Within each person’s intestines, an entire ecosystem of small organisms creates what is known as a microbiome. This ecosystem includes bacteria, archaea, viruses, and eukaryotic microbes.

The microbiome helps with a variety of functions within the human body. Keeping it healthy and balanced is important for everyone’s health.

In recent years, researchers have looked into the health of the gut’s microbiome as a potential cause of and solution to several conditions. One area of study looks at how what is going on in the gut’s microbiome may positively or negatively affect the disease activity of a person with hidradenitis suppurativa (HS).

HS is a painful and debilitating inflammatory skin condition that causes boil-like lesions to appear on the skin. The condition is progressive and characterized by periods of relapse and remission. Over time, the symptoms tend to get worse.

This article reviews what researchers know about the connection between the gut microbiome and HS. It also provides general tips on how to keep the gut healthy.

The gut microbiome is a collection of microorganisms that live in the intestinal tract. It includes trillions of organisms — mainly bacteria, but also viruses, protozoa, and fungi. Many now consider the microbiome as another organ within the human body due to the important role that it plays within the body.

Research suggests several benefits of the microbiome, including:

  • helping with metabolic functions
  • protecting against pathogens
  • educating the immune system

In other words, the microbiome either directly or indirectly impacts most physiologic functions within the human body.

At times, the microbiome can become unbalanced, allowing “bad” bacteria and other organisms to thrive. When this occurs, it can lead to a variety of potential symptoms, including:

  • fatigue
  • unexplained weight gain or loss
  • autoimmune condition flare-ups
  • affected sleep
  • allergies or rashes
  • digestive issues
  • unexplained mood changes
  • sugar cravings

For people with HS, having an imbalanced gut microbiome could contribute to increased levels of disease activity, more frequent flare-ups, or worsening symptoms.

A small but growing body of research is looking at the role that the gut microbiome plays in people with HS.

Currently, studies looking at the gut microbiome are limited. According to a review of 21 studies from 2021, only a few studies have looked at the gut’s role in HS. The researchers also noted that many of the studies they looked at did not consider other factors in the participants, such as whether or not they smoked.

One 2021 study indicated that a large number of participants with HS had a reduced level of certain “good” bacteria present in the gut. The absence of two strains is linked to inflammation in the body. The implication for HS is that the absence of these bacteria could influence the severity and frequency of HS flare-ups.

A 2020 study noted that several different microorganisms and their interactions with each other could affect HS severity and symptoms. The researchers also noted that the complexity of causes leading to HS and the ambiguity surrounding the condition make it difficult to determine which factors, including diet, are most important in treating HS.

All studies noted a need for additional research due to their current findings and the implications they have for better understanding and treating HS.

In addition to understanding the underlying causes and factors that affect HS, researchers are looking at people’s gut health as a potential means to expand treatment options for HS.

In the same 2021 review of studies, the researchers noted that future experiments should look more into the oral and gut microbiomes. They noted that learning more about the gut microbiome could help shape future treatments that focus on keeping the gut healthy.

Preventing and treating an imbalance of “bad” bacteria in the gut may help reduce the inflammatory response of HS. Research indicates that future treatments may also involve keeping the microbiome healthy and functioning normally, but it is not yet clear exactly how treatments will change.

Additional studies are necessary to fully understand what gut treatments may best help with controlling HS symptoms.

Regardless of whether or not a person has HS, everyone can benefit from keeping their gut microbiome healthy and balanced.

Some tips to help keep the microbiome healthy include:

  • Eat more fermented foods: In one 2021 study, researchers found that eating fermented foods helped keep the microbiome healthy. Fermented foods include yogurt and sauerkraut.
  • Consume more fish: A 2021 study indicated that people who regularly ate cod or salmon had decreased levels of “bad” bacteria in their gut microbiome.
  • Reduce artificial sweetener intake: Another 2021 study indicated that reducing one’s artificial sweetener intake may help improve gut health. In the study, this prevented a breakdown of protective mucus and prevented inflammation in the gut and other areas of the body.
  • Skip probiotics: In a 2018 study, researchers found that taking probiotics following a round of antibiotics could delay the gut microbiome’s return to its normal balance. They suggested eating fermented foods over the use of probiotics.
  • Eat a variety of fruits and vegetables: Research suggests that people who regularly eat 30 or more varieties of fruits and vegetables have greater biodiversity than those who eat 10 or fewer. In general, the more diverse its environment, the healthier the gut.

People with HS may benefit from keeping their gut microbiome healthy and diverse. Studies suggest a correlation between gut health and a reduction in HS symptoms, but more research is necessary to understand the connection fully.

Once researchers have a better understanding of the gut microbiome’s effect on HS, they may be able to offer additional treatment options for the condition.

In the meantime, people can take steps to keep their gut healthy by eating a variety of fruits and vegetables, fermented foods, and fish.