Stern Emily K, Brenner Darren M
Division of Gastroenterology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Clin Transl Gastroenterol. 2018 Feb 15;9(2):e134. doi: 10.1038/ctg.2018.2.
Irritable bowel syndrome (IBS) is a common, heterogeneous disorder characterized by abdominal pain associated with changes in bowel habits. The pathogenesis of IBS is multifactorial and may relate to alterations in the gut microbiota, changes in visceral sensation and motility, and genetic and environmental factors. Administration of systemic antibiotics may increase the risk of IBS by altering gastrointestinal homeostasis. Therapeutic interventions for IBS with diarrhea that are thought to target alterations in the gut microbiota include the nonsystemic antibiotic rifaximin, the medical food serum-derived bovine immunoglobulin, prebiotics, probiotics, and dietary modification. SYN-010 is a modified-release statin formulation that reduces methane production by Methanobrevibacter smithii and is currently in development for the treatment of patients with constipation-predominant IBS. Use of these interventions in the management of patients with IBS may function to restore a healthy gut microbiota and ameliorate symptoms of IBS.
肠易激综合征(IBS)是一种常见的异质性疾病,其特征为腹痛并伴有排便习惯改变。IBS的发病机制是多因素的,可能与肠道微生物群的改变、内脏感觉和运动的变化以及遗传和环境因素有关。全身性抗生素的使用可能通过改变胃肠道稳态而增加患IBS的风险。被认为针对肠道微生物群改变的腹泻型IBS治疗干预措施包括非全身性抗生素利福昔明、医用食品血清来源的牛免疫球蛋白、益生元、益生菌和饮食调整。SYN-010是一种缓释他汀制剂,可减少史氏甲烷短杆菌产生甲烷,目前正在开发用于治疗以便秘为主的IBS患者。在IBS患者管理中使用这些干预措施可能有助于恢复健康的肠道微生物群并改善IBS症状。