Gut bless you: The microbiota-gut-brain axis in irritable bowel syndrome

Abstract

Irritable bowel syndrome (IBS) is a common clinical label for medically unexplained gastrointestinal symptoms, recently described as a disturbance of the microbiota-gut-brain axis. Despite decades of research, the pathophysiology of this highly heterogeneous disorder remains elusive. However, a dramatic change in the understanding of the underlying pathophysiological mechanisms surfaced when the importance of gut microbiota protruded the scientific picture. Are we getting any closer to understanding IBS' etiology, or are we drowning in unspecific, conflicting data because we possess limited tools to unravel the cluster of secrets our gut microbiota is concealing? In this comprehensive review we are discussing some of the major important features of IBS and their interaction with gut microbiota, clinical microbiota-altering treatment such as the low FODMAP diet and fecal microbiota transplantation, neuroimaging and methods in microbiota analyses, and current and future challenges with big data analysis in IBS.

Keywords: Big data analysis; Irritable bowel syndrome; Machine learning; Microbiota; Microbiota-gut-brain axis; Neurogastroenterology; Structural and functional magnetic resonance imaging.

Figure 1

Integration of multimodal and interdisciplinary approaches for big data analysis in irritable bowel syndrome. Created with BioRender.com. ANS: Autonomic nervous system; CNS: Central nervous system; FODMAP: Fermentable oligosaccharides, disaccharides, monosaccharides and polyols; FMT: Fecal microbiota transplant; 5-HT: 5-hydroxytryptamine (serotonin); SCFAs: Short chain fatty acids; GABA: γ-aminobutyric acid; TLRs: Toll-like receptors.