Abstract
Irritable bowel syndrome (IBS) is still a common functional gastrointestinal disease that presents chronic abdominal symptoms but with a pathophysiology that is not yet fully elucidated. Moreover, the use of the synergistic combination of prebiotics and probiotics, known as synbiotics, for IBS therapy is still in the early stages. Advancements in technology led to determining the important role played by probiotics in IBS, whereas the present paper focuses on the detailed review of the various pathophysiologic mechanisms of action of probiotics, prebiotics, and synbiotics via multidisciplinary domains involving the gastroenterology (microbiota modulation, alteration of gut barrier function, visceral hypersensitivity, and gastrointestinal dysmotility) immunology (intestinal immunological modulation), and neurology (microbiota–gut–brain axis communication and co-morbidities) in mitigating the symptoms of IBS. In addition, this review synthesizes literature about the mechanisms involved in the beneficial effects of prebiotics and synbiotics for patients with IBS, discussing clinical studies testing the efficiency and outcomes of synbiotics used as therapy for IBS.
Highlights
Based on the recent knowledge regarding the efficiency of prebiotics and probiotics use as an alternative therapy for Irritable bowel syndrome (IBS), the purpose of this review is to investigate the latest reported beneficial effects of their combined use as synbiotics in the treatment of IBS in clinical studies, while defining the individual implications of prebiotics and probiotics at the human gut level
World Health Organization (WHO) as “live microorganisms which when administered in adequate amounts confer a health benefit on the host” [25], present multiple beneficial physiological effects at the gut level, which capacitates their application as IBS therapy
Direct epithelial barrier function modification has been expressed by L. acidophilus and S. thermophilus probiotic strains that independently decreased the permeability of HT-29 and Caco-2 cells and increased their trans-epithelial resistance [75]
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Some studies tightly correlated the IBS with chronic micro-inflammation ( known as low-grade inflammation) at the intestinal mucosa level that induce modifications in the natural GI functions [14,15,16]. This aspect makes the IBS multifactorial nature an impediment in finding an overall efficient treatment. Based on the recent knowledge regarding the efficiency of prebiotics and probiotics use as an alternative therapy for IBS, the purpose of this review is to investigate the latest reported beneficial effects of their combined use as synbiotics in the treatment of IBS in clinical studies, while defining the individual implications of prebiotics and probiotics at the human gut level. The novelty of the present paper is represented by the new interpretation via the multidisciplinary approach of the probiotics in IBS to move forward the knowledge in the field
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