Microbiotalk: "World Microbiome Day"

30 years of experience in opinion and health surveys at Ipsos Public Affairs - France
An expert in opinion and health issues, this dual role gives him a comprehensive overview of societal issues (environment, gender equality, public policy evaluation) and health issues, enabling him to anchor the data obtained in the heart of a complex reality.

He has been leading the International Microbiota Observatory since its creation.

So, I don't have much time to present an investigation that I could talk about for hours, so I'll have to summarize my points.
Just to introduce you to this device which has existed for 3 years now and which is an exciting device because it is implemented worldwide.

We interviewed people in America, North America, United States, South America, Brazil, Mexico, we have people in Northern Europe with Finland, we have Eastern Europe with Poland, we have Asia with China and Vietnam.
We have a panorama like this of countries and people we interview which gives us a very rich wealth of data collected and which shows us above all that knowledge about the microbiota, the attraction also for everything related to behavior and the desire to change one's behavior to do good varies from one country to another.
As you can see, every year we've welcomed new countries; it's a tool that has evolved year after year. Last year it was Poland, Finland, and Vietnam; this year it's Germany and Italy who are the new members—welcome to them.
We will see that it is also interesting to have included Germany in this survey because Germany is rather a poor performer when it comes to the microbiota, but we will come back to that.

As is typical of Le French Gut, we've changed our approach. We usually present a global overview, but this year it's France versus the rest of the world. We'll try to compare ourselves, see how we compare, and how we stand compared to others on this topic.

The first topic is of course knowledge and knowledge of the terms of the microbiota, how are we French? We are not bad, there are 88% of French people today who have already heard of the term microbiota, compared to the rest of the world which is at 71% it is much better.
We are slightly behind Asian countries, which have a much stronger culture of understanding and behavior regarding what to do to maintain a healthy gut microbiome. Vietnamese people, for example, have a 94% knowledge rate.
Looking at the details, it's good, but we could do much better because, as you can see, only a third of French people currently know precisely what the microbiota is. The good news, as you can see, is that this knowledge is evolving; it's progressing year after year. In 2023, it was 81%, in 2024, 85%, and this year, 88%, and the proportion of people who are well-informed about the microbiota is also increasing.

So this is good news that we should be pleased with. So what do we know about the microbiota? Well, that's one of our specific areas of expertise. For us, the microbiota is primarily the gut microbiota—you see, we know it much better than others—and the vaginal microbiota.
Here too we are better than the others, you can see there are really big differences compared to the rest of the world. Regarding the skin microbiota we are roughly the same, where we are really less good is with the lung microbiota, the ENT pulmonary microbiota and the urinary microbiota, which we know a little less well.
It may seem like a minor detail, but today you have countries, again in Asia, and a little more so in Brazil, where these other types of microbiota are better known and perhaps there are strange correlations, but these are also the countries where we have the best behaviors regarding the microbiota.

Regarding knowledge now, where do we stand today? Well, first of all, yes, we can see it in the title, we are a little behind the rest of the world, but knowledge is progressing and it is rather good, we should be satisfied with that.
How did we measure the knowledge of the French? We simply gave them a quiz and that's when they tell us it's true, it's false or I don't really know the right answer.
You can see that there are quite a few topics on which today a large part of our fellow citizens know things about the microbiota.
Our diet, for example, has significant consequences on the balance of our microbiota. 80% of French people say yes, it's true, they know it.
An imbalance in the microbiota can have some important consequences on health, 78% know this.

You see, there are many issues today where you have the green answer, on which our fellow citizens have the right answer, and that is something we should be satisfied with.
So we are making progress compared to 2023, this knowledge has not progressed much this year but we are on knowledge which is now progressing.
And this is where I'd like to make a brief digression. Once you have people who begin to know and understand the role of the microbiota...

And how important it is, I think there is something being put in place to ensure there is much more prevention and that the French do much more. The only downside is that today, as you can see, we are a little behind the rest of the world in our knowledge of the microbiota.
Not on the fact that it could have important consequences but rather on everything you see at the bottom of the ranking which is in yellow, that is to say on the fact that I am looking into it a little bit.

Your microbiota is located in the gut, you can see it, we're a little better at that, but many diseases like irritable bowel syndrome can be due to an imbalance of the microbiota.
This is less well known in France. The fact that the microbiota allows the gut to deliver essential information to the brain is also somewhat less known in France.
So there is some information that is a little less known and as a result we have an overall score of 5.6 out of 9 while the rest of the world is 5.9, it's a little better.
And that's the problem in France today, and that's our specialty. We have good knowledge of the terminology of the microbiota, we have good knowledge of what needs to be done and of the role and importance of the microbiota, but this is not translated into action.
And that's a real issue. And when you look at today, when we ask the French if they have changed their behavior to protect and better balance their microbiota, today only 45% of the French tell us that this is the case, compared to 56% in the rest of the world.

