortality - 3rd leading cause of death in children under 5 - 20-30% of UK residents experience diarrhoea
32
give some symptoms surrounding diarrhoea (eg. from gastroenteritis) causing moderate to severe dehydration
- dark urine, thirst, lethargy, tachycardia (fast HR) - hypovolemia (loss of blood volume) can cause dizziness - severe cases may require hospitalisation and IV fluids
33
how and where can diarrhoea lead to the risk of infection spreading from gastroenteritis?
- hospitals, schools, care homes - contaminated food production and water supply
34
what is infectious gastroenteritis in terms of the category of disease it falls under?
- it is a notifiable disease - this means if someone presents with this, we have to report them online to the government so the statistics are recorded
35
what are protozoa?
small, unicellular eukaryotes
36
are protozoa harmful?
they are a normal part of our microbiome (commensal)... but some are pathogenic
37
what does the bacteria Giardia intestinalis cause?
giardiasis
38
what does the bacteria Cryptosporidium spp. cause?
cryptosporodiosis
39
what types of diseases are giardiasis and cryptosporidiosis?
notifiable diseases
40
what does the bacteria Entamoeba histolytica cause?
amoebiasis and amoebic dysentery
41
describe giardiasis cysts
- infective and transmitted in water, food or via hands / fomites - can resist water treatment, boiling is needed
42
describe giardiasis trophozoites
- motile and attachment to epithelium in small intestine - have flagella and adhesive ventral disk
43
symptoms of giardiasis
chronic diarrhoea flatulence nausea stomach cramps weight loss within 1-14 days, lasting 1-3 weeks
44
treatment of giardiasis
- ORT - drug treatment if severe - should stay hydrated and try to clear it without drug
45
describe cryptosporidiosis cysts
- egg form - infective and transmitted in water, food or via hands / fomites - high chlorine tolerance, boiling is needed
46
describe cryptosporidiosis trophozoites
- cell form - parasite the gut epithelium in small intestine
47
symptoms of cryptosporidiosis
- chronic watery diarrhoea - nausea - stomach cramps - fever - weight loss - within 2-10 days, lasting 1-2 weeks
48
treatment of cryptosporidiosis
- ORT - drug treatment if severe
49
describe the mortality rate of cryptosporidiosis
high mortality rate in children and infants
50
what is bacterial gastroenteritis usually caused by?
- food poisoning common bacterial causes include: - Campylobacter - Salmonella - Escherichia coli
51
where is Campylobacter most often found?
undercooked chicken unpasteurised milk untreated water
52
what foods is Salmonella from?
those such as: meats raw eggs milk dairy
53
where is E. coli most often from?
meat salad products unpasteurised milk
54
describe Campylobacteriosis in terms of its rarity, shape and action
- most common cause of food poisoning in the UK - rod-shaped coil with flagella at both ends - bacteria invade GI epithelium and macrophages (produce toxins that inhibit growth of healthy body cells and damage DNA)
55
symptoms of Campylobacteriosis
- asymptomatic in 25-50% - diarrhoea (often bloody) - fever - stomach cramps - nausea and vomiting
56
when do Campylobacteriosis symptoms start after infection and how long do they last?
- start within 2-5 days - last 1 week
57
describe the transmission of Campylobacteriosis
- consumption of contaminated food such as: undercooked meat (eg. poultry) unpasteurised milk untreated water
58
treatment of campylobacteriosis
- self-limiting (unpleasant but will clear on its own) - ORT - manage symptoms but antibiotics may be needed if severe
59
explain the use of antidiarrheals for campylobacteriosis
might make illness worse due to extended exposure to bacterial toxins
60
describe salmonellosis
- Salmonella bacteria can cause food poisoning - bacterial cells can perforate intestinal wall - enterotoxins disrupt ion and water transport
61
symptoms of salmonellosis
- sometimes asymptomatic - diarrhoea (can be bloody) - fever - stomach cramps
62
when do salmonellosis symptoms start after infection and how long do they last?
- start within 6hours - 6days (can present very quickly) - last 4-7 days
63
describe the transmission of salmonellosis
- eating contaminated food such as: undercooked meat (eg. poultry) unpasteurised milk eggs
64
treatment of salmonellosis
- self-limiting - ORT - manage symptoms - antibiotics may be needed if severe
65
describe the use of antidiarrheals in salmonellosis
might make illness worse due to extended exposure to bacterial toxins
66
describe E. coli infection. give specific example
- E. coli bacteria can cause food poisoning - there are lots of different strains of E. coli - Escherichia coli O157:H7 is Shiga toxin-producing E. coli - toxin can rupture and destroy red blood cells so it is very problematic
67
symptoms of E. coli infection
- diarrhoea (often bloody) - stomach cramps - vomiting
68
when do E. coli symptoms start after infection and how long do they last?
- start within 3-5 days - last 5-7 days
69
describe the transmission of E. coli infection
- consumption of contaminated food such as: undercooked meat (eg. beef) unwashed raw leafy vegetables untreated water
70
treatment of E. coli
- self-limiting - ORT - manage symptoms - antibiotics may be needed if severe
71
describe the use of antidiarrheals in E. coli treatment (be specific)
can make illness worse, due to extended exposure to Shiga toxin
72
what accounts for most cases of gastroenteritis?
viruses
73
describe rotavirus
- 70% of cases of gastroenteritis - highly contagious but vaccine available - infect gut epithelia - leading cause of paediatric gastroenteritis
74
symptoms of rotavirus
diarrhoea vomiting nausea fever stomach pain
75
when do rotavirus symptoms start after infection and how long do they last?
- start within 1-2 days - last 3-8 days
76
transmission of rotavirus
- faecal-oral, contact with infected vomit or faeces - contaminated food / surfaces
77
what precautions must be taken if a baby has rotavirus?
parents must be careful when changing baby's nappy
78
treatment of rotavirus
- self-limiting ORT - rest at home to limit transmission (very contagious)
79
describe norovirus
- 20% of cases of gastroenteritis - highly contagious (known as winter vomiting bug) - infect gut epithelia
80
symptoms of norovirus
diarrhoea vomiting nausea fever stomach pain headaches and body aches
81
when do norovirus symptoms start after infection and how long do they last?
- start within 1-2 days - last 2-3 days
82
describe the transmission of norovirus
- faecal-oral - contact with infected vomit or faeces - contaminated food / surfaces - outbreaks are common among people living close together
83
treatment of norovirus
- self-limiting - ORT - rest at home to limit transmission
84
gastroenteritis is a notifiable disease but many cases are not diagnosed or recorded. why is this?
- people stay at home and get better themselves without getting the specific cause determined - there are actually billions of cases annually worldwide
85
causative agents are rarely determined directly for gastroenteritis. why? what happens instead?
- deductions are made based on duration / type of symptoms - stool samples are only taken in severe cases and for those at more risk of complications
86
treatment for gastroenteritis is mostly non-specific and self-management. what does this include?
- ORT - paracetamol - nutritional replacement - antibiotics used in severe cases but can cause complications - antidiarrheals may not be advised due to increased exposure to certain toxins (eg. bacterial)

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