Microbiome of GERD Patients Differs from Microbiome of Healthy Patients

August 5, 2009

Researchers have found that the microbiome of patients with gastroesophageal reflux disease is altered in comparison to healthy patient.

The microbiome of patients with gastroesophageal reflux diseases (GERD) is altered in comparison to healthy patients, researchers at New York University’s Langone Medical Center have discovered.

Patients suffering from GERD, specifically esophogitis and Barrett's esophagus, were found to have a microbiome “dominated by Gram-negative bacteria,” compared to healthy patients, whose esophaguses were highly concentrated with Streptococcus. According to the researchers, this discovery shows “GERD is associated with global alteration of the microbiome in the esophagus” and may, with further investigation, provide new treatment options.

Zhiheng Pei, MD, PhD, assistant professor of pathology and medicine at NYU Langone Medical Center and lead author of the study and his team of researchers examined 34 biopsy samples from patients and classified them as either “normal, esophagitis, or Barrett's esophagus (intestinal metaplasia),” according to an abstract of the study published in the August 2009 issue of Gastroenterology. The team used bacterial 16S ribosomal RNA gene survey for analysis of the samples and then classified the results into types using unsupervised cluster analysis and phenotype-guided analyses. The presence of Gram-negative bacteria was “primarily correlated with esophagitis (odds ratio, 15.4) and Barrett's esophagus (odds ratio, 16.5),” also according to the journal abstract.

The researchers state that about 10 million people in the United States suffer from GERD, though they add that “the cause and an unexpected increase in its prevalence over the last three decades remains unexplainable.” Findings of the new study may lay a “foundation for further study of the condition as a microecological disease with new treatment possibilities,” according to the researchers.

“These findings have opened a new approach to understanding the pathogenesis of reflux-related disorders,” said Pei. “At this time, we don't yet know whether the changes in bacterial populations are triggering GERD or are simply a response to it. But if changes in the bacterial population do indeed cause reflux, it may be possible to design new therapies with antibiotics, probiotic bacteria or prebiotics.”