%0 Journal Article
%T The Gut Microbiota and Irritable Bowel Syndrome: Friend or Foe?
%A Uday C. Ghoshal
%A Ratnakar Shukla
%A Ujjala Ghoshal
%A Kok-Ann Gwee
%A Siew C. Ng
%A Eamonn M. M. Quigley
%J International Journal of Inflammation
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/151085
%X Progress in the understanding of the pathophysiology of irritable bowel syndrome (IBS), once thought to be a purely psychosomatic disease, has advanced considerably and low-grade inflammation and changes in the gut microbiota now feature as potentially important. The human gut harbours a huge microbial ecosystem, which is equipped to perform a variety of functions such as digestion of food, metabolism of drugs, detoxification of toxic compounds, production of essential vitamins, prevention of attachment of pathogenic bacteria to the gut wall, and maintenance of homeostasis in the gastrointestinal tract. A subset of patients with IBS may have a quantitative increase in bacteria in the small bowel (small intestinal bacterial overgrowth). Qualitative changes in gut microbiota have also been associated with IBS. Targeting the gut microbiota using probiotics and antibiotics has emerged as a potentially effective approach to the treatment of this, hitherto enigmatic, functional bowel disorder. The gut microbiota in health, quantitative and qualitative microbiota changes, and therapeutic manipulations targeting the microbiota in patients with IBS are reviewed in this paper. 1. Introduction Functional bowel disorders, including irritable bowel syndrome (IBS), are common gastrointestinal disorders all over the world. Previously, IBS was thought to be a psychosomatic disorder. However, in the last few decades, advances in our understanding of the pathophysiology of IBS have revealed several factors, including alterations in the microbiota, as potentially relevant to the cause of this syndrome and the precipitation of its symptoms. Indeed, alterations in the gut microbiota are being increasingly implicated in the pathogenesis of several gastrointestinal and systemic diseases. We wish, therefore, to review the gut microbiota and its alterations in, and relationships to, IBS. 2. Gut Microbiota in Health The human gut harbours a huge microbial ecosystem, which is equipped to perform a variety of functions such as the digestion of food, metabolism of the drugs, detoxification of toxic compounds, production of essential vitamins, prevention of attachment of pathogenic bacteria to the gut wall and maintenance of homeostasis in the gastrointestinal tract (GIT) [1¨C3]. The human gut is first colonized at birth; this microbiota gradually increases in size and diversity up to the end of the first year of life; by that time, the gut microbiota has come to resemble that of the adult and remains relatively stable thereafter [4]. The composition of the gut microbiota varies
%U http://www.hindawi.com/journals/iji/2012/151085/