The gut microbial ecology in adults with chronic constipation before and after treatment with lubiprostone. human gut metagenome

Background: Identification of specific gut microorganisms associated with chronic constipation may be useful for diagnostic and therapeutic purposes. The objectives of this pilot study were to evaluate whether the gut microbial community of constipated individuals had specific microbial characteristics/signatures and to assess the effects of lubiprostone treatment on the gut microbial community. Methods: Stool diaries, breath H2 and CH4 levels and stool samples were collected from healthy individuals and patients meeting the Rome III criteria for chronic functional constipation. The constipated subjects received four-weeks of lubiprostone during which stool diaries were maintained. Before and after treatment, stool samples were evaluated for the gut microbial communities using next generation sequencing and quantitative real-time PCR. Results: Nine constipated subjects were compared to ten healthy individuals. Microbial diversity in healthy and constipated samples at baseline was not significantly different, inferring that symptom-based diagnosis, here the Rome III criteria, did not imply different gut microflora between non-constipated and constipated subjects. Despite increases in stool frequency and improvements in consistency after lubiprostone treatment, gut microbial diversity after treatment showed no significant change compared to the initial one. Conclusion: By rigorously applying bioinformatics tools, we explored the structure of the microbial communities in the guts of healthy and constipated subjects defined by Rome III criteria. We found little difference in microbial composition between the two groups. Although constipated subjects experienced significant improvement in stool form and frequency after lubiprostone treatment, this improvement did not correlate to a significant alteration in the microbial composition.