Summary: A new study suggests that gut microbiota changes are common in endometriosis. They found that measuring one of the metabolites, 4HI, could help diagnose the condition reliably, early, without using invasive methods.
Some health conditions, like endometriosis, are pretty common, yet science does not fully understand their causes. Thus, chronic pain specialists guess that it is due to genetics, changes in the menstrual cycle, hormonal issues, and more.
But could this relatively common gynecological health problem be due to changes in gut microbiota?
Well, new research suggests that it is quite likely. This means that this disease condition is much more related to metabolic disorders and chronic inflammation than imagined earlier.
Endometriosis is a pretty common problem affecting about 11% of women of reproductive age. So, the numbers are massive. It causes chronic pelvic pain, menstruation, bowel and urinary issues, along with other symptoms like fatigue and mood swings. It is also a common cause of female infertility.
It is a condition when endometrial tissues that line the uterus start growing in other body parts or nearby organs. This causes local inflammation and pain. Moreover, since these tissues are sensitive to hormones, the condition keeps causing cyclic pain, worsening during certain days each month.
The condition is quite challenging to manage without the help of chronic pain specialists since such symptoms may also occur due to other reasons like inflammatory bowel disease, ovarian cysts, and other conditions. Further, since its causes are not fully understood, the condition is quite challenging to treat.
Although it is the second most common gynecological problem, its diagnosis is extremely challenging. Therefore, it is little surprise that many women are not diagnosed with the condition for years. UK data shows that, on average, it takes more than eight years to confirm its diagnosis since the symptom’s onset!
Needless to say, if diagnosis confirmation takes so long, the condition is not well-managed in most instances. Most women just continue to receive symptomatic treatment, like painkillers, during periods of exacerbation.
But now, a new study published in Med provides hope to millions of women globally. This new study suggests that its diagnosis can be confirmed with great accuracy using a stool test.
Previous studies have suggested that endometriosis might be somehow related to gut health. Multiple studies have shown that dysbiosis or changes in gut microbiota are quite common in the condition.
In this new study, 18 women with confirmed endometriosis and 37 control or healthy women were enrolled. Overall, researchers analyzed 371 metabolites in their stool samples. They found that some of them were increased, while others were reduced in those living with endometriosis.
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However, one metabolite, 4HI (4-hydroxyindole), was significantly lowered in women living with endometriosis. Researchers say this is only possible if there are significant gut microbiota changes.
Endometriosis is not the first condition in which they have seen this distinct change in 4HI levels. They have also found similar changes in patients living with inflammatory bowel disease (IBD).
These findings are interesting since researchers need to understand the relationship between endometriosis and IBD. It is quite possible that early management of endometriosis may even help prevent IBD, a much more severe condition, in many instances.
Although further investigations are needed, researchers are quite excited about this finding. They say that creating a non-invasive stool test for early endometriosis diagnosis might be possible now.
Not only that, researchers also decided to check if injecting 4HI into animal models of endometriosis may help. They found that 4HI could really help. This suggests that measuring 4HI in stool can help diagnose endometriosis early and might even have a role in treating the condition.
Not only that but these findings also align with broader preventive approaches in clinics like Interventional Pain Management St. Louis, where early intervention is often emphasized.
Source:
Talwar, C., Davuluri, G. V. N., Kamal, A. H. M., Coarfa, C., Han, S. J., Veeraragavan, S., Parsawar, K., Putluri, N., Hoffman, K., Jimenez, P., Biest, S., & Kommagani, R. (2024). Identification of distinct stool metabolites in women with endometriosis for non-invasive diagnosis and potential for microbiota-based therapies. Med, 0(0). https://doi.org/10.1016/j.medj.2024.09.006
