title: Gut microbiota role in irritable bowel syndrome: New therapeutic strategies.
abstract: In the last decade the impressive expansion of our knowledge of the vast microbial community that resides in the human intestine, the gut microbiota, has provided support to the concept that a disturbed intestinal ecology might promote development and maintenance of symptoms in irritable bowel syndrome (IBS). As a correlate, manipulation of gut microbiota represents a new strategy for the treatment of this multifactorial disease. A number of attempts have been made to modulate the gut bacterial composition, following the idea that expansion of bacterial species considered as beneficial (Lactobacilli and Bifidobacteria) associated with the reduction of those considered harmful (Clostridium, Escherichia coli, Salmonella, Shigella and Pseudomonas) should attenuate IBS symptoms. In this conceptual framework, probiotics appear an attractive option in terms of both efficacy and safety, while prebiotics, synbiotics and antibiotics still need confirmation. Fecal transplant is an old treatment translated from the cure of intestinal infective pathologies that has recently gained a new life as therapeutic option for those patients with a disturbed gut ecosystem, but data on IBS are scanty and randomized, placebo-controlled studies are required.
authors.affiliation: Eleonora Distrutti, Lorenzo Monaldi, S.C. di Gastroenterologia ed Epatologia, Azienda Ospedaliera di Perugia, 06100 Perugia, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Distrutti
authors.affiliation: Eleonora Distrutti, Lorenzo Monaldi, S.C. di Gastroenterologia ed Epatologia, Azienda Ospedaliera di Perugia, 06100 Perugia, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Monaldi
authors.affiliation: Eleonora Distrutti, Lorenzo Monaldi, S.C. di Gastroenterologia ed Epatologia, Azienda Ospedaliera di Perugia, 06100 Perugia, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Ricci
authors.affiliation: Eleonora Distrutti, Lorenzo Monaldi, S.C. di Gastroenterologia ed Epatologia, Azienda Ospedaliera di Perugia, 06100 Perugia, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Fiorucci
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000254:growth & development*; D000069467:Fecal Microbiota Transplantation; D000069196:Gastrointestinal Microbiome; D054884:Host-Pathogen Interactions; D006801:Humans; D007422:Intestines / Q000382:microbiology*; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D056692:Prebiotics; D019936:Probiotics / Q000627:therapeutic use; D058616:Synbiotics; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D056692:Prebiotics
keywords: Antibiotics; Fecal transplantation; Gut microbiota; Irritable bowel syndrome; Prebiotics; Probiotics; Synbiotics