An article published in the Postgraduate Medicine discussed that irritable bowel syndrome (IBS), characterized by recurrent abdominal pain and disordered bowel habits, is one of the most common functional bowel disorders. This condition poses a substantial burden on both patient health-related quality of life and healthcare costs.

Proposed pathophysiologic mechanisms for the occurrence of IBS include altered gastrointestinal motility, visceral hypersensitivity, changes in gut permeability, immune activation, gut-brain dysregulation, central nervous system dysfunction, and changes in the gut microbiota. The authors reported that both qualitative and quantitative differences have been observed in the gut microbiota of IBS patients relative to the healthy population.

The present article provided an overview of specific interventions with the potential to modulate the gut microbiota in IBS, including elimination diets, prebiotics, probiotics, synbiotics, and non-systemic antibiotics. It has been noted that although probiotics and synbiotics are generally well tolerated, differences in the composition and concentration of different bacterial species and inclusion or exclusion of prebiotic components vary widely across studies and have prevented their use in IBS. Whereas, non-systemic antibiotics, such as rifaximin, have been indicated for the treatment of IBS with diarrhea in adults and have demonstrated efficacy and good tolerance in clinical trials. Meanwhile, more consistent evidence is needed regarding the efficacy and safety of elimination diets, prebiotics, probiotics, and synbiotics in the treatment of patients with IBS.

It was stated that additional well-designed studies are needed that examine alterations in the gut microbiota due to these interventions and their potential associations with clinical symptoms of IBS.