So there is a problem, we have the knowledge, we know how important it is and yet we do not change our behavior and we will come back to this subject a little later. What worries me about these results is what we see regarding older people. Among older French people, only 44% have changed their behavior to achieve a better balance of their gut microbiota.

But we are at ages, at these ages, where you start to develop chronic diseases, real health problems, and yet, even today, the oldest French people do not modify or modify their behavior less than others to allow for a better balance of the microbiota.

When asked, "What have you done to better balance your microbiota?"
So, there are things that are progressing in France today and that are quite good. Having a varied and balanced diet at 84% puts us at the level of the rest of the world. Not smoking tobacco makes you even better than others, you smoke less. To shower at least twice a day, which was the wrong answer, the correct answer was of course no, we did not shower more than twice a day.

More of us are doing it.
So, is it due to hygiene problems?

People always say that the French are less clean than others.
I don't know.

Or is it because these are lessons that have now entered the minds of the French?
Nevertheless, they exhibit these good behaviors.

On the other hand, when it comes to the practice of physical activity, the consumption of probiotics or prebiotics, you can see, we are out of step on these subjects.

We're a little bit less good, you can see that. Our overall score is 4.3 out of 7. When I brought home a 4.3 out of 7, it was quite a celebration.

But we are less good, as you can see, than the rest of the world on these subjects. And in fact, the real problem is the level of information the French have today to finally take the plunge, take the leap and succeed in treating their microbiomes better than they do today.

And there is a lack of awareness on the part of healthcare professionals. And that's a real shame. Because today, when you ask the French, "Who do you trust most today to inform you about the microbiota?" Healthcare professionals are the first to go out at 96%, more than in the rest of the world and still increasing compared to last year. And it's much more than teachers, family, journalists, or sports coaches.

Healthcare professionals have an extremely important role to play on this issue because they have the trust of the French people.

And when we look at what they are actually doing, we realize that somewhere our healthcare professionals are not meeting expectations on this issue. When French people are asked, "Has a healthcare professional ever made you aware of the importance of preserving the balance of your microbiota as much as possible?"

37% in France versus 46% worldwide. "Do you explain the best practices to adopt to maintain a healthy balance in your gut microbiota?" 35% compared to 38% worldwide.

On all these items, on everything related to explanation and raising awareness about prevention and what needs to be done to achieve a good balance in this microbiota, we are falling short. And that's a real shame because the French are ready. They know how important it is today to have a balanced microbiota, and yet this information isn't being provided to them. And where we see it is with antibiotics.

I showed you a figure earlier when I told you that 67% of French people know that antibiotics have a negative impact on their microbiota. And yet, when asked, "The last time you saw a healthcare professional who prescribed antibiotics, did they do the following things?"

"Are you mentioning any digestive issues that may arise from taking antibiotics?" Yes, at 45%. That's the best figure. On the other hand, giving you advice to limit as much as possible the negative consequences of taking antibiotics on your microbiota, only 31%.

And to tell you that taking antibiotics can have negative consequences on the balance of your microbiota, only 29%. There's a problem there. There's a problem. The French know, and yet, healthcare professionals are not providing them with the information they need.

So it is this gap now that health professionals must help us with, I would say, to get through this and push the French to do better, to do more on this. Regarding the microbiota test, since "French gut oblige", we still went to ask them about the possibility of testing their microbiota.

So, regarding the possibility of testing their microbiota, the French don't know much about it. 18% have already heard of it. We are much less well-known than the rest of the world, at 27%. So, there is still a lot of communication and a lot of explanation to be given to the French so that they know what is going on.

However, when asked "Would you be interested in testing your microbiota?", well, 47% of them say "Yes, why not". So, it's based on self-reporting. Of course, it's something that... We know we won't get 47%.
If 47% of French people agreed to have their microbiota tested, that would be something exceptional. As you can see, this means that today, regarding these tests, regarding the possibility of knowing exactly what is happening with the microbiota, there are many French people who are in favor.

So, what are you in favor of testing?

Ultimately, they should first test the microbiomes they know best, since our specific expertise lies in knowing much more about the intestinal microbiota and the vaginal microbiota. This does not mean that they are against testing other microbiomes, but they know less about them. So, they come out, you see, at much lower levels.

