Modulation of microbiota as a target in the management of patients with irritable bowel syndrome

Abstract

Irritable bowel syndrome (IBS) is one of the most common diseases of the digestive tract. IBS negatively affects the quality of life and work ability of patients. It is generally accepted that IBS is an important medical and social problem associated with high financial costs both on the part of the patient and the public health system. The pathophysiology of the disease involves the participation of many factors (genetic, dietary, psychosocial, infectious) and the mechanisms of their implementation, including disruption of interaction along the functional “gut-brain axis”, visceral hypersensitivity, changes in motility, low-grade inflammation, increased permeability of the epithelial intestinal barrier, modulation of microbiota, changes in neurohumoral regulation and processes of central processing of peripheral stimuli. Research shows an important role for gut microbiota in the development of IBS. Modulation of the intestinal microbiota through diet, the use of pre- and probiotics or fecal microbiota transplantation is considered as a promising target for disease therapy. A reduction in the number of bacteria of the genus Bifidobacterium is described as a universal change in the microbiota in IBS, regardless of the clinical course and severity of the disease and the possibility of using different strains of Bifidobacterium in treatment regimens for the disease is of particular interest. This article provides a review of the literature on modern approaches to prescribing probiotics for IBS. Using our own clinical observations as an example, we demonstrated the effectiveness and safety of prolonged administration of the probiotic strain Bifidobacterium longum 35624® for up to 12 weeks.