What is the link between stroke recovery and gut health?

Stroke recovery and gut bacteria

A new study has identified types of gut bacteria associated with slower stroke recovery.

Miquel Lledós, its lead author, said: "The influence of the gut microbiome - the trillions of bacteria and other micro-organisms that live in the gut - is a modifiable risk factor associated with the risk of ictus and with post-stroke neurological outcomes."

Researchers used faecal (stool) samples from 89 people who had experienced an ischaemic stroke (the most common type of stroke, caused by a blockage in the brain). Compared with faecal samples from a control group, researchers could isolate groups of bacteria that are associated with a higher risk of stroke.

One particular bacterium related to poor functional outcomes at three months. The research suggests that new therapies that change the microbiome (for example, through diet or faecal transplantation) could improve post-stroke recovery, or even reduce the risk of a stroke. Research was already emerging last year about this possibility.

Commenting on this research, Dr Clare Jonas, the research communications and engagement lead at the Stroke Association, said: "We've known for some time that there's a two-way link between gut health and brain health. This can manifest in a variety of ways, including changes in gut health after a stroke. Gut health can also affect cardiovascular health, which in turn can affect the risk of having a stroke.

"This new finding into gut health and stroke recovery is exciting because it gives us an insight into specific types of gut-dwelling bacteria and their link to risk of stroke and subsequent recovery. There's still a lot to do to understand the role these bacteria play in stroke, but this work lays the basis for possible future treatments. The broader the range of treatments available, the more people can be given the best possible chance of surviving and thriving after a stroke."

Glen Eastick, 35, experienced a stroke in 2020 during a regular working day as a personal trainer. After the stroke, he was back at work after three weeks. Getting back to work was vital for Glen: he and his partner had a six-week-old baby at the time, and Glen was self-employed. But his recovery has been difficult.

"I was doing a lot of stuff online at the time because of lockdown and I was relying heavily on my vocabulary," Glen explains. "When I'm doing online sessions, I need to explain things a lot more than I would have to if I were working face-to-face.

"When I first started doing my personal training again, I was very conscious of the fact that my voice or my words could go again. It took a while for me to get my confidence back when I was talking to people."

Stroke tends to affect people later in life but can sometimes affect people in their 30s and younger. Glen was at higher risk of stroke because of a hole in his heart (a PFO), now closed through surgery. This meant he was at higher risk for stroke due to this abnormality, rather than cardiovascular disease, which tends to be the more common cause of strokes in older people.

After recovering from his stroke Glen felt anxious in case he had another. Managing the anxiety was one of the more challenging parts of his recovery.

"For someone in their 30s, if you live up to 80 you've got 50 years of worrying about whether you're going to have another one," he says.

During his recovery, Glen says the support of family and friends was really important. He was also helped by a support group and counselling for health anxiety. Despite the fact this new research is unlikely to have changed his outcomes, he still feels passionately about stroke research. Glen will be doing the Great South Run 2022 to raise money for the Stroke Association, and currently volunteers as a media spokesperson for the charity.

Stroke is the fourth biggest cause of death in the UK, but it's not necessarily fatal. In the UK there are 1.3 million people who've survived a stroke. New research like the gut bacteria study has the potential to improve stroke recovery outcomes for survivors, as well as awareness campaigns like Act FAST.

Stroke survivors and their families can access a dedicated helpline by the Stroke Association (0303 3033 100, 10 am-4 pm Mon-Fri, 10 am-1 pm Sat) to get info and support and find out about local services.