The Role of Gut-Microbiota in the Pathophysiology and Therapy of Irritable Bowel Syndrome: A Systematic Review

Abstract

Irritable Bowel Syndrome (IBS) is one of the most prevalent chronic gastrointestinal diseases, which is characterized by recurrent abdominal pain and altered bowel habits. The pathophysiological mechanisms are not completely clear for IBS, multiple factors such as genetic, psychosocial, environmental, visceral hypersensitivity, low-grade inflammation, gastrointestinal motility changes, food components, and intestinal microbiota are thought to play a role in the disease process of IBS. The rapid progression of recent microbiome research using advanced microbiological technologies has shed light on dysbiosis related to the pathophysiology of IBS. We used PubMed, PubMed Central, and Medline as our primary databases to search for articles using keywords and medical subject heading (MeSH) keywords on April 30, 2022, to render a total of 4062 articles. Then, a total of 10 articles were selected following a quality assessment. Despite the variable findings in different studies, most studies have concluded that IBS patients have a reduction in bacterial diversity and an increase in the temporal instability of the microbiota. IBS is known as a stress disorder, and the gut-microbiome-brain axis has been associated with the pathogenesis of the disease. Additionally, the potential of dietary manipulation of gut microbiota and the use of probiotics, prebiotics, and synbiotics in the treatment of IBS has been studied in recent years and shown promising results. We concluded that the gut microbiome plays a substantial role in the pathophysiology of IBS.

Irritable Bowel Syndrome: Treating the Gut and Brain/Mind at the Same Time

“…Prebiotics are defined as fibers that stimulate the growth of beneficial gut microflora and are resistant to enzymatic digestion in the human gastrointestinal tract (GIT) [ 8 ]. The mechanisms of action of prebiotics are aimed at reducing inflammation through the formation of short-chain fatty acids [ 37 ].…”

Management of irritable bowel syndrome: a narrative review

“…The pathophysiology of IBS remains unclear with present theories encompassing a range of factors including irregularities in motility, visceral sensation, gut-brain interaction, gut dysbiosis, and psychosocial distress ( 4 , 5 ). The multifactorial etiology and diverse clinical presentation of IBS have made its management challenging.…”

The Variability of Tryptophan Metabolism in Patients with Mixed Type of Irritable Bowel Syndrome

“…Low-grade immune activation may exist in IBS-M. Bacterial and food endotoxin could play a role in the immunological response and may damage the intestinal barrier [ 7 , 8 ]. Intestinal bacteria can exert an influence directly or by participating in the metabolism of dietary ingredients [ 9 , 10 ]. The first line of treatment for IBS is an appropriate diet [ 11 , 12 , 13 , 14 ].…”