Every year, diarrhea results in the deaths of 500,000 children in low- and middle-income countries. Recently, researchers from Denmark and Ethiopia have discovered a connection between chronic diarrhea and a distinct pattern of gut bacteria. This finding could lead to new treatments that may save lives.
Our intestines host a diverse community of microbes that help train our immune systems, produce essential vitamins, and convert the food we eat into beneficial substances. Disruptions in this gut microbiome can lead to a range of health issues, including obesity, diabetes, and diarrhea.
In developing nations, both acute and chronic diarrhea are significant issues among children, resulting in the deaths of half a million children under five annually. While acute diarrhea generally resolves on its own and responds well to antibiotics, chronic diarrhea can leave children severely ill and stunted in growth, complicating treatment. The underlying causes of chronic diarrhea have not been well understood—until now.
“For adults, persistent diarrhea can be very uncomfortable, but it rarely poses a serious risk to life. In contrast, for children, it can have lasting effects. Although treatment for acute diarrhea has improved over the past fifty years, progress in addressing chronic diarrhea has been minimal,” states Dennis Sandris Nielsen, a professor in the Department of Food Science at the University of Copenhagen.
In a groundbreaking study published in Nature Communications, Nielsen, along with his Ethiopian colleague Getnet Tesfaw, examined the gut microbiomes of over 1,300 children under the age of five in Ethiopia. The study found a clear difference: children suffering from chronic diarrhea exhibited significantly less bacterial diversity compared to their healthy peers.
“Our findings establish a direct connection between the composition of gut bacteria and the duration of diarrhea. Those with chronic diarrhea carry an abundance of harmful bacteria while showing a notable deficiency in beneficial bacteria,” shared Tesfaw, who is set to defend his PhD thesis on this subject later in November.
A Self-Perpetuating Cycle of Diarrhea
The researchers employed DNA sequencing technology to identify both beneficial and harmful bacteria present in stool samples. They found that children with chronic diarrhea had an excess of harmful bacteria, such as Escherichia and Campylobacter, alongside a significant decrease in beneficial bacteria like Faecalibacterium.
The study also highlighted a lack of bacteria that produce short-chain fatty acids, a type of essential compound typically generated by good bacteria that supports gut health.
Acute diarrhea is defined as lasting from one to six days, while chronic diarrhea continues for more than a week. According to Nielsen, the research suggests that chronic diarrhea occurs as beneficial microbes that produce short-chain fatty acids are diminished to a level where the children’s gut microbiomes fail to recover, possibly due to antibiotics used during acute diarrhea treatment.
“The evolution into chronic diarrhea appears to be fueled by the reduction of beneficial bacteria. While we don’t yet understand the exact mechanisms at play, we hypothesize that the antibiotics essential for treating acute diarrhea may also eliminate good gut bacteria. Consequently, children might find themselves trapped in a cycle where chronic diarrhea prevails because of inadequate nutrition that fails to restore the necessary beneficial bacteria,” he elaborates.
Local “Superfood” as a Potential Solution
The recent analysis of gut bacteria in children suffering from chronic diarrhea sheds light on the potential causes of this condition, paving the way for innovative, targeted treatments aimed at restoring a healthy gut microbiome.
According to Tesfaw, a crucial aspect of addressing this issue should involve creating an optimal diet tailored to help restore the microbiome in affected children. This diet ought to be familiar, accessible, and sustainable for the local population. The researchers already have a promising primary ingredient in mind.
“In Ethiopia, there’s a nutrient-dense superfood grain known as teff, which is high in fiber and nutrition. It shows great promise as a dietary supplement that could help combat chronic diarrhea,” Nielsen states.
Nevertheless, additional research is necessary, and the researchers are keen to secure funding for a new research initiative in the near future.
