Endometriosis is a condition where cells similar to the womb lining grow elsewhere in the body, leading to inflammation, pain, and scar tissue. It is often difficult to diagnose, with people waiting almost 9 years on average from first reporting symptoms to receive a diagnosis. 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), which is significantly lower in people with endometriosis than those without the condition.
Endometriosis is a condition that affects up to 11% of women of reproductive age and can cause severe symptoms such as pain, cramping, heavy menstrual bleeding, and digestive issues. On average, people wait almost 9 years from first reporting symptoms to receive a diagnosis. The study found that people with endometriosis and those with inflammatory bowel disease (IBD) have lower levels of the bacterial metabolite 4HI in their stool than those without these conditions. The researchers also discovered that 4HI could potentially prevent and treat endometriosis in animal models.
Studies have shown that people with endometriosis have a less diverse gut microbiome than those without the condition, raising questions about whether endometriosis is responsible for the lower diversity or if a lack of diversity increases the risk of developing endometriosis. The study examined stool samples from women with endometriosis and controls, identifying 371 metabolites, with 61 differing between the two cohorts. The researchers found that 4HI was significantly reduced in stool samples from women with endometriosis, possibly due to alterations in gut microbiota.
The researchers suggest that the distinct stool metabolite signature found in people with endometriosis is similar to signatures found in other gut disorders like ulcerative colitis and Crohn’s disease. They propose that a non-invasive stool test could be developed for diagnosing endometriosis based on these differences in stool metabolites. While this test is still in development and will take 2-5 years to be available for clinicians to use, it could significantly reduce the time it takes to diagnose endometriosis.
In addition to using stool metabolites for diagnosing endometriosis, the researchers also investigated the effects of administering 4HI in animal models of the condition. They found that 4HI prevented the initiation and progression of inflammation and pain associated with endometriosis. Further studies are being conducted to evaluate the safety and efficacy of 4HI as a potential treatment for endometriosis, offering hope for more precise therapeutics and improved outcomes for people with the condition.
Overall, the findings of this study mark an important step forward in the understanding and treatment of endometriosis. Developing a non-invasive stool test for diagnosing the condition could significantly shorten the diagnostic process, allowing for earlier intervention and treatment. By identifying the role of gut microbiota and its metabolites in endometriosis pathogenesis, new avenues for combating the disease are being explored, potentially benefiting women worldwide who are suffering from this often debilitating condition.
