Imbalance of the Intestinal Flora (Dysbiosis): Medical History

The anamnesis (medical history) represents an important component in the diagnosis of dysbiosis (imbalance of the intestinal flora).

Family history

Social history

  • Is there any evidence of psychosocial stress or strain due to your family situation?

Current medical history/systemic history (somatic and psychological complaints).

  • Do you often suffer from a bloated abdomen?
  • Do you often have a feeling of fullness?
  • Do you suffer from fatigue, tiredness or headaches?
  • Do you often feel nauseous?
  • Do you have frequent changes in stool frequency (e.g., diarrhea, constipation)?

Vegetative anamnesis including nutritional anamnesis.

  • Have you lost body weight?
  • Do you like to eat sweet (mono- and disaccharides; especially sucrose/household sugar) and white flour products?
  • Have you noticed any changes in bowel movements (frequency, quantity, color, texture)?
  • Do you like to drink coffee, black and green tea? If so, how many cups per day?
  • Do you drink other or additional caffeinated beverages? If so, how much of each?
  • Do you smoke? If yes, how many cigarettes, cigars or pipes per day?
  • Do you drink alcohol? If yes, what drink(s) and how many glasses per day?
  • Do you use drugs? If yes, what drugs and how often per day or per week?

Self history incl. medication history.

  • Pre-existing conditions (gastrointestinal diseases, food intolerances).
  • Operations
  • Allergies

Medications

  • Analgesics/non-steroidal anti-inflammatory drugs
  • Anti-infectives against viruses, fungi or parasites
  • Antibiotics (broad spectrum of activity reduces microbial diversity)Note: The broader the spectrum of activity and the longer the duration of therapy, the greater the microbiome damage!
    • The frequent or long-term treatment of premature infants with antibiotics led to a strong disturbance of the intestinal flora: fewer “healthy” bacterial groups such as Bifidobacteriaceae (the only bacterial family in the order of Bifidobacteriales) and more frequently “unhealthy” species such as Proteobacteria (= “microbiotic scar”) were found in a follow-up examination at the age of 21 months.
    • The bacterial flora is largely regenerated within 30 to 90 days after drug treatment, but it changes their interplay with fungi, which also colonize the intestine.
  • Antidepressants – atypical antipsychotics.
  • Antihistamines
  • Beta blockers
  • Benzodiazepines
  • Corticoids (cortisol)
  • Gold (bactericidal)
  • Laxatives (osmotic laxatives).
  • Metformin
  • Ovulation inhibitor
  • Proton pump inhibitors (proton pump inhibitors, PPI; acid blockers) (due toblocked gastric acid production).
  • Statins
  • Cytostatics
  • Et al.

Notice: Antibiotics are not the only agents that kill intestinal bacteria; of more than 1,000 approved agents, one in four alters the composition of intestinal flora.

X-rays

Environmental pollution – intoxications