The role of intestinal microbiota and microbial metabolites in the development of functional constipation

Abstract

The main link in the pathogenesis of functional constipation (FC) with slow intestinal transit is a decrease in the motor function of the colon. Data from experimental and clinical studies indicate that the gut microbiota is involved in the regulation of colonic motility through various mechanisms. At the same time, the study of the molecular processes underlying the influence of the intestinal microbiota and its metabolites on the motor function of the colon is at an early stage. The review analyzes the literature on the role of intestinal microbiota in the development of FD, presents data on the mechanisms of action of various microbial metabolites on the motor and secretory function of the colon, and briefly describes new approaches to the treatment of FD based on modulating the composition of the intestinal microflora. FZ is accompanied by specific changes in the composition of the intestinal microbiota, and in recent years, researchers have established cause-and-effect relationships between certain enterotypes and the development of FZ. To date, the main microbial metabolites have been identified that have a stimulating or inhibitory effect on propulsive peristalsis, as well as on the intensity of secretion of anions and water by colonocytes. Approaches to optimizing the composition of the microbiota in FZ are based on the use of pro- and prebiotics, antibiotics, as well as the use of intestinal microbiota transplantation. A deeper understanding of the molecular mechanisms mediating the influence of the microbiota and its metabolites on colonic motor function may serve as the basis for the development of new approaches to the treatment of FZ.