Abstract
BackgroundChronic constipation is one of the most prevalent functional gastrointestinal disorders, yet its etiology is multifactorial, and the pathophysiological mechanism is still unclear. Previous studies have shown that the gut microbiota of constipated patients differs from healthy controls; however, many discrepancies exist in the findings, and no clear link has been confirmed between chronic constipation and changes in the gut microbiota. Growing evidence indicates that age, gender, and hormone levels can affect the composition of gut microbiota. The aim of this study is to examine the overall changes in gut microbiota within a specific sub-population of patients, namely, constipated women of reproductive age.MethodsWe carried out a cross-sectional study comparing the fecal microbial composition of 30 healthy women and 29 constipated women using 16S rRNA gene sequencing. Only women of reproductive age were recruited to reduce the effects of age, gender, and hormone levels on the microbiome, and to prevent conflating the impact of these factors with the effects of constipation.ResultsThere were obvious differences in the gut microbiota in constipated women of reproductive age compared with the healthy controls, manifesting mainly as a significant increase in the abundance of Bacteroides (p < 0.05) and a significant decrease in the abundance of Proteobacteria (p < 0.01). The overall composition of the gut microbiota in each group was different, which was reflected in the ratios of Firmicutes to Bacteroidetes (F/B), which was 1.52 in the constipated group vs. 2.21 in the healthy group. Additionally, there was a significant decrease in butyrate-producing bacteria, like Roseburia and Fusicatenibacter (p < 0.01).ConclusionThe overall composition of the gut microbiota changed in constipated women of reproductive age, characterized by a loss in Proteobacteria and an increase in Bacteroidetes. Furthermore, the abundance of some butyrate-producing bacteria also reduced. These changes may reflect the unique interactions between host and some bacteria, or some bacterial metabolic products, which may be important targets for future studies to explore the pathogenesis of constipation.
Highlights
Chronic constipation is a common symptom-based gastrointestinal disease without organic lesions
Zhu et al (2014) used 16S rRNA gene sequencing to prove that children with FC had a significantly decrease of Bacteroidetes, especially Prevotella, and a significant increase of some subgenera of Firmicutes, such as Lactobacillus. – used qPCR to determine that adults with FC had a significant loss in the abundance of Bifidobacterium and Bacteroides
The fecal microbiomes of constipated women of reproductive age and healthy controls were analyzed by 16S rRNA gene sequencing, because one patient with constipation failed to collect stool sample
Summary
Chronic constipation is a common symptom-based gastrointestinal disease without organic lesions. Constipation is harmful to the intestinal tract itself and can affect other diseases, and is known to aggravate cardiovascular and cerebrovascular diseases, leading to mental disorders (Li et al, 2016) Since it is not a life-threatening disease, and it is not a medical emergency, chronic constipation is often overlooked and not reported by patients suffering from it. New advances in molecular biology methods have replaced traditional culture-based methods and are the current standard approach to analyze gut microbiota. These tools have revealed the tremendous diversity, richness, and functional capacity of human microbiome. The aim of this study is to examine the overall changes in gut microbiota within a specific sub-population of patients, namely, constipated women of reproductive age
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