Exploring Gut Microbiota Imbalance in Irritable Bowel Syndrome: Potential Therapeutic Effects of Probiotics and Their Metabolites

Abstract

Irritable bowel syndrome is a common functional gastrointestinal disorder characterized by recurrent abdominal discomfort, bloating, cramping, flatulence, and changes in bowel movements. The pathophysiology of IBS involves a complex interaction between motor, sensory, microbiological, immunological, and psychological factors. Diversity, stability, and metabolic activity of the gut microbiota are frequently altered in IBS, thus leading to a situation of gut dysbiosis. Therefore, the use of probiotics and probiotic-derived metabolites may be helpful in balancing the gut microbiota and alleviating irritable bowel syndrome symptoms. This review aimed to report and consolidate recent progress in understanding the role of gut dysbiosis in the pathophysiology of IBS, as well as the current studies that have focused on the use of probiotics and their metabolites, providing a foundation for their potential beneficial effects as a complementary and alternative therapeutic strategy for this condition due to the current absence of effective and safe treatments.

Keywords: Irritable bowel syndrome; gastrointestinal; metabolites; probiotics; symptoms; treatment.

Figure 1

Pathophysiology of the IBS. The pathophysiology of IBS involves the interaction of psychological, genetic, microbiological, neurological, and immunological factors, which contribute to symptoms, dysbiosis, motility alterations, and immune dysregulation. IBS, Irritable Bowel Syndrome [9,10,13,14,15,17,18,19,20,25,26,28,29,30,31,32,38,39].

Figure 2

Beneficial effects of probiotics in managing IBS through modulation of the gut microbiota. Probiotics improve intestinal motility, balance inflammatory responses, reduce visceral hypersensitivity, and regulate stress and microbiota-gut-brain axis. IBS, irritable bowel syndrome; IBS-C, IBS-predominant constipation; IBS-D, predominant diarrhea [56,58,59,61,62,63,66,67,71,72,73,74,75,76,83,84,85,86,87,88,89,90].

Figure 3

Effects of gut microbiota-derived metabolites, such as vitamins, SCFA, BAs, and neurotransmitters, on the regulation of the gut-brain axis, gut homeostasis, and IBS-associated symptoms. IBS, Irritable Bowel Syndrome; BAs, Bile Acids; SCFA, Short-Chain Fatty Acids [61,102,103,104,105,108,109,110,112,115,117,118,119,120,121,122,123,124,125,126,127,128,129,130,131,132,133,134,135,136,137,138,139,140,141,142,143,144,145,146,147,148,149,150,151,152,153,154,155,156,157,158,159,160,161,162,163].