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If you suffer from chronic GI or nasal/respiratory problems but have been unable to get a proper diagnosis; or if you have tried antibiotics and antimicrobials to treat your irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), other chronic gut/respiratory problems with little success, it may be helpful to know what a biofilm is and why it may be at the root of your problems. ​ It's estimated that a staggering 23000 people die from antibiotic-resistant infections every year, and the number is increasing. If your previous attempts at getting diagnosed or treating an existing GI condition haven’t been effective, it may be time to consider alternative treatment options to disrupt the biofilms living within you.

What Are Biofilms?

Biofilms are everywhere. They can essentially exist anywhere where aqueous conditions are present. There can be found in many environments, from underwater to the insides of our mouths (like the plaque on our teeth). They are all generally thought to be formed from microorganisms, like bacteria When the ideal environmental conditions are present, free-floating microorganisms will attach to the surface of a substance and begin to “set up shop,” so to speak. The microbes start to build a protective matrix made up of sugars and proteins called extracellular polymeric substances (EPS). The EPS acts as a protective shell for the bacteria living in the colony, allowing the microbes to share nutrients, replicate, and exchange genomic information to evade destruction (ie antibiotic resistance). There is a strategic advantage for microbes to form a biofilm colony. The colony is usually more resilient to stress and solo microorganisms. The protective matrix helps prevent antimicrobials and other substances from harming the inhabitants of the biofilm while allowing certain microorganisms to go dormant, which makes antibiotics less effective in killing the bacteria. Infectious microbes commonly known to produce biofilms may include Staphylococcus sp., Pseudomonas aeruginosa, Streptococcus sp., Listeria monocytogens, Clostridium sp., N. gonorrhea, and Candida albicans. Growth generally occurs through the layering of microorganisms and the EPS layer, and seeding dispersal. Clumps of cells or individual cells can leave the colony — a process called seeding dispersal — and reattach themselves to new areas of a surface. This can happen for any number of reasons but usually results in there being more than one biofilm colony on any given surface. Biofilm and Human Health It is estimated that up to 80% of chronic illnesses are caused by an abundance of biofilm in the body. Chronic lung infections in cystic fibrosis patients, chronic sinusitis, and inflammatory bowel disease are all caused by different kinds of biofilms within the body. Illnesses associated with biofilms can include:

  • Chronic sinusitis

  • S. aureus skin infection

  • Antibiotic-associated enteritis caused by Clostridium difficile

  • Chronic UTIs

  • Candidiasis

  • Autistic behaviours caused by neurotoxins from Clostridium overgrowth

  • Lyme disease

Biofilms make the treatment of chronic illnesses more difficult because they are resistant to antibiotics and antimicrobial treatments. Additionally, if diagnostic testing is looking for a particular bacterial presence, it may not show up on a test until the bacteria has dispersed from the film colony. Indications that You Have a Biofilm Problem Biofilms love the large intestine and upper respiratory pathways because the GI tract is generally moist - a condition that biofilms thrive. Generally, there are not any specific symptoms that indicate the presence of biofilm, but there are some signs that your symptoms are biofilm-related.

  • If you have previously tried to treat your IBS or IBD symptoms with antibiotics or antimicrobials and the symptoms have persisted. For example, confirmed cases of SIBO sometimes do not improve with antimicrobial treatment. This is an indication that biofilms may be to blame.

  • Your symptoms improve with antimicrobial treatment, but they seem to be recurring. This commonly happens with chronic sinusitis – a patient feels great during treatment, but all symptoms return when treatment is discontinued.

  • Though chronic GI or sinusitis symptoms are present, there are minimal to no pathogenic overgrowths or infections evident in stool samples, nasal cultures, or sputum cultures.

Natural Biofilm Disruptors Since testing for IBS, IBD, and other GI problems rely on the identification of specific microorganisms, biofilms can make diagnosing and treating your chronic gut symptoms particularly problematic. Biofilms provide a sort of protective shield against detection and prevent traditional treatments from breaking through the EPS barrier to get to the targeted organisms. There are natural ways to disrupt the biofilm in your gut, which can alleviate your symptoms and make testing for particular bacteria easier for your health practitioner. Here are just a few of the natural biofilm disruptors that have been proven to aid in the breaking down of biofilms:

  • Garlic

  • Oregano oil

  • Serrapeptase

  • Alpha lipoic acid

  • Polysaccharide-digesting enzymes like Nattokinase and bromelain

  • N-acetyl-cysteine

As always, before beginning any kind of treatment, it is important to work with your healthcare practitioner to determine the best course of action and to ensure biofilm agents pose no harm. To discuss your gut health and treatment options, and to find an approach that’s right for you, call Dr. Courtney Holmberg, ND at 647-351-7282 to schedule a consultation today References:

  • Anwar H, Costerton JW. Enhanced activity of combination of tobramycin and piperacillin for eradication of sessile biofilm cells of Pseudomonas aeruginosa. Antimicrob Agents Chemother 1990;34:1666-71.

  • Bjarnsholt T1. The role of bacterial biofilms in chronic infections. APMIS Suppl. 2013 May;(136):1-51.

  • Centers for Disease Control and Prevention. U.S. Department of Health and Human Services. 2013.

  • Costerton W, Veeh R, Shirtliff M, Pasmore M, Post C, Ehrlich G. The application of biofilm science to the study and control of chronic bacterial infections. J Clin Invest 2003;112:1466-77.

  • Foster TJ, Geoghegan JA, Ganesh VK, Hook M. Adhesion, invasion and evasion: the many functions of the surface proteins of Staphylococcus aureus. Nat Rev Microbiol 2014; 12:49-62.

  • Hoiby N, Bjarnsholt T, Givskov M, Molin S, Ciofu O. Antibiotic resistance of bacterial biofilms. IJAA 2010; 35(4): 322-332.

  • Moskowitz SM, Foster JM, Emerson J, Burns JL. Clinically feasible biofilm susceptibility assay for isolates of Pseudomonas aeruginosa from patients with cystic fibrosis. J ClinMicrobiol 2004;42:1915-22.

  • Zapotoczna M, McCarthy H, Rudkin JK, O'Gara JP, O'Neill E. An essential role for coagulase in Staphylococcus aureus biofilm development reveals new therapeutic possibilities for device-related infections. JID 2015; 212: 1883-1893.


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