Gut Microbiota-Based Therapies for Irritable Bowel Syndrome.

Emily K Stern, Darren M Brenner

Journal: Clinical and translational gastroenterology 2018;9(2):e134

PMID: 29446765

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Plain Language Summary

Irritable bowel syndrome (IBS) is a common, complex disorder characterised by pain associated with changes in bowel habits. The gut micriobiome describes the collective bacteria that inhabit the gastrointestinal (GI) tract, and it is hypothesised that alterations in gut microbiota play a role in the development of IBS. This aim of this review is to provide an overview of the role of altered GI homeostasis in IBS and assess the available therapeutic options. The current literature suggests that gut microbiota contributes to IBS development through GI inflammation, gut permeability, intestinal motility, gut-brain communication and gas production. Many treatment options exist but have differing efficacy depending on IBS subtype. Based on this review, the authors suggest further research is warranted to better understand the mechanisms and benefits of IBS treatment options.

Abstract

Irritable bowel syndrome (IBS) is a common, heterogeneous disorder characterized by abdominal pain associated with changes in bowel habits. The pathogenesis of IBS is multifactorial and may relate to alterations in the gut microbiota, changes in visceral sensation and motility, and genetic and environmental factors. Administration of systemic antibiotics may increase the risk of IBS by altering gastrointestinal homeostasis. Therapeutic interventions for IBS with diarrhea that are thought to target alterations in the gut microbiota include the nonsystemic antibiotic rifaximin, the medical food serum-derived bovine immunoglobulin, prebiotics, probiotics, and dietary modification. SYN-010 is a modified-release statin formulation that reduces methane production by Methanobrevibacter smithii and is currently in development for the treatment of patients with constipation-predominant IBS. Use of these interventions in the management of patients with IBS may function to restore a healthy gut microbiota and ameliorate symptoms of IBS.

Address: Division of Gastroenterology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

DOI: 10.1038/ctg.2018.2