Topic Highlight
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 21, 2014; 20(27): 8886-8897
Published online Jul 21, 2014. doi: 10.3748/wjg.v20.i27.8886
Intestinal microbiota in pathophysiology and management of irritable bowel syndrome
Kang Nyeong Lee, Oh Young Lee
Kang Nyeong Lee, Oh Young Lee, Department of Internal Medicine, Hanyang University College of Medicine, Seoul 133-791, South Korea
Author contributions: Lee KN performed the literature review and drafted the paper; Lee OY performed the critical revision of the manuscript.
Correspondence to: Oh Young Lee, MD, PhD, Department of Internal Medicine, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 133-791, South Korea. leeoy@hanyang.ac.kr
Telephone: +82-2-22908343 Fax: +82-2-22988314
Received: February 9, 2014
Revised: April 2, 2014
Accepted: June 14, 2014
Published online: July 21, 2014
Processing time: 162 Days and 9 Hours
Abstract

Irritable bowel syndrome (IBS) is a functional bowel disorder without any structural or metabolic abnormalities that sufficiently explain the symptoms, which include abdominal pain and discomfort, and bowel habit changes such as diarrhea and constipation. Its pathogenesis is multifactorial: visceral hypersensitivity, dysmotility, psychosocial factors, genetic or environmental factors, dysregulation of the brain-gut axis, and altered intestinal microbiota have all been proposed as possible causes. The human intestinal microbiota are composed of more than 1000 different bacterial species and 1014 cells, and are essential for the development, function, and homeostasis of the intestine, and for individual health. The putative mechanisms that explain the role of microbiota in the development of IBS include altered composition or metabolic activity of the microbiota, mucosal immune activation and inflammation, increased intestinal permeability and impaired mucosal barrier function, sensory-motor disturbances provoked by the microbiota, and a disturbed gut-microbiota-brain axis. Therefore, modulation of the intestinal microbiota through dietary changes, and use of antibiotics, probiotics, and anti-inflammatory agents has been suggested as strategies for managing IBS symptoms. This review summarizes and discusses the accumulating evidence that intestinal microbiota play a role in the pathophysiology and management of IBS.

Keywords: Immunity; Irritable bowel syndrome; Microbiota; Permeability; Probiotics

Core tip: Irritable bowel syndrome (IBS) is a functional bowel disorder with multiple pathophysiology, which is not fully understood. Intestinal microbiota has recently been postulated to be involved in the pathophysiology of IBS. Many studies of IBS focus on investigating the efficacy of modulating the microbiota by probiotics and antibiotics. However, the role of the intestinal microbiota in the pathophysiology and management of IBS is not clear. This review provides the accumulating evidence on it.