Emerging role of the gut microbiome in post-infectious irritable bowel syndrome: A literature review

Abstract

Post-infectious irritable bowel syndrome (PI-IBS) is a particular type of IBS, with symptom onset after an acute episode of infectious gastroenteritis. Despite infectious disease resolution and clearance of the inciting pathogen agent, 10% of patients will develop PI-IBS. In susceptible individuals, the exposure to pathogenic organisms leads to a marked shift in the gut microbiota with prolonged changes in host-microbiota interactions. These changes can affect the gut-brain axis and the visceral sensitivity, disrupting the intestinal barrier, altering neuromuscular function, triggering persistent low inflammation, and sustaining the onset of IBS symptoms. There is no specific treatment strategy for PI-IBS. Different drug classes can be used to treat PI-IBS similar to patients with IBS in general, guided by their clinical symptoms. This review summarizes the current evidence for microbial dysbiosis in PI-IBS and analyzes the available data regarding the role of the microbiome in mediating the central and peripheral dysfunctions that lead to IBS symptoms. It also discusses the current state of evidence on therapies targeting the microbiome in the management of PI-IBS. The results of microbial modulation strategies used in relieving IBS symptomatology are encouraging. Several studies on PI-IBS animal models reported promising results. However, published data that describe the efficacy and safety of microbial targeted therapy in PI-IBS patients are scarce. Future research is required.

The Networked Interaction between Probiotics and Intestine in Health and Disease: A Promising Success Story

“…Once the infection is treated and inflammation subsides, the gut microbiota tends to recover and return to its pre-infection state. However, in some cases, the infection and associated inflammation can cause lasting changes to gut microbiota composition, provoking symptoms that are categorized as post-infectious irritable bowel syndrome and may include abdominal discomfort, bloating, and alternation between diarrhea and constipation [ 157 ]. It is important to note that the exact mechanisms underlying the relationship between gut inflammation and gut microbiota are still being studied.…”

The role of vitamin D in pediatric systemic lupus erythematosus - a double pawn in the immune and microbial balance

“…The relationship between the intestinal microbiome and multiple systemic pathologies such as atopy (asthma), autoimmunity (SLE, celiac disease) or even post-infectious irritable bowel syndrome is well known. In the case of SLE, the presence of autoimmunity is marked at the intestinal level mainly by a low Firmicutes - Bacteroidetes ratio, together with an increase in Prevotella, Rhodococcus, Eggerthella and Klebsiella ( 35 – 39 ). Vitamin D3 also exerts effects on the integrity of the intestinal barrier, the bacterial translocation capacity and the microbial balance, thus revealing another way through which it can mediate interactions with the host’s immune system, imprinting the pathogenesis of SLE ( 35 ).…”

Development of Gut Microbiota in the First 1000 Days after Birth and Potential Interventions

“…These environmental factors may trigger dysbiosis, leading to increased vulnerability of the child’s intestine to Shigella species. A recent review showed that while the exact mechanisms are still not entirely clear on how post-infectious irritable bowel syndrome (PI-IBS) starts, alterations in gut microbiota, immune responses, and gut-brain interactions likely contribute to the development of PI-IBS [ 117 ], suggesting the connection between microbiota and PI-IBS.…”