And besides, why test your microbiota? Here again, the French are quite honest

When you want to test your microbiota, it is first, in quotes, in a somewhat selfish way, that is to say, to carry out a complete health assessment.

Firstly, 64% of them say it, if I'm not mistaken, to prevent and slow down the onset of pathologies. So it's something that helps them take preventative measures for their own health. Here again, you can see that we are much higher than in the rest of the world. And then, I'll go straight to the second-to-last figure, it could also be, even if it comes out lower, to support research and development of new microbiota-based therapies at 28%.

And that's the figure that's interesting and shows the true potential of the tests and the French Gut.

The fact is that today, 28% of French people say, "I, yes, would be willing to do analyses to advance French research on this subject." And finally, when we get to the heart of the matter, that is, the donation of salt you were just talking about, 46% of French people tell us that they would be willing to do it. We are still below and far behind the rest of the world. The rest of the world represents 59%. One small detail, because we are also working on this subject, we have the same concern for colorectal cancer screening.
It's all about poop, really. And the French have a much harder time with this subject than other populations.

You can see it in that figure. We have problems. That's what could be said very quickly about this survey. I encourage you to look at the overall results. They are extremely informative. Above all, you will discover how culturally and depending on the country where one lives, one has a relationship with the microbiota, knowledge and behaviors that are extremely different.

Thank you so much.
 

Joël Doré is an internationally renowned French microbiologist, recognized for his pioneering work on the human gut microbiota. He is a research director at INRAE and scientific director of MetaGenoPolis. 
For more than 40 years, he has devoted his research to the interactions between gut microorganisms and their human hosts. He is one of the first researchers to have highlighted the importance of microbiota in the prevention and development of chronic diseases (IBD, obesity, and diabetes).
He also works to disseminate science to the general public and health professionals, notably through the Le French Gut project, which he co-leads.
A prolific author and lecturer, he advocates a holistic and preventive approach to health, in which diet and the quality of the microbiota are key factors.

I'm going to start by talking about the situation we're experiencing. Today, at the global level, it is an epidemic of chronic diseases with an uncontrolled increase for the past 70 years, diseases that affect the cardiovascular system, cardiometabolism, overall, obesity, diabetes, but also the inflammatory, joint or intestinal diseases, liver diseases and then diseases that concern plus the nervous system, neurodegenerative or neuropsychiatric, for example.

And that's 41 million deaths in 2019.

74% of deaths are linked to a chronic disease. That's one in four people by 2025, today, affected by at least one of these conditions and often, we have multiple health conditions, cumulative chronic diseases. One in two people in the Organization's predictions The global health situation will be one of obesity by 2035.

So, we can see that things are really evolving in a way. Quite impressive, and not in a good way.
What does that mean?

That means we haven't understood what we're dealing with. We are dealing with a microbial human, we are dealing with a symbiosis and this is not yet taken into account in our behaviors that have been mentioned, but also in the medical practice today. We were able to characterize the microbiota, we were able to test the microbiota in a somewhat generic sense of the term and characterize the variations or variabilities of the microbiota in different contexts.

On the left, here, we have this image of a differentiation of the microbiomes of people living in the environment industrialized or non-industrialized environment. And then, in the middle, what we're representing here is this story tells us that the microbiota matters, the microbiota plays a role in a large number of pathologies for in which an alteration of the microbiota has been documented compared to individuals who remained healthy. And these are quite numerous diseases, which ultimately concern the major pathologies of modern society, which are increasing in incidence, as we have seen. But it also concerns human parameters and including intestinal permeability, inflammation, oxidative stress, which ages our cells a little faster than we would like, in fact, and which can also further alter the gut microbiota.

We can see how this situation can become somewhat of a vicious cycle to establish itself in the form of a vicious circle. And that's what we're documenting today in chronic diseases. Perhaps it relates to this idea that we don't have everything to has clearly understood what we have to do when we addressed to the microbial human. So, when we zoom in a little on the current perception of this which relates to testing of the gut microbiota,

There's a kind of growing sense of anger. A little, and which translates into opinion pieces in newspapers or then in the scientific literature. These are comments from colleagues in North America, here they tell us about DTC, direct to the consumer characterization of the microbiota at the request of Mr. Average Citizen really needs to be a little better regulated than it is today. And so, this may be a topic of our discussions. But we're starting from that basis.

Today, there are many small companies that offer microbiota analysis, sometimes requiring a few hundreds of euros and which will provide a report of one forty pages with beautiful images that tell you how you look when we take a selfie from inside. This is problematic because these people will see their doctor with a good relationship that medicine cannot manage today. And we would indeed like to achieve this virtuous circle which would allow doctors to prescribe the analysis of microbiota along with biology analyses classic blood or urine test through medical biology laboratories which are the natural interface in this diagram, this circuit.

