Early Diagnosis of Inflammatory Bowel Disease Possible with Experimental Test

Intestinal mucus lining may hold the key to diagnosing inflammatory bowel disease early.

A novel test revealed changes in the intestinal bacteria of mice that could lead to inflammatory bowel disease 12 weeks earlier than current testing methods. This approach could lead to earlier diagnosis and better disease management, according to a new study published by Inflammatory Bowel Diseases.

Inflammatory bowel diseases can cause severe pain, weight loss, and diarrhea.

Currently, diagnosis only occurs after a patient displays symptoms and have altered stool bacteria. Since the condition is incurable, achieving disease control early after diagnosis is key to preventing irreversible damage and poor quality of life. It is still unknown whether changes in bacteria are the result of inflammation or bring about inflammation.

The bacteria found in stool samples is different than those in the mucus lining of the intestines, which may affect the results of current tests. In the study, the authors examined the bacteria in the composition of the lining, as it may give a more accurate picture of the disease.

"Stool samples do not fully replicate the complex picture of the microbiota in the gut which lives in communities in discrete locations within the gut,” said lead researcher Sheena Cruickshank, PhD. “We took mucus samples which are found right next to the cells of the gut and therefore closer to where the problems develop. As a result, we could see changes in the microbiota 12 weeks before they were detectable in the stool samples."

The underlying causes of inflammatory bowel diseases are widely unknown, but researchers believe that it is a combination of genetics, lifestyle, environment, and bacteria in the gut.

These changes can lead to a thinning of the mucus lining, which may grant bacteria access to the epithelium and results in an immune system trigger that increases inflammation, according to the study.

“The bacteria in the gut usually live in a carefully balanced system and this is incredibly useful for digestion and keeping us healthy,” Dr Cruickshank said. “However, for some reason, this balance can be disturbed.”

The authors hypothesized that examining bacteria earlier in the illness can provide insight on how the balance of bacteria can be disrupted and which bacteria are involved with inflammation, according to the study. Additionally, assessing bacteria early could also be used to improve treatment and screening.

These findings may lead to faster diagnoses and could even lead to novel drugs used to preserve the composition of intestinal bacteria.

"Being able to observe what is upsetting this balance earlier and understanding the bacteria involved will give us much greater opportunities to understand the causes of some of these painful diseases and better help patients,” Dr Cruickshank concluded.