King's College London, School of Medicine, Diabetes and Nutritional Sciences Division, London, UK.
Curr Opin Clin Nutr Metab Care. 2011 Nov;14(6):581-7. doi: 10.1097/MCO.0b013e32834b8082.
Irritable bowel syndrome (IBS) is a common disorder of the gastrointestinal tract, about which there has been considerable recent research. The aim of this article is to briefly review the aspects of IBS pathogenesis that involve the gastrointestinal microbiota, and then to critically appraise the recent and emerging evidence for the use of probiotics and prebiotics in its management.
The increased risk of developing IBS following gastroenteritis and the co-existence of dysbiosis, elevated luminal gas production and immune activation, indicate that the gastrointestinal microbiota may be a therapeutic target in IBS. Most systematic reviews indicate that probiotics have a beneficial impact on global IBS symptoms, abdominal pain and flatulence. However, recent trials indicate that different probiotics can improve, have no effect, or even worsen symptoms, confirming that benefits are likely to be strain and symptom-specific. There are no recent clinical trials of prebiotics in IBS, although previous studies indicate potential benefit at lower doses.
Clearly, some probiotics have considerable potential in the management of IBS; however, the benefits are likely to be strain-specific. Preliminary studies suggest low doses of prebiotics may improve symptoms of IBS, although further robust clinical trials are required.
肠易激综合征（IBS）是一种常见的胃肠道疾病，最近有大量相关研究。本文旨在简要综述涉及胃肠道微生物群的 IBS 发病机制方面，并批判性地评价益生菌和益生元在其治疗中的最新和新兴证据。
肠胃炎后发生 IBS 的风险增加，以及肠道菌群失调、腔内气体产生增加和免疫激活共存，表明胃肠道微生物群可能是 IBS 的治疗靶点。大多数系统评价表明益生菌对 IBS 的整体症状、腹痛和腹胀有有益影响。然而，最近的试验表明，不同的益生菌可以改善、没有效果，甚至恶化症状，这证实了益处可能与菌株和症状特异性有关。目前尚无益生菌治疗 IBS 的临床试验，尽管先前的研究表明低剂量可能有潜在益处。
显然，一些益生菌在 IBS 的治疗中有很大的潜力；然而，益处可能与菌株特异性有关。初步研究表明，低剂量的益生元可能改善 IBS 症状，但需要进一步进行严格的临床试验。
