Do Autoimmune Diseases Begin in the Gut?

Medscape—December 17, 2014

My name is Dr. Stephen Paget. I am the physician-in-chief emeritus at Hospital for Special Surgery.

Today I am going to talk about the microbiome, an extraordinary concept that is probably not well understood by most physicians but that truly defines us as people. The microbiome is those bacteria that live in various parts of our bodies, particularly the intestine. Our immune systems are defined by the microbiome and the interactions with those bacteria, almost 80% of which are not the usual bacteria that we know about. It now has become clear that the makeup of those bacteria can define whether we are healthy or have disease. What is truly extraordinary is that we now have ways to change a person's bacterial growth and microbiome.

From Gut to Immune System

People who have persistent, antibiotic-resistant Clostridium difficile colitis are undergoing fecal transplant to enhance microbiomes that are not functioning well. Fecal transplant can be accomplished in various ways, even in pill form, to change the flora and the balance within the person's intestine, and heal them completely.

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