For what ?

Finally, to integrate this microbiota data into medical practice. This is to diagnose alterations in the microbiota and of symbiosis. This is to monitor the evolution of the symbiosis along the path of the patient, particularly during treatment. And then, it's to integrate microbiota data and the symbiosis data in the nutritional recommendation, for example, or in medical care. In order for this virtuous circle to be established,

What do we need?

We need standards. I'm going to explain to you that we already have them. You need large numbers and, of course, Le French gut plays a role in this scheme by contributing large numbers to build the reference. And then, it will be necessary to demonstrate it with evidence, with proof scientific that there is a clinical benefit, a benefit to the intake. If indeed the doctor is trained in the gut microbiota. Patient education and training will also be necessary for healthcare professionals. In reality, we quite often see today that patient education is almost entirely happening online, a little faster than the adaptation of the training of healthcare professionals with scientific knowledge who It itself is evolving very quickly.

As I was saying, we have the standards. As far as we are concerned, we published the standards in 2017 which allow for the analysis of the intestinal microbiota in a completely standardized, so much so that if it were done from the same applies in the United States, Europe, and Australia. For example, we will get the same result.

This is what is truly necessary for a clinical application. And then, we also saw the appearance of equipment from reference that allows us to calibrate the processes we put into work to perform this analysis. And we have scientific colleagues in the United States or in England, for example, who offer us tools that they are going in that direction. That aspect is settled.

What remains to be provided for this scheme, it's the large number and the French microbiota, Le French gut aims to accelerate research on the microbiota and therefore to provide this additional information. This is a project of public interest aimed at improving prevention to screen, diagnose and treat diseases chronicles tomorrow. And the goal we have set for ourselves is by 2029, to collect and characterize those of 100,000 volunteers in France, adults, French residents and also healthy people versus sick people.

For what ?

To define the reference, the standards of the microbiota, the ranges of variation of the classical parameters, usual and dominant of the intestinal microbiota in the healthy individual and better understand his alteration in the disease. It's also about laying the groundwork for real development nutritional recommendations, possibly preventive and personalized to pave the way for new therapies, particularly in the context of chronic diseases, and also to raise awareness among the general public, adults and children who are or will be monitors their health tomorrow. This is a project led by INRAE, which is carried out in very close collaboration with the assistance public and Paris hospitals, at PHP, and which brings together public and private partners, public institutions such as Agro ParisTech, Inserm, and the CEA, the Pasteur Institute and INRIA and private companies including Biocodex, since the start, as has been mentioned, for the pharmaceutical sector, but also partners who cover more the nutrition aspect or the ingredientists and GMT for microbiota analysis intestinal for medicine.

This is a project that is supported by many partners communication. I'd like to say, you can all actually be like that, But we have ambassadors, including Michel Cymes, including Marine Lorphelin, Jimmy Mohamed and Julien Scanzi, who will speak after me, and who communicate with millions of people via the Internet, in particular.

How do we proceed?

We've been working on this for years, I'd say, to simplify the volunteer's journey as much as possible. And so, you will have to, as a volunteer, register on the Internet and create a personal page. And then, of course, you'll have to check that you are eligible. Eligibility is based on a few criteria. To be over 18 years old today, not to be under guardianship or under guardianship, reside in metropolitan France and not having taken antibiotics or undergone a colonoscopy in the three months preceding the donation. Finally, if you receive your collection kit and that you have an antibiotic to take for a reason.

If you're not feeling well, come back and see us in three months and everything will be fine. There is no problem. And the process is, I register, I sign a consent form. This is a classic example of ethics in cohort studies. An informed consent that will tell you that you participate in the study. And then also a second consent that will tell us if you agree to be contacted again in the future to explore the relationship between food, health and microbiomes through additional questionnaires, for example, or else you propose to participate in specific studies on complex questions in the science of microbiomes. You fill out a few questionnaires, the mandatory basic questionnaire is completed in approximately one about fifty questions, so it's 15-20 minutes.

However, you also have optional questionnaires that you can fill out this form, which will tell us more about you, eating habits, lifestyle habits or regarding your health. The kit shown here in the upper right corner is a kit which is somewhat similar for those concerned by the screening for the risk of colorectal cancer. In fact, we simplified it as much as possible. You place a saddle on a small paper hammock in the toilet and you have a cotton swab or the equivalent to place it in the saddle and then you place this piece of cotton stem in a tube that completely stabilizes your sample for one week and which is sent by mail. That's really minimized in terms of impact.

