Probiotics and irritable bowel syndrome: Rationale, putative mechanisms, and evidence of clinical efficacy

Research output: Contribution to journalArticle

82 Scopus citations

Abstract

The irritable bowel syndrome (IBS) follows an acute, presumably infectious diarrheal illness in ∼15% of patients. There may be a persistent, mild inflammatory state with changes in mucosal function or structure. Changes in the colonic bacterial flora reported in IBS seem related to predominant bowel. Colonic bacteria normally metabolize nutrients with the formation of gas and short chain fatty acids. The latter may induce propulsive contractions and accelerate colonic transit or they may enhance fluid and sodium absorption in the colon. This review addresses the mechanisms, rationale and current evidence for the efficacy of probiotics, including Lactobacilli, Bifidobacteria, and VSL#3, in the treatment of IBS. The mechanisms influenced by probiotics include immune function, motility, and the intraluminal milieu. Probiotics may suppress the low-grade inflammation associated with IBS or restore normal local immune function. Lactobacilli and Bifidobacteria subspecies are able to deconjugate and absorb bile acids, potentially reducing the colonic mucosal secretion of mucin and fluids that may contribute to functional diarrhea or IBS with diarrhea. Therapeutic trials show the potential benefit of Bifidobacteria or Lactobacilli species alone or in the specific probiotic combination, VSL#3, on symptoms in IBS. Colonic transit was retarded in IBS patients treated with VSL#3 without induction of significant changes in bowel function. In summary, probiotics are promising therapies in IBS.

Original languageEnglish (US)
Pages (from-to)264-269
Number of pages6
JournalJournal of clinical gastroenterology
Volume40
Issue number3
DOIs
StatePublished - Mar 1 2006

Keywords

  • Bifidobacteria
  • Bloating
  • Flatulence
  • Immune
  • Inflammation
  • Irritable bowel syndrome
  • Lactobacilli
  • Probiotics
  • VSL#3

ASJC Scopus subject areas

  • Gastroenterology

Fingerprint Dive into the research topics of 'Probiotics and irritable bowel syndrome: Rationale, putative mechanisms, and evidence of clinical efficacy'. Together they form a unique fingerprint.

  • Cite this