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The Microbatome and Intestinal Microflora in Diverticular Disease

Floch, Martin H. MD, MACG, AGAF

Journal of Clinical Gastroenterology: April 2011 - Volume 45 - Issue - p S12–S14
doi: 10.1097/MCG.0b013e3182106795
DD Shire CME

On completion of this educational activity, learners will be better able to: (1) Evaluate the normal human microflora of the colon. (2) Assess the alterations in the microflora that have been observed in inflammatory diseases of the colon.

The microflora of the human gastrointestinal tract contain 1014 organisms, more bacteria than make up the body. The largest number is in the colon, and the anaerobes outnumber the aerobes by 100 or 1000:1. The anaerobic species of Bacteroides, Eubacterium, and Bifidobacterium usually predominate, and usually the most common organism is Faecalibacterium prausnitzii. Other details are described in this study. Of note is that there are changes in the normal flora in patients suffering from inflammatory bowel disease and the irritable bowel syndrome. As diverticular disease and diverticulitis seem to have some chronic inflammatory component to their pathophysiology, it is suspicious that there is a dysbiosis, but we have not had studies published on the flora in diverticular disease. Further suspicion of the role of a dysbiotic flora is raised since the initial reports that both mesalamine, an anti-inflammatory agent, and probiotics, either Escherichia coli Nissle or Lactobacillus casei, have been effective in controlling recurrent attacks. The details of these studies are described.

Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT

Disclosure: None.

Reprints: Martin H. Floch, MD, Section of Digestive Diseases, Yale University School of Medicine, 40 Temple Street, Suite 1A, New Haven, CT 06510 (e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.