Nevertheless, there are people who find it difficult to make this gesture. There, and we understand it. Become one of our volunteers, become part of from our communications team. I'll talk about it later.

Where are we today?

We have a little over 25,000 participants who have indeed, they came to us as volunteers. That's a quarter of our goal. So, we will continue to work, continue to communicate and continue to include new volunteers. In terms of age, it's mostly people middle-aged, between 40 and 60. That's where we have the most people.

We have a little less than we would like to have for elderly or very elderly people. A little less than we would like to have for young adults. It's 70% women. So, gentlemen, to your tablets or your toilets. And then, it's a nationwide distribution that matches impressively with demographicsof the French population. So, we are very happy to be able to actually have an inclusion of volunteers throughout the country. Slightly less in the North, slightly less in Corsica.Obviously, I want to say, but despite everything, we have a very good representation.

And then, a third of our volunteers are... patients who consult for a pathology, mainly respiratory or cardiometabolic diseases. In fact, hypertension, for example, comes next digestive diseases. Obviously, then there are systemic diseases or autoimmune. And then, finally, neurological diseases. The nervous system is involved.

So, I can't see the figures because it's a bit far from it for me, but we have a little over 80% of people who have never smoked among our volunteers. Around 80% of people are omnivores. Of course, we are also interested in eating habits. And then, we have a high proportion of people who, declare that they have regular physical activity considering that it's at least 30 minutes a day dynamic walking.

There you go, and you can all communicate. Ideally, you should contact frenchgut-press at inrae.fr to have the tools available communication that is entrusted to you, which may be, for example, a poster to print and put in your pharmacy or your supermarket. And then, possibly, kits too, flyers to distribute it around you. Get people in the family involved as well. This is important to us.

Patricia Renoul has been president of the APSSII (Association of Patients Suffering from Irritable Bowel Syndrome) since 2022, having been a volunteer since 2019 and then a member of the Board of Directors. 

The APSSII was created in 2010 by two professors of gastroenterology, Professor Sabaté (AP-HP) and Professor Piche (CHU Nice). The APSSII is a non-profit organization approved by the Ministry of Health.

The Association of Patients Suffering from Irritable Bowel Syndrome  (APSII) is a national non-profit organization. 1 1901 and which has ramifications throughout the territory, across all our regions. Since the end of 2024, we have received accreditation from the Ministry of Health, which gives us the opportunity to represent all patients in hospital settings, whether they are private or public or within the institutions national.

For our association, this is indeed a big step and recognition. This also obliges us, since some of our members, in order to confirm our approval, they must participate to the representation of users in these bodies. So, that's still a big step forward for our association which, as Elodie reminded us, she is 15 years old today. So, the association was born from an observation that had been posed by the two professors mentioned above, Professor Sabaté and Professor Piche, that the disease, that is to say, bowel syndrome deserving, suffered from low regard by the entire population, including of course the healthcare professionals.

Hence the creation of APSII in 2010. So, these missions are the missions of an association of patients and which also echo the values of the APSII. First and foremost, it's about helping and supporting those who are suffering to allow them to break out of their isolation. You will see that, as some of you may already know
For you, this disease is not fatal, but it is a disease which affects daily life and sometimes for years and years. The second or second objective, the main objective of The association's purpose is to support research, to promote it and support her. And you will see that we are now very involved in Le French Gut, and it's for the association, by the way, a first significant financial support from so with Le French Gut.

The third mission, the third objective is to inform and to inform aboutreliable way. And then, the fourth objective is to defend rights of the suffering. So, behind the defense of the rights of the suffering, there is all the support that we have put in place for children and teenagers. Support for caregivers, that is to say relatives of patients, and also support for all people who wish to benefit from a recognition as disabled workers.

So, I'll go back to a basic point and the definition of irritable bowel syndrome. That's the scientific definition. The diagnosis of the IBS is made on the basis of the Rome criteria. It was a group of scientists who met in Rome, and which laid down a number of conditions in 2016, criteria. And so, IBS is defined as pain recurrent abdominal pain. So, it's primarily a pain that occurs at least one day per week in the last three months, with at least two of the following criteria. In relation to defication before, after, associated with a changes in stool frequency and associated with a change in appearance, in look,
of the appearance of the stools. So, to put it simply, irritable bowel syndrome, It's a pain, it's an abdominal pain and adisorder, a transit disorder to which we can add all a whole host of, let's say, effects, a few effects secondary symptoms include bloating and gas pain, perianal pain, back pain.

