Ann Nutr Metab. 2018;72(4):296-306. doi: 10.1159/000488773. Epub 2018 Apr 25.
Functional bowel disorders (FBD) resemble a group of diseases of the gastrointestinal (GI) tract that are without a clear pathogenesis; the best known is probably the "irritable bowel syndrome" (IBS). Only recently we have been able to explore the role of the gut microbiota in FBD due to progress in microbiological analytic techniques. There are different ways to explore the role of the gut microbiota and its dysbiosis in FBD. Comparison of the microbial composition in a group of patients with FBD, for example, with IBS to a group of healthy volunteers is one way. Studies have shown that the microbiota in FBD is different from that of healthy controls, but the recorded differences are not necessarily specific for FBD, they may also occur in other diseases. Another approach to explore the role of the gut microbiota in FBD is to challenge the existing "flora" with novel bacteria (probiotics) or with nutritional substrates that stimulate bacterial growth (prebiotics). More than 60 such trials including several thousand patients have been performed in IBS. These studies have produced mixed outcome: some probiotics appear to be better than others, and some appear to work only for a part of the IBS symptoms and not for all. An extreme form of this approach is the transfer of an entire microbiota from 1 healthy person to another, called fecal microbiota transplantation. This has rarely been tested in FBD but is not without risk in benign disorders.
功能性肠病（FBD）类似于一组无明确发病机制的胃肠道（GI）疾病；其中最著名的可能是“肠易激综合征”（IBS）。由于微生物分析技术的进步，我们最近才能够探索肠道微生物群在 FBD 中的作用。有几种方法可以探索肠道微生物群及其在 FBD 中的失调作用。例如，将一组 FBD 患者的微生物组成与一组健康志愿者进行比较是一种方法。研究表明，FBD 中的微生物群与健康对照组不同，但记录到的差异不一定是 FBD 特异性的，它们也可能发生在其他疾病中。另一种探索肠道微生物群在 FBD 中作用的方法是用新型细菌（益生菌）或刺激细菌生长的营养底物（益生元）来挑战现有的“菌群”。已经在 IBS 中进行了超过 60 项这样的试验，包括数千名患者。这些研究的结果喜忧参半：一些益生菌似乎比其他益生菌更好，一些益生菌似乎只对 IBS 症状的一部分有效，而不是全部。这种方法的极端形式是将来自 1 个健康人的整个微生物群转移到另一个人身上，称为粪便微生物群移植。这在 FBD 中很少被测试，但在良性疾病中并非没有风险。
