Associations of Clinical Symptoms and Bowel Characteristics With Intestinal Microbiota in Patients With Irritable Bowel Syndrome: ACG Governors Award for Excellence in Clinical Research

The pathophysiology of irritable bowel syndrome (IBS) is believed to involve alterations in the brain-gut axis; however, the etiological triggers and mechanisms by which these changes lead to symptoms of IBS remain poorly understood. Although IBS is often considered a condition without an identified “organic” etiology, emerging evidence suggests that alterations in the gastrointestinal microbiota and altered immune function may play a role in the pathogenesis of the disorder. These recent data suggest a plausible model in which changes in the intestinal microbiota and activation of the enteric immune system may impinge upon the brain-gut axis, causing the alterations in gastrointestinal function and the clinical symptoms observed in patients with IBS. This review summarizes the current evidence for altered intestinal microbiota and immune function in IBS. It discusses the potential etiological role of these factors, suggests an updated conceptual model for the pathogenesis of the disorder, and identifies areas for future research.

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How to improve effectiveness of treatment of patients with irritable bowel syndrome?

Medical Council ◽

10.21518/2079-701x-2021-5-134-140 ◽

2021 ◽

pp. 134-140

Author(s):

E. V. Golovanova

Keyword(s):

Irritable Bowel Syndrome ◽

Intestinal Microbiota ◽

Symptom Severity ◽

Clinical Symptoms ◽

Functional Gastrointestinal Disorders ◽

Gastrointestinal Diseases ◽

Controlled Study ◽

Bacterial Strains ◽

Double Blind ◽

Irritable Bowel

This article discusses ways to improve the effectiveness of treatment of irritable bowel syndrome (IBS), one of the most common functional gastrointestinal disorders (FGID). The significance of this issue is caused by high frequency of pathology detection among the young employable population and the difficulties in choosing an effective treatment that relieves not only the symptom severity, but also the frequency of relapses. Inadequate therapy reduces patients’ compliance with treatment and significantly worsens their quality of life. The choice of a drug that fails to provide a positive effect on all factors that form the pain syndrome is the most common reason for ineffective treatment. In addition, the measures aimed at managing such pathogenic factors as intestinal microbiota dysbiosis are often not taken. Meanwhile, numerous studies have shown that the intestinal microbiota imbalance is accompanied by increased intestinal permeability, which leads to the penetration of aggressive agents through extended intercellular spaces. This is accompanied by the occurrence of subclinical inflammation in the submucosal layer, which results in impaired motor function and increased visceral sensitivity. Thus, the intestinal microflora imbalance is one of the most important factors that form clinical symptoms of IBS. The article substantiates the advantages of using trimebutin, a gastrointestinal tract motility regulator, in functional gastrointestinal diseases from the standpoint of evidence-based medicine. The modern scientific knowledge on the effectiveness of microbiota adjustment in alleviating IBS symptoms is presented. In particular, the double-blind, placebo-controlled study has shown the efficacy of a multi-strain probiotic complex in relieving clinical symptom severity of IBS. The optimal treatment regimen for a patient with IBS should include a drug regulating the gastrointestinal motility and reducing visceral hypersensitivity and a probiotic complex containing bacterial strains that have proved their efficacy in this group of patients.

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The intestinal microbiota changes paradigms in irritable bowel syndrome

Infectio ro ◽

10.26416/inf.50.2.2017.901 ◽

2017 ◽

Vol 2 (50) ◽

Author(s):

Gabriela-Loredana Popa ◽

Silvana-Adelina Gheorghe ◽

Mădălina Preda

Keyword(s):

Irritable Bowel Syndrome ◽

Intestinal Microbiota ◽

Irritable Bowel

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The role of intestinal microbiota in the development of urolithiasis in patients with an irritable bowel syndrome

Ukrainian Therapeutical Journal ◽

10.30978/utj2020-3-29 ◽

2020 ◽

Vol 0 (3) ◽

pp. 29-36

Author(s):

I. A. Derkach ◽

A. E. Dorofeyev ◽

M. M. Rudenko ◽

G. A. Dorofeyeva ◽

Yu. Z. Dynia

Keyword(s):

Irritable Bowel Syndrome ◽

Intestinal Microbiota ◽

Irritable Bowel

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Faculty Opinions recommendation of The role of stress on physiologic responses and clinical symptoms in irritable bowel syndrome.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.8118957.8516055 ◽

