Irritable bowel syndrome (IBS) is a multi-factorial gastrointestinal condition affecting 8 -22 % of the population with a higher prevalence in women and accounting for 20 -50 % of referrals to gastroenterology clinics. It is characterised by abdominal pain, excessive flatus, variable bowel habit and abdominal bloating for which there is no evidence of detectable organic disease. Suggested aetiologies include gut motility and psychological disorders, psychophysiological phenomena and colonic malfermentation. The faecal microflora in IBS has been shown to be abnormal with higher numbers of facultative organisms and low numbers of lactobacilli and bifidobacteria. Although there is no evidence of food allergy in IBS, food intolerance has been identified and exclusion diets are beneficial to many IBS patients. Food intolerance may be due to abnormal fermentation of food residues in the colon, as a result of disruption of the normal flora. The role of probiotics in IBS has not been clearly defined. Some studies have shown improvements in pain and flatulence in response to probiotic administration, whilst others have shown no symptomatic improvement. It is possible that the future role of probiotics in IBS will lie in prevention, rather than cure.

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Irritable bowel syndrome (IBS) is a poorly understood gastrointestinal condition affecting approximately one-fifth of the UK population, with a higher prevalence in women and accounting for up to half of referrals to gastroenterology clinics in the UK. It is characterized by abdominal pain, excessive flatus, variable bowel habit and abdominal bloating with no evidence of organic disease. IBS commonly occurs after gastroenteritis or following a course of antibiotics. Suggested aetiologies include motility and psychological disorders and psychophysiological phenomena, although there is also evidence that disruption to the intestinal microbiota can play a role in IBS. Episodes such as hysterectomy, first incidence of bacterial gastroenteritis or a course of antibiotics have been shown to contribute to symptoms compatible with those of IBS. The intestinal microflora in IBS has been shown to differ from that of healthy individuals. Faecal microfloras of IBS patients harbour higher numbers of facultative organisms, such as Klebsiella spp. and enterococci, and low numbers of lactobacilli and bifidobacteria. The role of probiotics in IBS has not been clearly defined. Some studies have shown improvements in pain and flatulence in response to probiotic supplementation, while others have shown no symptomatic or objective improvements. Administration of probiotics reduced caecal and faecal yeast proliferation in IBS patients treated with antibiotics, suggesting that they prevent the disruption of the intestinal microbiota known to be associated with IBS. It is possible that the role of probiotics in the management of IBS will lie in prevention, rather than cure.