And I'll spare you the details because in the testimonies, obviously, we are collecting more and more from our members of side effects, in any case of the disease. So, I added a short sentence, a definition said to be evolving. We are now talking, then, still about the syndrome of Irritable bowel syndrome, not irritable colon syndrome since it's the intestine, it's also the intestine small intestine and colon. And today we're talking about the gut-brain interaction. which, obviously, reflects the entire connection that is occurs between the gut and the brain and vice versa. So, here are some figures regarding IBS, I'm going to speak in acronyms. 5 to 10% of the French population is affected which is not what is not less. So, obviously, with levels of gradation different, we have among our members people who suffer from irritable bowel syndrome in a moderate and others who really need to stop their professional activity.

Two-thirds of people affected by the syndrome Irritable bowel syndrome affects women. Once again, there you have it, as Etienne reminded us earlier, women, yes, were affected undoubtedly many more, more concerned, and dare more go to healthcare professionals to declare their illness. This is the primary reason for seeking medical advice in gastroenterology. So, this figure, obviously, this statistic talks a lot.

And then, to also talk about food, and I'll will return, 73% of sufferers believe that diet triggers their symptoms. So, those suffering from the syndrome of Irritable bowel syndrome, as you've understood, is also known as IBS.
a chronic condition, since that is the very definition of Irritable bowel syndrome, which is considered chronic, Obviously, this goes hand in hand with his career's difficulties, of daily difficulties.

Again, it's not a fatal disease, but it is a disease that is often debilitating. When people have 10 or 15 bowel movements a day. Yes, yes, it's disabling. Yes, one cannot lead a professional life, a social life, a family life, a normal family life. And yet, it is a pathology that is misunderstood, misunderstood and very trivialized. How often do we hear about the suffering around us?

They told us, "There you go, I went to see a professional."

"It's about health," he replied, "but it's all in your head."

And besides, everyone has a stomachache anyway. No, no, there you go. And it is a pathology with multifactorial causes. So, multifactorial causes that can be the source difficulties arise because we don't really know that there are there's no single cause, obviously. However, we have identified causes today but there is still research into the causes of Irritable bowel syndrome.

Among the causes identified today, visceral hypersensitivity, modification of the anomaly in the control messages to the brain or of the spinous monk. An intestinal infection, problems with intestinal motility, disturbances as well in the context of visceral hypersensitivity. And obviously, a major cause has been identified. Today, the imbalance of the microbiota. And that, obviously, is a cause we hope for that Le French Gut project will be able to work on, and especially with us.

So, this is a source of difficulties. Obviously, this diagnosis is a bit complicated, but it is also a source of what is a source of complexity. That's the therapeutic response. Because the causes are multifactorial, therapeutic responses are associated with them also multidisciplinary, varied. So, the patients are treated with medication, are
also treated by a non-drug approach. They are also advised to engage in physical activity. But what's complicated, in my opinion, is that the patients, they try many things. So, obviously, there are things that work, but there are things that don't work. There are things that work for a while and then don't work anymore afterwards. So, there you have it, that's what healthcare professionals are telling us.
In any case, all doctors who receive IBS patients, they tell us that those suffering from IBS are patients, complicated patients.

So, it's always the suffering ones facing the IBS, IBS is a source of physical pain. You probably doubt it, since that's the very definition of Irritable bowel syndrome and psychological pain. When you're in pain every day, for hours, sometimes for weeks, for months, even for years. We have members who have been diagnosed at the age of 14 and who, today, they have 70.

As you can imagine, it's a life, excuse my language, but it's a life of hardship.

So, one cannot be in very good mental health as well when you've been suffering like that for a while for so many years. Therefore, consequently, a quality of life which is heavily impacted, as I was saying previously, professional life, emotional, social, and family life. It is the IBS and, above all, also a source of incomprehension in the eyes of others. What I was saying earlier, we can say that we can say yes, everyone has a stomachache. So, it's an invisible disease and one that really is misunderstood even sometimes by those close to them.
And then, it is a source of guilt because of a psychosomatic approach. Indeed, the disease. So, you have a stomachache, it's all in your head and then relax, do some tai chi and you'll feel better. So, today, I was telling you in particular that 73% of patients felt that diet triggered their symptoms. 93% of sufferers believe that diet worsens the symptoms. So, you see here, in fact, the major issue is the difficulty feeding oneself. So, there are answers, obviously, since that makes part in particular of the therapeutic response, that is to say
It may be possible to adapt, to adjust one's diet. But it's not that simple. We're talking about the poor regime due to FODMAPS, which isn't what is not easy to follow, for which we need of dietary support. We're talking about the Mediterranean diet, of the NICE regime.