2011 ◽

Author(s):

Peter Holzer

Keyword(s):

Irritable Bowel Syndrome ◽

Clinical Symptoms ◽

Irritable Bowel ◽

Physiologic Responses

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Diarrhea Predominant-Irritable Bowel Syndrome (IBS-D): Effects of Different Nutritional Patterns on Intestinal Dysbiosis and Symptoms

Nutrients ◽

10.3390/nu13051506 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1506

Author(s):

Annamaria Altomare ◽

Claudia Di Rosa ◽

Elena Imperia ◽

Sara Emerenziani ◽

Michele Cicala ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Intestinal Microbiota ◽

Gastrointestinal Disorder ◽

Additional Energy ◽

Nutritional Advice ◽

Intestinal Dysbiosis ◽

Gi Symptoms ◽

Mutualistic Relationship ◽

Irritable Bowel ◽

Fodmap Diet

Irritable Bowel Syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by abdominal pain associated with defecation or a change in bowel habits. Gut microbiota, which acts as a real organ with well-defined functions, is in a mutualistic relationship with the host, harvesting additional energy and nutrients from the diet and protecting the host from pathogens; specific alterations in its composition seem to play a crucial role in IBS pathophysiology. It is well known that diet can significantly modulate the intestinal microbiota profile but it is less known how different nutritional approach effective in IBS patients, such as the low-FODMAP diet, could be responsible of intestinal microbiota changes, thus influencing the presence of gastrointestinal (GI) symptoms. The aim of this review was to explore the effects of different nutritional protocols (e.g., traditional nutritional advice, low-FODMAP diet, gluten-free diet, etc.) on IBS-D symptoms and on intestinal microbiota variations in both IBS-D patients and healthy subjects. To date, an ideal nutritional protocol does not exist for IBS-D patients but it seems crucial to consider the effect of the different nutritional approaches on the intestinal microbiota composition to better define an efficient strategy to manage this functional disorder.

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Unraveling the ties between irritable bowel syndrome and intestinal microbiota

World Journal of Gastroenterology ◽

10.3748/wjg.v20.i10.2470 ◽

2014 ◽

Vol 20 (10) ◽

pp. 2470 ◽

Cited By ~ 41

Author(s):

Sung Noh Hong

Keyword(s):

Irritable Bowel Syndrome ◽

Intestinal Microbiota ◽

Irritable Bowel

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Pathogenetic Substantiation of the Therapeutic Impact on Microbiota in Irritable Bowel Syndrome

Russian Journal of Gastroenterology Hepatology Coloproctology ◽

10.22416/1382-4376-2019-29-4-7-14 ◽

2019 ◽

Vol 29 (4) ◽

pp. 7-14

Author(s):

Yu. O. Shulpekova ◽

G. H. Babaeva ◽

V. Yu. Rusyaev

Keyword(s):

Irritable Bowel Syndrome ◽

Intestinal Microbiota ◽

Intestinal Bacteria ◽

Host Cells ◽

Intestinal Microbiome ◽

Bacterial Strains ◽

Blastocystis Hominis ◽

Therapeutic Impact ◽

Irritable Bowel ◽

Positive Effect

Aim. This review aims to describe the nature of changes in the intestinal microbiota in irritable bowel syndrome (IBS) and provide a pathogenetic justification of the feasibility of a therapeutic impact on microbiota. General findings. An important aspect of the interaction of intestinal bacteria with the “host” cells is their contact with pattern recognition receptors of enterocytes, dendritic cell receptors, as well as a transcellular transport of antigens in the region of Peyer’s patches. The area of interaction of intestinal bacteria and the human body is not limited to the intestines. Intestinal bacteria demonstrate a significant humoral effect due to signalling molecules, some of which exhibit neurotransmitter properties. The study of the bacterial cross-feeding for various species, i.e. mutual use of nutrient substrates produced by bacteria of various species, is of a great interest. The development of a lowactivity inflammation in IBS can partly be explained by the increased interaction of flagellin with the corresponding receptor, as well as the influx of excess bacteria from the small intestine. The majority of studies on IBS have demonstrated the predominance of intestinal bacteria with pro-inflammatory potential (Enterobacteriaceae) and the lack of bacteria with a pronounced anti-inflammatory, antimicrobial and enzymatic action (Lactobacillus and Bifidobacterium), as well as increased mucus degradation. Similar changes are observed in inflammatory bowel diseases. Reduced microbial diversity increases susceptibility to intestinal infections and parasitoses, including those caused by protozoa conditionally pathogenic for adults, such as Blastocystis hominis hominis, Dientamoeba fragilis, Giardia lamblia. With the help of nutrition correction, the use of probiotics and functional foods containing certain probiotic strains, plant fibres (primarily psyllium) and, in some cases, nonabsorbable antibiotics, a positive effect can be achieved in a significant number of IBS patients. Recent works have shown that clinical improvement is accompanied by a change in the composition of the intestinal microbiota.Conclusion. For the pathogenetic treatment of irritable bowel syndrome, the use of non-drug treatment is justified, such as diet optimization and prescription of plant fibres and probiotic bacterial strains. The positive effect of such an approach is largely determined by modification of the intestinal microbiota composition. This opens up prospects for a further, more targeted impact on the intestinal microbiome.

