TY - JOUR T1 - Unique pathology of colonic spirochaetosis characterised by mucosal eosinophilia is linked to diarrhoea and IBS JF - Gut JO - Gut SP - 978 LP - 979 DO - 10.1136/gutjnl-2016-312405 VL - 66 IS - 5 AU - Thomas M Goodsall AU - Nicholas J Talley AU - Loui Rassam AU - Nicola K Wood AU - Alkesh Zala AU - Mike Jones AU - Marjorie M Walker Y1 - 2017/05/01 UR - http://gut.bmj.com/content/66/5/978.abstract N2 - Dear Sir,We read with interest the commentary of Raes1 on the growing clinical role of microbiome-based companion diagnostics. We agree that the future of microbiome in medical practice will be in using markers for diagnosis as well as predicting and personalising treatment. We report here new observations on a colonic bacteria that, while traditionally considered a commensal, may be important in chronic diarrhoea and IBS.Colonisation of the colon by Brachyspira aalborgi and B. pilosicoli is characterised by the histological finding of extensive, densely packed, end-on attachment of spirochaetes to the mucosal wall, which is visible on H&E stain as a hazy mucosal border; bacterial colonisation is dramatically demonstrated by Warthin-Starry staining like Helicobacter pylori (figure 1).2 ,3 The significance of this finding and its role in human disease has been debated in the literature and generally colonic spirochaetosis (CS) is considered to be a … ER -