But in any case, there is a real difficulty in feeding oneself and, consequently, a risk of develop eating disorders. When you follow a diet for six months and who is quite restrictive, it becomes really very complicated. And that has repercussions for what follows. So that's the research on the microbiota. Well, for us, for the patients, at least, it's a considerable hope. So, like all patients, obviously, we are very impatient and especially when faced with research and for us, research on the microbiota is a new therapeutic target related to diet and the microbiota imbalance. Therefore, dysbiosis is understood as a cause of Irritable bowel syndrome.

And so, for us, this is a path of research.

Obviously, major. That's it, and I'll end with this message, truly a great one a message of hope for us, since the Association of patients suffering from irritable bowel syndrome is in the process of concluding an agreement with both INRAE and the APHP within the framework of the French gut project.
So, this will translate into a targeted mobilization on the irritable bowel syndrome, irritable bowel syndrome. The project involves collecting salts from patients suffering of irritable bowel syndrome, to analyze them and obviously to search for appropriate therapeutic approaches and suitable therapeutic approaches that would be appropriate for us, Obviously, there is hope, a significant hope. As you have seen, the answers are, the answers therapeutic approaches are multidisciplinary, are complex, sometimes complicated. So, if we had an identified cause and an answer therapeutic, that would be for us, obviously, a different way of life.
 

Gastroenterologist at Thiers Hospital and Clermont-Ferrand University Hospital, author and lecturer, health influencer on the topic of gut microbiota

I'm not going to talk to you about the microbiota, which I do very often, no, not Irritable bowel syndrome, which I also get often, but my activity is a little more about being a health influencer as mentioned. So, I'm going to explain a little bit about how it all started with a fecal transplantation and that's why I'm here right now

Now, let me talk to you.

So, I am indeed a gastroenterologist in Auvergne at the Thiel hospital at the Pierre-Montferrand University Hospital. I have a relatively general gastroenterology practice. I'm not stunned by the treatment, now by the microbiota and also through the transmission of knowledge to colleagues and then to the widest possible audience. So, I'm going to explain how I am doing in general activity. to now be on social media followed by a few thousand people. So, you probably already know this, but you may have heard to talk about fecal transplantation. Something has revolutionized this therapy, it was the publication in 2013 of a very large Dutch study that... demonstrated the effectiveness of fecal microbiota transplantation, the act of treating a patient through the microbiota, and therefore of a subject healthy. And so, this study, which was published in two parts, has perfectly demonstrated the effectiveness of this procedure for recurrent infection at a bacteria called Clostridioides difficile. I was fortunate, in fact, from the moment this study was published, to have a patient who was suffering from that and therefore, to be able to help her to propose this treatment. And this patient, who was very close to dying,
This was her sixth hospitalization because of this infection and she was in a deplorable state of health.

And we tried that procedure, which wasn't done at the time, she was still in France and she recovered very quickly. And I thought to myself, what we just did is incredible. A patient was probably saved by transferring her microbiota.
from someone else. The power of this microbiota is incredible. And so, afterwards, I continued to take a little interest in it. I was fortunate enough to be part of an expert committee of the NSM to draft and structure a protocol for the implementation of this procedure. And then, very quickly, the French group was formed fecal transplantation under the impetus of Harry Sokol, that you most likely know. Recommendations have been established for this fecal transplant in healthcare. But beyond the fecal transplant itself, it's really the microbiota and its impact on our health which really really interested. And so, yes, it marked a turning point in my career. Because in those years, I was thinking more about orienting myself towards digestive endoscopy and not really in the care of the microbiota in itself. And it is this curiosity surrounding the microbiota that has made a moment where knowledge was becoming exponential.

Every day, there were new studies that showed the role of the gut microbiota in our health. I was fortunate to have access to this knowledge as a doctor, as a scientist, as a member from the French fecal transplantation group. And I thought to myself, this knowledge, it concerns everyone's health. We are all microbial and to take care of our health, as a human being, we must also take care of our health microbial. I talk about it very often.
And in fact, I felt concerned by that. I thought to myself, these acquaintances that I was fortunate enough to have Having acquired them, I need to share them. And then, COVID-19 really marked a bit of a turning point for many things. And really, for patients, probably the desire to be even more proactive in one's health. There was also access, enormous access to information and disinformation.

