Endometriosis is a condition that affects up to 11% of women of reproductive age, causing cells similar to endometrial tissue to grow outside the uterus. It is often difficult to diagnose, with an average of almost 9 years from first reporting symptoms to diagnosis. However, a new study suggests that endometriosis could be diagnosed using a non-invasive stool sample to measure levels of a bacterial metabolite called 4-hydroxyindole (4HI) that is lower in people with endometriosis than those without.
The study, published in the journal Med, found that people with endometriosis and inflammatory bowel disease (IBD) have lower levels of 4HI in their stool samples. Additionally, the researchers showed that 4HI reduced endometriosis initiation and progression in animal models, leading them to suggest that it might be an effective treatment for the condition. This development could significantly impact the diagnosis and treatment of endometriosis, as it provides a simple diagnostic tool that could potentially transform the way the condition is managed.
The connection between gut microbiota and endometriosis is also explored in the study, as people with endometriosis were found to have a less diverse gut microbiome than those without the condition. The researchers identified 371 metabolites in stool samples from women with endometriosis and controls, with 61 metabolites differing between the two groups. Notably, one specific metabolite, 4HI, was significantly reduced in women with endometriosis, suggesting an altered gut microbiota composition in these individuals.
Dr. Meltem Özkan Girgin, an OB/GYN specialist, highlighted the potential impact of a simple diagnostic tool such as a stool test for endometriosis, especially in areas where access to gynecologists or pelvic scans is limited. Dr. G. Thomas Ruiz, a board-certified OB/GYN, commented on the intriguing connection between endometriosis and IBD, suggesting that early intervention in endometriosis could be possible if IBD occurs prior to the condition.
The researchers are now working towards developing a non-invasive stool test for diagnosing endometriosis, which could be easily implemented in clinical settings. They estimate that it could take 2-5 years to develop and make the test available for clinicians to use. In addition, further studies are being conducted to evaluate the safety and efficacy of 4HI as a potential treatment for endometriosis. While the findings are promising, it is important to note that the study cohort was relatively small, and further research is needed to validate the results and explore potential therapeutic applications.
Overall, the discovery of a potential diagnostic marker and treatment for endometriosis through stool metabolites offers hope for improved management of this challenging condition. By identifying key differences in gut microbiota composition and metabolites associated with endometriosis, researchers are opening up new possibilities for early diagnosis and targeted treatments that could benefit women affected by this debilitating condition.
