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March 2022 - Maximilian Baumgartner

Dipl.-Ing. Maximilian Baumgartner

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Irritable bowel syndrome (IBS) is the most common digestive disorder, affecting up to 15% of the Western population. Involvement of the bacterial ecosystem in our gut (microbiome) has been suggested, as transplantation of stool from healthy individuals leads to symptomatic improvement in IBS patients. We describe previously unrecognized endoscopically visible biofilms that are attached to the intestinal wall in almost two-thirds of patients with IBS and one-third of patients with Ulcerative colitis. They are associated with a disrupted microbiome (ie, overgrowth of Escherichia coli and Ruminococcus gnavus) and increased levels of bile acids. This novel concept has the potential to revolutionize diagnostic algorithms and treatment approaches in IBS.

Selected Literature

  1. Chassaing B, Koren O, Goodrich JK, Poole AC, Srinivasan S, Ley RE, Gewirtz AT. Dietary emulsifiers impact the mouse gut microbiota promoting colitis and metabolic syndrome. Nature [Internet]. 2015; Available from:
  2. Johnsen PH, Hilpüsch F, Cavanagh JP, Leikanger IS, Kolstad C, Valle PC, Goll R. Faecal microbiota transplantation versus placebo for moderate-to-severe irritable bowel syndrome: a double-blind, randomised, placebo-controlled, parallel-group, single-centre trial. The Lancet Gastroenterology and Hepatology. 2018;3(1):17–24.
  3. Costello SP, Hughes PA, Waters O, Bryant RV, Vincent AD, Blatchford P, Katsikeros R, Makanyanga J, Campaniello MA, Mavrangelos C, Rosewarne CP, Bickley C, Peters C, Schoeman MN, Conlon MA, Roberts-Thomson IC, Andrews JM. Effect of Fecal Microbiota Transplantation on 8-Week Remission in Patients with Ulcerative Colitis: A Randomized Clinical Trial. JAMA - Journal of the American Medical Association [Internet]. 2019. Available from: PMID: 30644982
  4. Lloyd-Price J, Arze C, Ananthakrishnan AN, Schirmer M, Avila-Pacheco J, Poon TW, Andrews E, Ajami NJ, Bonham KS, Brislawn CJ, Casero D, Courtney H, Gonzalez A, Graeber TG, Hall AB, Lake K, Landers CJ, Mallick H, Plichta DR, Prasad M, Rahnavard G, Sauk J, Shungin D, Vázquez-Baeza Y, White RA, Bishai J, Bullock K, Deik A, Dennis C, Kaplan JL, Khalili H, McIver LJ, Moran CJ, Nguyen L, Pierce KA, Schwager R, Sirota-Madi A, Stevens BW, Tan W, ten Hoeve JJ, Weingart G, Wilson RG, Yajnik V, Braun J, Denson LA, Jansson JK, Knight R, Kugathasan S, McGovern DPB, Petrosino JF, Stappenbeck TS, Winter HS, Clish CB, Franzosa EA, Vlamakis H, Xavier RJ, Huttenhower C. Multi-omics of the gut microbial ecosystem in inflammatory bowel diseases. Nature [Internet]. 2019; Available from: PMID: 31142855
  5. Tytgat HLP, Nobrega FL, van der Oost J, de Vos WM. Bowel Biofilms: Tipping Points between a Healthy and Compromised Gut? [Internet]. Trends in Microbiology. 2019. Available from:
  6. Biofilme als Ursache für Reizdarm [Internet]. 2021 [cited 2021 Oct 11]. Available from:
  7. APA. Reizdarmsyndrom meist in Verbindung mit bakteriellen Biofilmen [Internet]. Salzburger Nachrichten. 2021 [cited 2021 Oct 11]. Available from:
  8. Dem Reizdarm mit einer Spitzpistole zu Leibe rücken [Internet]. 2021 [cited 2021 Oct 17]. Available from:
  9. [Cited 2021 Oct 11]. Available from:
  10. Nye J. Bacterial biofilms frequently identified during endoscopy among patients with irritable bowel syndrome or ulcerative colitis [Internet]. 2021 [cited 2021 Oct 11]. Available from:
  11. Cover 1. Gastroenterology. Elsevier BV; 2021 Oct 1;161(4):OFC.
  12. Khare V, Krnjic A, Frick A, Gmainer C, Asboth M, Jimenez K, Lang M, Baumgartner M, Evstatiev R, Gasche C. Mesalamine and azathioprine modulate junctional complexes and restore epithelial barrier function in intestinal inflammation. Sci Rep. 2019 Feb 26;9(1):2842. PMCID: PMC6391397
  13. Evstatiev R, Cervenka A, Austerlitz T, Deim G, Baumgartner M, Beer A, Krnjic A, Gmainer C, Lang M, Frick A, Schachner H, Khare V, Gasche C. The food additive EDTA aggravates colitis and colon carcinogenesis in mouse models. Sci Rep. 2021 Mar 4;11(1):5188. PMCID: PMC7933154
  14. Frick A, Khare V, Jimenez K, Dammann K, Lang M, Krnjic A, Gmainer C, Baumgartner M, Mesteri I, Gasche C. A Novel PAK1–Notch1 Axis Regulates Crypt Homeostasis in Intestinal Inflammation. Cellular and Molecular Gastroenterology and Hepatology. 2021 Jan 1;11(3):892-907.e1.
  15. Lang M, Baumgartner M, Rożalska A, Frick A, Riva A, Jarek M, Berry D, Gasche C. Crypt residing bacteria and proximal colonic carcinogenesis in a mouse model of Lynch syndrome. Int J Cancer. 2020 Oct 15;147(8):2316–2326. PMCID: PMC7496850
  16. Tardelli M, Bruschi FV, Fuchs CD, Claudel T, Auer N, Kunczer V, Baumgartner M, A H O Ronda O, Verkade HJ, Stojakovic T, Scharnagl H, Habib A, Zimmermann R, Lotersztajn S, Trauner M. Monoacylglycerol Lipase Inhibition Protects From Liver Injury in Mouse Models of Sclerosing Cholangitis. Hepatology. 2020 May;71(5):1750–1765. PMCID: PMC7317927
  17. Gröschel C, Prinz-Wohlgenannt M, Mesteri I, Karuthedom George S, Trawnicek L, Heiden D, Aggarwal A, Tennakoon S, Baumgartner M, Gasche C, Lang M, Marculescu R, Manhardt T, Schepelmann M, Kallay E. Switching to a Healthy Diet Prevents the Detrimental Effects of Western Diet in a Colitis-Associated Colorectal Cancer Model. Nutrients [Internet]. 2019 Dec 23;12(1). Available from: PMCID: PMC7019913
  18. Baumgartner M, Lang M, Orgler E, Khare V, Moser D, Holley H, Gmainer C, Krnjic A, Evstatiev R, Primas C, Mandorfer M, Kazemi-Shirazi L, Zioutis C, Berry D, Gasche C. 443 – Intestinal Biofilms are an Endoscopic Feature of Irritable Bowel Syndrome. Gastroenterology [Internet]. 2019; Available from:

Dipl.-Ing. Maximilian Baumgartner

Dipl.-Ing. Maximilian Baumgartner
Medizinische Universität Wien
Universitätsklinik für Innere Medizin III
Klinische Abteilung für Gastroenterologie und Hepatologie
Währinger Gürtel 18-20
1090 Wien

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