And for me, as a caregiver, I identified more with the idea of holistic medicine, integrative medicine and a sensitive medicine. And so, the micro-onester certainly has its place in all of this. So, how can we raise awareness among everyone? I thought to myself, there are people around me who are working on science theses, who work in laboratories, who write hundreds of scientific pages. And besides, it wasn't really my thing. I thought to myself, rather than... I'm turning to the general public, and so I'm going to try to write a book for the general public on the science of the micro-earth. I wasn't ready to do it at all. I'm not the last one either. I think one of the last ones is probably in the room. Patrick Vega, who wrote a great novel with a plot revolving around of the intestinal micro-one, so the arm sees it anyway. And so, I, being neither the first nor the last, I still wanted to contribute and write, so... this book which brought together a little bit of all the knowledge I had crises of recent years and that I wanted to put to good use of the general public.

So, it was a bit of a struggle to find a publisher, not at all in the field, but I still managed to do it with certain fortunate circumstances, to write this book, to publish it and then, in fact, to write a book wherever we want It's pointless to transmit a lot of knowledge if no one reads it. It's of little interest, and so I engaged in a battle to try and make this book known. And so, I don't have a show on the radio or on TV, I'm not very familiar with newspapers, but we're fortunate at the moment, Having everyone have access to social networks gives everyone a voice. And so, I've taken ownership of this means of communication a little bit. First, to get my book. And then, in  fact, I very quickly realized that more that it was a lever to promote my book, it was really a channel of communication in its own right, and even if most people those who followed me on social media didn't buy my book. It's not a big deal as long as they had access to the same knowledge that I could share with them through posts, whether it be videos, carousels, etc. And so, it allowed me to gradually raise awareness among an audience increasingly broad in scope, ultimately, though, to encourage behavioral changes, since Joel insisted that we are victims, the world as a whole, from an epidemic of chronic diseases and that most of these chronic diseases have a very important link with our environment, but also our way of life.

Environment and lifestyle have a very significant impact about our microbiota, and the microbiota is probably one of our health and we're going to have to take back a little bit all this knowledge to try and bring back a little bit of gold in all of this, and try to reduce these chronic diseases a little bit and to improve our health, prevention, etc. I first went on LinkedIn, then on Instagram. I suggested 2 to 3... So it's quite a bit of work, and then there were things to learn something you don't learn when you're a doctor, like writing posts about it.

Please write to me in a way that is appropriate for a general, non-medical audience, non-scientific, to amplify, to popularize without distorting which is something quite complicated. And then try to learn a little about algorithms, because social media also consists of algorithms and then there are new tools, whether it's Canva, Magic, for subtitles, CapCut for shooting videos, etc. So it's really a second job in its own right, that I have learned in recent years. And so, this will give us a whole transformation around the microbiota, around intestinal health, around our lifestyle to try to promote behavioral changes that benefit everyone and also to promote... So I could have included it, that's true, also projects like Le French Gut, I was lucky enough to do it. I was able to take advantage of my exposure on social media to also talk, and I do it from time to time, of this citizen science project which is everyone.

So we can all say whatever we want on social media.

So the doctors a little less so, and especially since the arrival of a charter in 2025 which was expected. We are probably the only category of people who on social networks are subject to a charter where basically you can't just say anything without potentially having problems, and that's perfectly normal. Unfortunately, this charter does not apply to a whole host of others who can, who have total freedom to say anything and everything. So it's really something complex. Social networks and access to information for all and then there's the fact that everyone can express themselves on these networks. It's both something wonderful and at the same time something potentially dangerous when you don't know how to sort the information.

So, what was my assessment?

I am already fortunate to have a community that has grown considerably, these past few years, and which now gives me a certain legitimacy to continue talking about all of this. I know that people are interested in being subscribed on social media. This shows that there is an interest in health and prevention.
and for intestinal microproblems and for intestinal health. So that's something really positive. It also gives me the opportunity, beyond simply talking about the intestinal microproblem, but to talk more broadly about health and prevention, in particular to promote screening and prevention talking about screening and prevention of treatable cancer during Marseille Bleu, for example, to try to debunk some false beliefs, to raise awareness among the general public as much as possible and therefore to continue in this direction. And then, as we were saying, Étienne, one of the major issues, since the general public is starting to become familiar with the microphone, begins to take ownership of her health, begins to experience changes behavioral, but there are in reality who are healthcare professionals.

So I think that's probably where the real issue lies.

It's about improving the knowledge of healthcare professionals or, more broadly, on the impact of micro-activity on our health, because it is also up to them to be able to give preventative advice, also to raise awareness and take over a little bit of what I'm doing and that others are doing on social media. So there are of course other projects, a website and then training courses, really, because there is a real lack of training. I even think that currently, in medicine, 10 years of medical studies, not much at all. In my ten years of life, I never once heard the word microbiota. The word probiotic was used once, even though it wasn't that long ago. So there's a real delay at a time when we all have access to this information. via the Internet, via networks, via AI, etc.