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Altered gut microbiota as a possible cause of IBS - Harmful bacteria increased in IBS, protective bacteria decreased.
      04/09/19 01:59 PM

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Harmful bacteria increased in IBS, protective bacteria decreased

Pittayanon R, et al. Gastroenterology. 2019;10.1053/j.gastro.2019.03.049.
April 2, 2019

Although diversity of the gut microbiota in patients with irritable bowel syndrome was similar to controls, a systematic review published in Gastroenterology identified specific bacteria that were either present or protective in IBS.

Paul Moayyedi, PhD, MPH, AGAF, of the division of gastroenterology at McMaster University in Canada, and colleagues wrote that research over the last 10 years has positioned an altered gut microbiota as a possible cause of IBS.

“The previous observational studies have demonstrated that the change of intestinal microbiota as a result of acute gastroenteritis is associated with an increased risk of subsequent development of IBS,” they wrote. “However, the data on specific bacterial groups in IBS is conflicting and still inconclusive.”

Researchers searched databases for case-control studies that compared the fecal or colon microbiomes of adult or pediatric patients with IBS with microbiomes of healthy individuals. They were looking for specific differences in gut microbes between the groups of patients.

In their analysis of 24 studies, investigators identified several harmful bacteria that were increased in patients with IBS, including family Enterobacteriaceae, family Lactobacillaceae, and genus Bacteroides. The presence of these different kinds of bacteria could be due to a number of factors, including previous infection and inflammation.

Moayyedi and colleagues wrote that their most consistent findings were groups of protective bacteria like Clostridiales I, Facalibacterium and genus Bifiobacterium were decreased in patients with IBS compared with controls.

The built-in limitations of the studies included in the review led to a lack of consistency in the results. Moayyedi and colleagues wrote that future studies should describe variables such as antibiotic use and diet and use standardized practice for sample storage and DNA extraction.

“This review highlights the heterogeneity of the microbiota in IBS patients; however, proposes some evidence that certain bacteria may be helpful in IBS treatment,” they concluded.

Article in Press
Gut Microbiota in Patients With Irritable Bowel Syndrome"a Systematic Review
Rapat Pittayanon1,2
, Jennifer T. Lau1
, Yuhong Yuan1
, Grigorios I. Leontiadis1
, Frances Tse1
, Michael Surette1
, Paul Moayyedi1,∗,'Correspondence information about the author Paul MoayyediEmail the author Paul Moayyedi
PlumX Metrics
showArticle Info


Background & Aims

Irritable bowel syndrome (IBS) is common but difficult to treat. Altering the gut microbiota has been proposed as a strategy for treatment of IBS, but the association between the gut microbiome and IBS symptoms has not been well established. We performed a systematic review to explore evidence for this association.

We searched databases, including MEDLINE, EMBASE, Cochrane CDSR, and CENTRAL, through April 2, 2018 for case"control studies comparing the fecal or colon microbiomes of adult or pediatric patients with IBS with microbiomes of healthy individuals (controls). The primary outcome was differences in specific gut microbes between patients with IBS and controls.

The search identified 2631 citations; 24 studies from 22 articles were included. Most studies evaluated adults presenting with various IBS subtypes. Family Enterobacteriaceae (phylum Proteobacteria), family Lactobacillaceae, and genus Bacteroides were increased in patients with IBS compared with controls, whereas uncultured Clostridiales I, genus Faecalibacterium (including Faecalibacterium prausnitzii), and genus Bifidobacterium were decreased in patients with IBS. The diversity of the microbiota was either decreased or not different in IBS patients compared with controls. More than 40% of included studies did not state whether cases and controls were comparable (did not describe sex and/or age characteristics).

In a systematic review, we identified specific bacteria associated with microbiomes of patients with IBS vs controls. Studies are needed to determine whether these microbes are a product or cause of IBS.

Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

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