Human stomach microbiota: Effects on health and disease

The gut microbiota is a complex ecological community, consisting of trillions of microbes which include bacteria, viruses, fungi and protozoa. The stomach was previously considered as a sterile site uninhabited by microbes due to its hostile environmental conditions. Breaking this concept, Helicobacter pylori was the first pathogen reported to inhabit the stomach. Recent studies have suggested that the stomach harbours transient as well as certain commensal bacterial and fungal species. The five major microbial phyla in the stomach have been identified as Firmicutes, Bacteroidetes, Actinobacteria, Fusobacteria and Proteobacteria.

The composition of gastric microbiota is dynamic and is affected by several factors.  These include age group, dietary habits, medication use, inflammation of gastric mucosa and H. pylori colonization.  Further, the role of host genetics has recently been studied in maintaining the stomach microbiota. Mutations in host genes may affect the host’s immune response towards commensal bacteria and reduce their number and diversity.

The essential multiple roles of gut microorganisms include maintaining homeostasis in the gut, contributing to immune function and extraction of nutrients and energy from our diets.  Loss of the normal balance between the gut microbiota and host has been associated with several abnormal conditions and disorders such as obesity, malnutrition, inflammatory bowel diseases (IBD), neurological disorders, and cancer. In the stomach, the interaction between H. pylori and the gastric microbiota can also influence gastric dis­ease progression. Further studies should focus on addressing the role of gastric dysbiosis in health and disease. Identifying gastric microbiota is essential to understand how the gut microbiota and H. pylori affect health and disease.