The genus Bilophila from the phylum Proteobacteria (Deltaprotobacteria) contains Gram-negative, bile-resistant bacteria with several disease-causing factors such as abscess formation, endotoxin, cytotoxicity, adherence as well as outer membrane proteins.1 They are commonly found in the large intestine of animals and humans and are known to cause inflammatory lesions. Bilophila are also commonly found in normal stool specimens and are occasionally part of the normal oral and vaginal flora. Bilophila wadsworthia has a broad resistance to Beta-lactam antibiotics including imipenem, cefoxitin, and penicillin G.3,7 Increased amounts of Bilophila have been found in individuals consuming animal-based diet.

Bilophila wadsworthia is closely related to Desulfovibrio species and Lawsonia intracellularis, which are considered colon pathogens. The species Bilophila wadsworthia is most commonly associated with appendicitis, cholecystitis, otitis and peritonitis and increases the risk of irritable bowel disease (IBD). With IBD, chronic inflammation of the large intestine causes cramping, diarrhea and weight loss. An estimated 14 million Americans have IBD and the incidence of the disease is on the rise. Increasing consumption of fat-rich, processed foods that encourage the growth of B. wadsworthia (via increase in taurocholic bile acid that triggers colitis), is thought to be a factor in this increase.2,3 Because B. wadsworthia is increased in patients with ulcerative colitis, this suggests the need to identify new patients with IBD using Deltaprotobacteria as biomarkers.6

Bilophila has been found to contribute to the development or progression of Acne inversa, a severe, chronic inflammatory dermatosis that can lead to physical and mental disorders
Source: PMC

In a follow-up set of unpublished studies, it has been suggested that there might be a beneficial way to manipulate fats to suppress growth of pathobionts through omega-3 supplementation. Findings from these studies reveal that a 5% supplementation of our established pro-inflammatory milk-fat diet with omega-3 fish oil completely inhibited blooms of B. wadsworthia that resulted in lower incidence and severity of colitis.

Bilophila wadsworthia is commonly involved in polymicrobial infections. This pathogen has been found to contribute to the development or progression of Acne inversa (AI, hidradenitis suppurativa, Velpeau's disease, Verneuil's disease), a severe, chronic inflammatory dermatosis that can lead to physical and mental disorders.5


  1. Molecular Typing in Bacterial Infections. Ivano Filippis, Marian L. McKee
  2. Biology Today and Tomorrow with Physiology. Cecie Starr, Christine Evers, Lisa Starr
  3. Desk Encyclopedia of Microbiology. Moselio Schaechter
  4. Metabolism of Cholesterol and Bile Acids by the Gut Microbiota
  5. Acne inversa goes an extra mile than hidradenitis suppurativa
  6. The interaction between gut microbiota and age-related changes in immune function and inflammation
  7. Antimicrobial Susceptibility Testing of Bilophila wadsworthia Isolates Submitted for Routine Laboratory Examination
  8. Interactions between diet, bile acid metabolism, gut microbiota, and Inflammatory Bowel Diseases. Suzanne Devkota 1 and Eugene B. Chang 2 Dig Dis. 2015; 33(3): 351–356

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