Gut microbiota in early life and its influence on health and disease: A position paper by the Malaysian Working Group on Gastrointestinal Health

Abstract

Abstract:The role of gut microbiota in early life and its impact on gut health and subsequent diseases remain unclear. There is a lack of research and awareness in this area, especially in the Asia-Pacific region, including Malaysia. This paper reports the position of a Malaysian Working Group on some key issues surrounding gut microbiota in early life and its role in gut health and diseases, as well as experts' stand on probiotics and prebiotics. The group reached a consensus that certain factors, including elective caesarean; premature deliveries; complementary feeding; use of antibiotics, prebiotics and/or probiotics; and exposure to the external environmental, have an impact on gut microbiota in early life. However, as evidence is lacking, especially from the Asia-Pacific region, further studies are needed to understand how gut microbiota in early life affects subsequent diseases, including allergy, inflammatory bowel disease, obesity and infantile colic. Lastly, although beneficial in acute diarrhoeal disease and probably allergic eczema, probiotics (and/or prebiotics) should be used cautiously in other gut dysbiotic conditions until more data are available.

Low fermentable oligosaccharides, disaccharides, monosaccharides, and polypols diet and irritable bowel syndrome in Asia

“…Dysbiosis in the gut microbiota has been shown to cause IBS, for example, exposure of environmental microbiota had led to the development of IBS after a major flood disaster . On the other hand, diet is an important determinant of gut microbiota abundance and diversity, especially in early life, where it may impact health and diseases in later life, including IBS …”

The Gut Microbiota: A Clinically Impactful Factor in Patient Health and Disease

“…and their microbiota exhibits less diversity as compared with term neonates. These discrepancies are the result of a multifactorial process wherein more than one external factor may coexist (namely, delayed enteral feeding, use of total parenteral nutrition and maternal and neonatal prophylactic antibiotic therapy) [15,35]. In addition, preterm neonates may have higher levels of potentially pathogenic bacteria (Proteobacteria bloom) and multi-drug-resistant bacteria, such as Escherichia, Klebsiella and Enterobacter species [20,35].…”

“…Dysbiosis of the gut microbiota has been implicated in multiple non-communicable disease states, such as obesity [12], atopy [8], autoimmunity [13] and malignancy [14], amongst others. In contrast, a 'healthy' microbiota appears to provide a plethora of beneficial effects to the host, resulting in a degree of protection and better health outcomes overall [3,8,15]. In light of such associations, and persuasive novel clinical data, it is now crucial for clinicians to become familiar with the fundamental concepts of gut microbiota research (see Table 1 for the glossary of terms), as well as the potential implications of this research for their patient cohorts.…”

Perplexing perinatal practices

“…However, there is a lot of interest in the infant microbiome. Caesarean section is associated with asthma, some autoimmune disorders and obesity, and alteration in the infant microbiome is associated with the same diseases . There is a theoretical argument that replacing the vaginal organisms might be beneficial.…”

“…Caesarean section is associated with asthma, some autoimmune disorders and obesity, and alteration in the infant microbiome is associated with the same diseases. 1 There is a theoretical argument that replacing the vaginal organisms might be beneficial. Vaginal seeding has been discussed in scientific publications, and in social and mainstream media.…”