Impact of Microbiota on Irritable Bowel Syndrome Pathogenesis and Management: A Narrative Review

Abstract

Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder, affecting 3-5% of the global population and significantly impacting patients' quality of life and healthcare resources. Alongside physical symptoms such as abdominal pain and altered bowel habits, many individuals experience psychological comorbidities, including anxiety and depression. Recent research has highlighted the critical role of the gut microbiota in IBS, with dysbiosis, characterized by an imbalance in microbial diversity, frequently observed in patients. The gut-brain axis, a bidirectional communication network between the gut and central nervous system, plays a central role in the development of IBS symptoms. Although interventions such as probiotics, prebiotics, synbiotics, and fecal microbiota transplantation (FMT) have demonstrated potential in modulating the gut microbiota and alleviating symptoms, their efficacy remains an area of ongoing investigation. This review examines the interactions between the gut microbiota, immune system, and brain, emphasizing the need for personalized therapeutic strategies. Future research should aim to identify reliable microbiota-based biomarkers for IBS and refine microbiome-targeted therapies to enhance patient outcomes.

Keywords: disorders of gut brain interaction (DGBI); gut–brain axis; irritable bowel syndrome; microbiota.

Figure 1

Microbiota alterations in IBS. (The figure is adapted with modifications from Surdea-Blaga et al., 2024, Microbiome in irritable bowel syndrome: advances in the field—A scoping review [25]).

Figure 2

An overview of suggested factors involved in IBS.

Figure 3

Summary of the mechanisms of action of different therapeutic approaches for IBS.