Chronic alcohol overconsumption may alter gut microbial metabolism: a retrospective study of 719 13C-D-xylose breath test results - PubMed (original) (raw)

Chronic alcohol overconsumption may alter gut microbial metabolism: a retrospective study of 719 13C-D-xylose breath test results

Steinar Traae Bjørkhaug et al. Microb Ecol Health Dis. 2017.

Abstract

Objective: Alterations of gut microbiota composition or function may participate in the pathophysiology of several diseases. We aimed to explore the effect of chronic alcohol overconsumption on gut microbial metabolism, as assessed by evaluating 13C-D-xylose breath test results. Materials and methods: We investigated all 13C-D-xylose breath tests performed at Lovisenberg Diaconal Hospital during the years 2005 to 2011, using patient files for diagnosing the patients into one of three patient categories: alcohol overconsumption, coeliac disease and functional bowel disorder. In addition, a group of healthy controls was included. The time curves of 13CO2 excretion in breath samples were divided into two phases, evaluating small intestinal absorption (0-60 min) and colonic microbial metabolism (90-240 min), respectively. Results: A total of 719 patients underwent 13C-D-xylose breath testing during the inclusion period. Thirty-five had a history of alcohol overconsumption, 66 had coeliac disease, and 216 had a functional bowel disorder, while 44 healthy controls were included for comparison. The alcohol overconsumption group had similar small intestinal phase results as the group of patients with untreated coeliac disease. During the colonic phase, the group of patients with alcohol overconsumption differed from all the other groups in terms of 13C-xylose recovery, with significantly less 13CO2 excretion compared to the other groups. Conclusion: The results suggest that patients with a history of alcohol overconsumption suffer from both small intestinal malabsorption and impaired colonic microbial metabolism. The role of gut microbiota in chronic alcohol overconsumption should be investigated further.

Keywords: Alcohol; breath tests; gut microbiota; malabsorption; xylose.

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Figures

Figure 1.

Figure 1.

Excretion of 13CO2 after 13C-D-xylose ingestion in different patient groups. The y-axis represents amount (percentage) of test meal expired per hour, while the x-axis represents time (minutes). During the small intestinal phase of the test (0–60 min), the group of patients with alcohol overconsumption and coeliac disease are similar, collectively differing from the other two groups. During the colonic phase of the test (90–240 min), these two groups have a distinctly different pattern, the latter with a rebound phenomenon lacking in the prior group.

Figure 2.

Figure 2.

Box plot showing the small intestinal phase (0–60 min) of 13CO2 excretion after ingestion of 13C-D-xylose in different patient groups. The results are expressed as area under the curve (percentage of dose 13C-recovery) for the first 60 min of the test, hence showing total amount of 13C-recovery. Compared to healthy controls and patient controls, patients with untreated coeliac disease and patients with high alcohol consumption show a pattern suggestive of malabsorption. The differences are statistically significant with _p_-values <0.001 for both groups compared to healthy controls.

Figure 3.

Figure 3.

Box plot showing the colonic phase (90–240 min) of 13CO2 excretion after ingestion of 13C-D-xylose in different patient groups. The results are expressed as area under the curve (percentage of dose 13C-recovery) for the last 150 min of the test, hence showing total amount of 13C-recovery. During this phase, the patients with alcohol overconsumption differ from healthy controls (p < 0.001), while there is no significant difference between the other three groups, respectively.

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Grants and funding

This work was supported by the Lovisenberg Diaconal Hospital.

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