Crucillà Salvatore, Caldart Federico, Michelon Marco, Marasco Giovanni, Costantino Andrea
Gastroenterology B Unit, Pancreas Center, University of Verona, 37134 Verona, Italy.
Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.
Microorganisms. 2024 Aug 14;12(8):1669. doi: 10.3390/microorganisms12081669.
(1) Background: Functional abdominal bloating and distension (FAB/FAD) are common disorders of the gut-brain interaction. Their physiopathology is complex and not completely clarified, although gut microbiota imbalances play a central role. The treatment of FAB/FAD still represents a clinical challenge for both patients and healthcare providers. Gut microbiota modulation strategies might play a crucial role in their management. The aim of this narrative review was to update the current evidence on FAB/FAD, with a focus on gut microbiota. (2) Methods: In October 2023, a review was conducted through the Medline, PubMed, and Embase databases. Selected literature included all available English-edited studies (randomized controlled trials and cross-sectional, cohort, and case-control studies). (3) Results: Twelve studies were selected, most of which investigated the relationship between IBS and microbiota, with bloating being one of its symptoms. The studies suggest that restoring a balanced microbiome appears to be the most promising solution for better management of FAB/FAD. Targeted approaches, such as the use of probiotics, prebiotics, antibiotics such as rifaximin or dietary modifications, may hold the key to alleviating symptoms. Other therapeutic options, such as diet, neuromodulators, and brain-gut behavioral therapies (i.e., cognitive-behavioral therapy) have shown promising outcomes, but strong data are still lacking. (4) Conclusions: Targeted approaches that focus on the gut microbiota, such as the use of probiotics, prebiotics, and antibiotics, are essential in managing FAB/FAD. Understanding the complex relationship between gut microbiota and FAB/FAD is crucial for developing effective treatments. Further studies are needed to explore the specific roles of different microbial populations in patients with FAB/FAD to enhance therapeutic strategies.
（1）背景：功能性腹胀和腹部膨胀（FAB/FAD）是肠脑互动的常见疾病。其生理病理学复杂且尚未完全阐明，尽管肠道微生物群失衡起着核心作用。FAB/FAD的治疗对患者和医疗服务提供者来说仍是一项临床挑战。肠道微生物群调节策略可能在其管理中发挥关键作用。本叙述性综述的目的是更新关于FAB/FAD的现有证据，重点关注肠道微生物群。（2）方法：2023年10月，通过Medline、PubMed和Embase数据库进行了一项综述。所选文献包括所有可用的英文编辑研究（随机对照试验以及横断面、队列和病例对照研究）。（3）结果：选取了12项研究，其中大多数研究了肠易激综合征与微生物群之间的关系，腹胀是其症状之一。研究表明，恢复平衡的微生物群似乎是更好管理FAB/FAD最有前景的解决方案。有针对性的方法，如使用益生菌、益生元、利福昔明等抗生素或饮食调整，可能是缓解症状的关键。其他治疗选择，如饮食、神经调节剂和脑肠行为疗法（即认知行为疗法）已显示出有前景的结果，但仍缺乏有力数据。（4）结论：针对肠道微生物群的有针对性方法，如使用益生菌、益生元和抗生素，对管理FAB/FAD至关重要。了解肠道微生物群与FAB/FAD之间的复杂关系对于开发有效治疗方法至关重要。需要进一步研究以探索不同微生物群体在FAB/FAD患者中的具体作用，以加强治疗策略。
