Pro- and Prebiotics in Management of Patients with Irritable Bowel Syndrome
Ratnakar Shukla, Ujjala Ghoshal and Uday C. Ghoshal
from: Probiotics and Prebiotics: Current Research and Future Trends (Edited by: Koen Venema and Ana Paula do Carmo). Caister Academic Press, U.K. (2015) Pages: 407-416.
Recently, several studies suggested that altered quantity and quality in gut microbiota, called dysbiosis, are important in the pathogenesis of irritable bowel syndrome (IBS). It is therefore worthwhile to evaluate whether therapeutic manipulation of the gut microbiota using probiotics would be effective and safe in management of these patients. Several studies showed that probiotics are effective in manipulation of altered gut microbiota and in improving the global IBS symptoms. Probiotics reduce visceral hypersensitivity, improve colonic transit time, enhance the intestinal epithelial barrier, modulate immune response via production anti-inflammatory and regulatory cytokines, and thus, inhibit the inflammation. Prebiotics, which are sometimes added to probiotics (symbiotics) improve the fermentation pattern, stool consistency, abdominal pain and bloating and flatulence in patients with IBS. Several meta-analyses have confirmed the efficacy of probiotics in management of IBS. Hence, it can be concluded that probiotics are useful in treatment of IBS, particularly diarrhea predominant subtypes, and most studies showed that abdominal pain, bloating and flatulence are the symptoms, which were relieved most read more ...