A common bacteria found in everyone’s gut may be responsible for the lingering symptoms of Crohn’s disease, even when inflammation is under control. A new study, published in March, reveals that an overabundance of sulfur-producing bacteria in the intestines could explain why some people with “quiescent” Crohn’s—a form of inflammatory bowel disease (IBD) without active inflammation—still experience painful cramps, frequent diarrhea, and other symptoms.
This research builds on a 2024 study that found high levels of sulfur-producing bacteria in people with Crohn’s who had symptoms despite no signs of inflammation. Dr. Allen Lee, the senior author of both studies and an assistant professor at the University of Michigan, explains that these bacteria, present in all human guts, are far more common in people with IBD.
The new study analyzed fecal samples from people with quiescent Crohn’s, active Crohn’s, irritable bowel syndrome (IBS) with diarrhea, and healthy individuals. Researchers discovered that those with quiescent Crohn’s had high levels of sulfidogenic microbes and sulfur metabolic pathways in their stool, similar to those with active Crohn’s. This suggests that even without inflammation, the immune system in their guts remains disrupted.
Hydrogen Sulfide: A Double-Edged Sword
Hydrogen sulfide, a gas produced when sulfur-producing bacteria break down sulfur compounds from food, plays a key role. In normal amounts, it can benefit the body by protecting the heart, regulating cholesterol, and supporting brain function. However, excessive hydrogen sulfide can harm the gut by breaking down the intestinal mucus layer, allowing bacteria to escape and trigger inflammation. This can lead to symptoms like diarrhea, abdominal pain, and fatigue.
Dr. Brad Pasternak, a pediatric IBD specialist, notes that high levels of hydrogen sulfide can damage colon cells and worsen inflammation. Excess hydrogen sulfide has also been linked to other conditions, including Parkinson’s, Alzheimer’s, and possibly cancer.
What This Means for Crohn’s Patients
The study offers hope for people with quiescent Crohn’s who still suffer from symptoms. Dr. Pasternak suggests that hydrogen sulfide could serve as a biomarker to identify patients who might benefit from targeted therapies or dietary changes to reduce sulfur-producing bacteria.
Dr. Supriya Rao, a gastroenterologist, already advises her patients to monitor their diets and avoid foods that trigger symptoms. She recommends limiting cruciferous vegetables (like broccoli and cauliflower) and incorporating fermented foods like yogurt, kefir, and kimchi to support gut health. Keeping a food diary can also help identify triggers.
Meanwhile, Dr. Lee and his team are exploring whether a low-sulfur diet could alleviate symptoms in quiescent Crohn’s patients. If successful, this approach could provide relief for those struggling with unexplained symptoms despite controlled inflammation.
This groundbreaking research highlights the importance of the gut microbiome in Crohn’s disease and opens new avenues for treatment and symptom management.
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