Current Treatment Options in Gastroenterology

, Volume 16, Issue 4, pp 591–604 | Cite as

Gastroduodenal “Dysbiosis”: a New Clinical Entity

  • Ayesha Shah
  • Mark Morrison
  • Gerald J HoltmannEmail author
Stomach (P Malfertheiner, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Stomach


Purpose of review

Like the rest of the gastrointestinal tract, the small intestine is colonised by microbes, but how this “microbiome” affects the immune system and digestive functions has largely been overlooked, especially in the “omics” era. Here, we present recent findings that show that the diversity, density and interactions of these microbes in the small intestine can play an important role in the pathogenesis of a number of gastrointestinal and extraintestinal disorders.

Recent findings

Changes in the small intestinal mucosa-associated microbiota (SI-MAM) have been shown to occur with inflammatory bowel diseases, functional gastrointestinal disorders, metabolic disorders such as obesity and type 2 diabetes. More recently, there is emerging evidence that small intestinal dysbiosis can be a driver for the progression of chronic liver disease. Initially believed that small intestinal dysbiosis (e.g. SIBO) is mainly due to alterations of luminal conditions (e.g. after surgical resections of the ileocecal valve), there is now enough evidence to conclude that small intestinal dysbiosis can occur without underlying structural abnormalities.


Alterations of the SI-MAM appear to play a key role for the manifestation and progression of inflammatory and metabolic disorders.


Microbiome Microbiota Small intestine 


Compliance with ethical standards

Conflict of interest

Mark Morrison reports grants from the National Health and Medical Research Council, during the conduct of the study and personal fees from Janssen-Cilag Australia and Yakult Inc., outside the submitted work. Ayesha Shah and Gerald Holtmann declare no conflict of interest.

Human and animal rights and informed consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  • Ayesha Shah
    • 1
    • 2
  • Mark Morrison
    • 3
  • Gerald J Holtmann
    • 1
    • 2
    Email author
  1. 1.Department of Gastroenterology and HepatologyPrincess Alexandra Hospital BrisbaneWoolloongabbaAustralia
  2. 2.Faculty of Medicine and Biomedical Sciences, And Faculty of Health and Behavioral SciencesThe University of QueenslandBrisbaneAustralia
  3. 3.Translational Research Institute, Brisbane Australia, Microbial Biology and MetagenomicsThe University of Queensland Diamantina InstituteBrisbaneAustralia

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