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.