Gut microbiota role in irritable bowel syndrome: New therapeutic strategies

Abstract

In the last decade the impressive expansion of our knowledge of the vast microbial community that resides in the human intestine, the gut microbiota, has provided support to the concept that a disturbed intestinal ecology might promote development and maintenance of symptoms in irritable bowel syndrome (IBS). As a correlate, manipulation of gut microbiota represents a new strategy for the treatment of this multifactorial disease. A number of attempts have been made to modulate the gut bacterial composition, following the idea that expansion of bacterial species considered as beneficial (Lactobacilli and Bifidobacteria) associated with the reduction of those considered harmful (Clostridium, Escherichia coli, Salmonella, Shigella and Pseudomonas) should attenuate IBS symptoms. In this conceptual framework, probiotics appear an attractive option in terms of both efficacy and safety, while prebiotics, synbiotics and antibiotics still need confirmation. Fecal transplant is an old treatment translated from the cure of intestinal infective pathologies that has recently gained a new life as therapeutic option for those patients with a disturbed gut ecosystem, but data on IBS are scanty and randomized, placebo-controlled studies are required.

The intestinal microbiota in allogeneic hematopoietic cell transplant and graft-versus-host disease

“…7 A healthy and balanced intestinal microbiota also protects the host from viral and bacterial infections by preventing colonization of pathogens in the gastrointestinal tract. 8,9 The importance and impact of the intestinal microbiota on health and disease has been increasingly revealed during the last decades, and imbalances in the intestinal microbiota have been linked to obesity, 10 type 2 diabetes, 11,12 irritable bowel syndrome, 13 and autoimmune diseases such as rheumatoid arthritis.…”

Behavioural and neurochemical consequences of chronic gut microbiota depletion during adulthood in the rat

“…Alterations in the bidirectional microbiota-gut-brain axis are reported to be involved in the pathogenesis of many well described disorders of the gut including irritable bowel syndrome (IBS) and inflammatory bowel disorder (IBD) (De Palma et al, 2014;Distrutti et al, 2016;Staudacher and Whelan, 2016). More recently brain disorders such as autism spectrum disorder (Mayer et al, 2014), and mood disorders have been associated with dysfunctional microbiota-gut-brain axis communication Dinan 2012, Foster andMcVey Neufeld 2013).…”

Targeting Histamine Receptors in Irritable Bowel Syndrome: A Critical Appraisal

“…IBS impairs the quality of life in patients to a similar degree as in patients with inflammatory bowel diseases 3 and the impairment is proportional to the severity of the symptoms experienced by the patient. 4 IBS is a heterogeneous entity with etiology comprising of multiple factors such as inflammation, neuroimmune interactions, 5 gut microbiota, 6 environmental pollution, 7 and abnormal gut-brain axis. 8 This heterogeneity has a significant impact on treatment.…”