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肠易激综合征中的生态失调。

Dysbiosis in Irritable Bowel Syndrome.

机构信息

Consultant Gastroenterologist, P. D. Hinduja Hospitals, Mumbai, Maharashtra, India, Corresponding Author.

Consultant Gastroenterologist, KIMS Hospital, Secunderabad, Telangana, India.

出版信息

J Assoc Physicians India. 2023 Sep;71(9):75-81. doi: 10.59556/japi.71.0353.


DOI:10.59556/japi.71.0353
PMID:38700306
Abstract

The human gut microbiota fosters the development of a dynamic group of microorganisms impacted by diverse variables that include genetics, diet, infection, stress, ingested drugs, such as antibiotics and small intestine bacterial overgrowth (SIBO) as well as the gut microbiota itself. These factors may influence the change in microbial composition, which results in dysbiosis (microbial imbalance) and exposes the gut to pathogenic insults. Dysbiosis is incidental to the etiology of inflammatory diseases such as irritable bowel syndrome (IBS) and metabolic diseases, including type 2 diabetes and obesity. IBS exhibits different symptoms like abdominal pain or discomfort, distention/bloating, and flatulence. To treat IBS, modification of dysregulated gut microbiota can be done using treatment strategies like a low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet, antibiotics that cannot be absorbed like rifaximin and neomycin, probiotics and prebiotics, and fecal microbiota transplantation (FMT). The remedial modalities in the existing literature have been demonstrated to be efficacious in the prevention and mitigation of IBS. Additionally, newer curative approaches with serum-derived bovine immunoglobulin (SBI) are an effective option. The focal point of the review paper is the pathophysiology of IBS, mainly due to dysbiosis and the various factors that advance dysbiosis. Here, we have also discussed the different treatment strategies targeting dysbiosis that effectively treat IBS. How to cite this article: Abraham P, Pratap N. Dysbiosis in Irritable Bowel Syndrome. J Assoc Physicians India 2023;71(9):75-81.

摘要

人类肠道微生物群促进了一组动态微生物的发展,这些微生物受到多种变量的影响,包括遗传、饮食、感染、压力、摄入的药物,如抗生素和小肠细菌过度生长(SIBO)以及肠道微生物群本身。这些因素可能会影响微生物组成的变化,导致菌群失调(微生物失衡),使肠道容易受到病原体的侵袭。菌群失调是炎症性疾病(如肠易激综合征(IBS))和代谢性疾病(包括 2 型糖尿病和肥胖症)病因的一个附带问题。IBS 表现出不同的症状,如腹痛或不适、腹胀/膨隆和胀气。为了治疗 IBS,可以通过使用治疗策略来调节失调的肠道微生物群,例如低可发酵寡糖、双糖、单糖和多元醇(FODMAP)饮食、不能被吸收的抗生素,如利福昔明和新霉素、益生菌和益生元,以及粪便微生物群移植(FMT)。现有文献中的补救方法已被证明可有效预防和缓解 IBS。此外,血清源性牛免疫球蛋白(SBI)等更新的治疗方法也是一种有效的选择。综述论文的重点是 IBS 的病理生理学,主要是由于菌群失调和促进菌群失调的各种因素。在这里,我们还讨论了针对有效治疗 IBS 的菌群失调的不同治疗策略。

如何引用本文:Abraham P, Pratap N. 肠易激综合征中的菌群失调。印度医师协会杂志 2023;71(9):75-81.

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