Abstract
Increased knowledge regarding the implications of gut microbiota in irritable bowel syndrome (IBS) suggests that a disturbed intestinal microenvironment (dysbiosis) might promote the development and maintenance of IBS symptoms and affects several pathways in the pathology of this multifactorial disease. Accordingly, manipulation of the gut microbiota in order to improve IBS symptoms has evolved as a novel treatment strategy in the last decade. Several different approaches have been investigated in order to improve the gut microbiota composition. Dietary modifications including supplementation with fibers, prebiotics, and probiotics are shown to improve symptoms and composition of gut microbiota in IBS; however, the exact probiotic mixture beneficial for each individual remains to be identified. The use of antibiotics still needs confirmation, although promising results have been reported with use of rifaximin. Fecal microbiota transplantation (FMT) has recently gained a lot of attention, and several placebo-controlled trials investigating FMT obtain promising results regarding symptom reduction and gut microbiota manipulation in IBS. However, more data regarding long-term effects are needed before FMT can be integrated as a customized treatment for IBS in the clinical routine.
Highlights
Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder (FGID), affecting between 10% and 20% of the population globally [1]
A broad range of studies have investigated the effect of supplementation with different types of fibers in patients with IBS, and increasing amount of evidence indicates that the dietary fibers acting as prebiotics, such as inulin and oligosaccharides, are able to influence the composition of the gut microbiota [41,42,43]
There is strong growing evidence suggesting that dysbiosis is central in the pathophysiology of IBS
Summary
Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder (FGID), affecting between 10% and 20% of the population globally [1]. Dietary strategies modulating gut microbiota in IBS Diet composition and food intake have been shown to play an important role in the symptom generation in IBS patients, and most of them claim that their symptoms can be related to the consumption of different foods [28]. Supplementation with soluble and moderately fermentable fibers such as psyllium and oats is a recommended treatment in IBS, shown to improve symptom severity and beneficially modulate stool consistency in all IBS-subtypes [36].
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