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Fecal microbiota Profiling in Irritable Bowel Syndrome and Inflammatory Bowel Disease Patients with Irritable Bowel Syndrome-Type Symptoms

10.21203/rs.3.rs-152044/v1 ◽

2021 ◽

Author(s):

Xiufang Cui ◽

Haiyang Wang ◽

Ziping Ye ◽

Yi Li ◽

Xinyun Qiu ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Irritable Bowel Syndrome ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Intestinal Microbiota ◽

Bowel Disease ◽

Sectional Study ◽

Genus Level ◽

Inflammatory Bowel ◽

Irritable Bowel

Abstract BACKGROUND: The intestinal microbiota is thought to be involved in the occurrence of Inflammatory Bowel Disease in remission (IBDR) with Irritable Bowel Syndrome (IBS)-type symptoms, but the specific distinct profile of these bacteria remains unclear. Therefore, the purpose of this research is to investigate this issue by conducting a cross-sectional study.METHODS: IBS patients were diagnosed according to Rome Ⅳ criteria, IBD diagnosed according to the criteria of European Crohn & Colitis Organization (ECCO), IBDR patients with IBS-type symptoms were defined according to related IBS-type symptoms meeting the Rome IV criteria in IBDR patients, and were included Crohn’s disease in remission (CDR) and ulcerative colitis in remission (UCR) based on Crohn’s Disease Activity Index (DAI) and Mayo Scoring System respectively. Healthy controls come from the physical examination center and exclude people with underlying diseases. All enrolled subjects were divided into six groups, as followed: Health Control, IBS, CDR with IBS-type symptoms (CDR-IBS+), CDR without IBS-type symptoms (CDR-IBS-), UCR-IBS+ and UCR-IBS-. We collected fresh fecal samples from all subjects and applied 16S rRNA sequencing analysis to detect the structure and diversity of the microbiota among different groups. RESULTS: A total of 97 subjects were included in this study, of which 18 were health controls, 34 IBS patients, 25 CDR and 20 UCR. The richness of intestinal microbiota in CDR-IBS-was significantly lower than that in the control and IBS groups based on the analysis of observed species and Chao index (P<0.05). The observed species index in CDR-IBS+ was significantly higher than CDR-IBS- group (median index: 254.8 vs 203, P=0.036). No difference was found in Alpha diversity between UCR-IBS+ and UCR-IBS-. At phylum level, there was no significant difference between UC or CD with IBS-type symptoms and those without related symptoms. At genus level, the number of Faecalibacterium in CDR-IBS+ increased significantly while Fusobacterium decreased compared with CDR-IBS-(mean relative abundance of Faecalibacterium: 20.35% vs 5.18%, P<0.05; Fusobacterium: 1.51% vs 5.2%, P<0.05). However, compared with UCR-IBS - group, the number of Faecalibacterium in UCR-IBS+ group decreased, while the number of Streptococcus increased, but there was no statistical difference in the genus structure. Regardless of the phylum or genus level, the abundance and composition of the microbiota of IBS patients were not distinct from those of healthy people.CONCLUSIONS: CD patients in remission with IBS-type symptoms may be related to the increase of Faecalibacterium and decrease of Fusobacterium. UC patients in remission with IBS-type symptoms cannot be explained by changes in the abundance and structure of intestinal microbiota from our across-sectional study.

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