Are biofilms keeping you sick?

You’ve been to numerous practitioners, paid countless dollars, and followed all the treatment recommendations just to get the same infection over and over again! It has gone on for so long, you have considered that maybe this is just a part of who you are, and it will never end. Sound like you?

We often imagine bacteria freely roaming around as single cells. However, most bacteria do not exist in this solo form in the human body, but rather in something called biofilms. It is now understood that the vast majority of human infections are actually biofilm mediated. Read on to learn how these microbial communities might be contributing to your gut troubles!

What are biofilms?

A biofilm is a sticky, slimy immobile structure produced by microbes such as bacteria and fungi when they adhere to and colonize a surface. Microorganisms have colonized different environments all over the planet including water, soil, pipelines, and the human body. Nearly any surface with naturally occurring moisture is an ideal place for biofilms to grow.

Biofilm with rod shaped bacteria hiding within the sticky matrix. Credit: Dr_Microbe

While not all biofilms are harmful, most are usually pathogenic (disease causing) in nature. According to the National Institutes of Health (NIH), 80% of all chronic infections are associated with biofilm formation. They are often found on surfaces of medical implants, sutures, catheters, and other hospital equipment leading to surgical implant infections, catheter-induced urinary tract infections, and lung infections. Biofilm facilitated infections can be serious and costly. This is because biofilms form a physical barrier that protects microbe colonies from the external environment and serve as a microbial “hideout”. This barrier prevents most immune cells from detecting pathogenic bacteria within it and provides a way to evade antibiotic treatment.

In fact, biofilms increase antimicrobial resistance which occurs when bacteria and fungi develop the ability to defeat the drugs designed to kill them. Resistant infections can be difficult and sometimes impossible to treat. Even worse, bacteria living in a biofilm can exhibit a 10 to 1,000-fold increase in antibiotic resistance compared to similar bacteria living in a free form state. Biofilms often contain numerous types of microbes. This means treatments that kill one type of bacteria might do nothing for its buddies!

Biofilms and your gut

Aside from the serious biofilm mediated infections in the hospital setting, pathogenic biofilms are central to the formation of many intestinal disorders.  As mentioned above, the GI tract is prime real estate for biofilms. The GI epithelium is lined with mucus to protect it, but this mucus lining can be damaged in patients with excessive inflammation, inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), Celiac disease, and other conditions. This allows bacteria to attach to the surface and build their slimy fortress causing further damage to the intestinal lining.

A recent study resulted in compelling evidence supporting that intestinal biofilms are a common feature of IBS and IBD. These biofilms were endoscopically shown to be present in 57% of patients with IBS and 34% of patients with ulcerative colitis. This revealed a significant difference (P < .001) compared with 6% of controls. It is concluded that these yellow-green adherent biofilms are associated with a dysbiotic gut microbiome.

Oddly, studies have also discovered that pathogenic F. nucleatum, P. gingivalis (periodontal bacteria), which are capable of forming biofilms better known as plaque on teeth, can be detected in intestinal biofilms. It is believed that these oral bacteria may have potential involvement in colorectal cancer (CRC) development by migrating from the oral cavity down into the colorectum, contributing to intestinal dysbiosis.

Not all biofilms are harmful, however. It is believed that biofilms are key contributors to the stability and functioning of the gut depending on the diversity of biofilm organization along the gastrointestinal tract. Overall, factors that control biofilm development depend on their microbial composition, our genetics, and our immune status. Changes to this delicate equilibrium is thought to be a considerable driver of intestinal diseases.

How are biofilms treated?

It is important to consider that despite their potential role in disease pathogenesis, intestinal biofilms remain understudied.

However, low efficiency and toxicity of various treatments available including antibiotics have driven researchers toward the discovery of many effective natural anti-biofilm agents. Recent research has proposed that natural extracts and natural anti-biofilm agents could be more efficient than chemically synthesized treatments and with lesser side effects!

For centuries, herbs and spices have been widely used for medicinal purposes. According to various studies, these natural agents have potential to treat and prevent pathogenic biofilms because they are a rich source of natural antimicrobials. Some promising natural antimicrobial agents that have been investigated include:

• Berberine

• Artemisinin

• Citrus seed extract

• Black walnut hulls

• Artemisia herb

• Echinacea

• Goldenseal

• Gentian

• Fumitory

• Galbanum oil

• Oregano oil

Check out various anti-biofilm agents and the microorganisms they kill here!

Studies using natural agents have also shown that the use of specific probiotic strains can form a beneficial biofilm on the gut mucosa, thus blocking the adhesion of pathogens and preventing biofilm formation. On the other hand, strategies that target existing biofilms involve the use of enzymes, such as proteases, that degrade the biofilm matrix (sticky structure) via various mechanisms to allow the diffusion of antimicrobials into the matrix. Agents that disrupt biofilms are fittingly referred to as “biofilm disruptors”! Check out these biofilm-degrading enzymes here!

Due to the release of microbes and biofilm byproducts from dismantling biofilms, treatment of biofilms is generally coupled with antimicrobial agents like the ones listed above. This approach is currently implemented in numerous functional medicine settings under the supervision of licensed practitioners.

In conclusion, the first step to addressing biofilms is to prevent their formation in the first place. Keeping your gut healthy and prioritizing overall hygiene are two significant ways to prevent them. While conventional medicine acknowledges them in the hospital mediated infection arena, they fail to make the connection between biofilms as part of the whole picture in other disease states. Luckily, research is discovering natural methods of eliminating these slime huts in addition to emerging screening methods that can actually provide imaging used for diagnosis.

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