title: Intestinal microbiota and diet in IBS: causes, consequences, or epiphenomena?
abstract: Irritable bowel syndrome (IBS) is a heterogeneous functional disorder with a multifactorial etiology that involves the interplay of both host and environmental factors. Among environmental factors relevant for IBS etiology, the diet stands out given that the majority of IBS patients report their symptoms to be triggered by meals or specific foods. The diet provides substrates for microbial fermentation, and, as the composition of the intestinal microbiota is disturbed in IBS patients, the link between diet, microbiota composition, and microbial fermentation products might have an essential role in IBS etiology. In this review, we summarize current evidence regarding the impact of diet and the intestinal microbiota on IBS symptoms, as well as the reported interactions between diet and the microbiota composition. On the basis of the existing data, we suggest pathways (mechanisms) by which diet components, via the microbial fermentation, could trigger IBS symptoms. Finally, this review provides recommendations for future studies that would enable elucidation of the role of diet and microbiota and how these factors may be (inter)related in the pathophysiology of IBS.
authors.affiliation: Department of Biochemical Engineering and Biotechnology, Faculty of Technology and Metallurgy, University of Belgrade, Belgrade, Serbia.
authors.forename: Mirjana
authors.initials: M
authors.lastname: Rajilić-Stojanović
authors.affiliation: Division Gastroenterology-Hepatology, School for Nutrition, Toxicology and Metabolism (NUTRIM), Maastricht University Medical Center+, Maastricht, The Netherlands.
authors.forename: Daisy M
authors.initials: DM
authors.lastname: Jonkers
authors.affiliation: Immunobiology Research Programme, Department of Bacteriology and Immunology, University of Helsinki, Helsinki, Finland.
authors.forename: Anne
authors.initials: A
authors.lastname: Salonen
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: Kurt
authors.initials: K
authors.lastname: Hanevik
authors.affiliation: Department Microbiology and Immunology, KU Leuven, Leuven, Belgium.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Raes
authors.affiliation: Department of Veterinary Biosciences, Microbiology, University of Helsinki, Helsinki, Finland.
authors.forename: Jonna
authors.initials: J
authors.lastname: Jalanka
authors.affiliation: 1] Immunobiology Research Programme, Department of Bacteriology and Immunology, University of Helsinki, Helsinki, Finland [2] Department of Veterinary Biosciences, Microbiology, University of Helsinki, Helsinki, Finland [3] Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands.
authors.forename: Willem M
authors.initials: WM
authors.lastname: de Vos
authors.affiliation: Digestive System Research Unit, University Hospital Vall d'Hebron, Ciberehd, Barcelona, Spain.
authors.forename: Chaysavanh
authors.initials: C
authors.lastname: Manichanh
authors.affiliation: Laboratory for Molecular Microbiology, Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Belgrade, Serbia.
authors.forename: Natasa
authors.initials: N
authors.lastname: Golic
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tìbingen, Germany.
authors.forename: Paul
authors.initials: P
authors.lastname: Enck
authors.affiliation: Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus.
authors.forename: Elena
authors.initials: E
authors.lastname: Philippou
authors.affiliation: Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Fuad A
authors.initials: FA
authors.lastname: Iraqi
authors.affiliation: Department of Psychiatry and Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland.
authors.forename: Gerard
authors.initials: G
authors.lastname: Clarke
authors.affiliation: Nottingham Digestive Diseases Biomedical Research Unit, University of Nottingham, Queens Medical Centre, Nottingham, UK.
authors.forename: Robin C
authors.initials: RC
authors.lastname: Spiller
authors.affiliation: Department of Medical Microbiology, School for Nutrition, Toxicology and Metabolism (NUTRIM), Maastricht University Medical Center+, Maastricht, The Netherlands.
authors.forename: John
authors.initials: J
authors.lastname: Penders
mesh_terms: D005247:Feeding Behavior; D005285:Fermentation / Q000502:physiology; D006801:Humans; D007422:Intestines / Q000382:microbiology / Q000503:physiopathology*; D043183:Irritable Bowel Syndrome / Q000209:etiology / Q000382:microbiology / Q000503:physiopathology*; D064307:Microbiota / Q000502:physiology*