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A review of the role of the gut microflora in irritable bowel syndrome and the effects of probiotics

Published online by Cambridge University Press:  09 March 2007

J. A. J. Madden  and
J. O. Hunter
J. A. J. Madden
Affiliation:
Gastroenterology Research Unit, Unit E7, Box 201 A, Addenbrookes NHS Trust, Hillņs Road, Cambridge CB2 2QQ, UK
J. O. Hunter*
Affiliation:
Gastroenterology Research Unit, Unit E7, Box 201 A, Addenbrookes NHS Trust, Hillņs Road, Cambridge CB2 2QQ, UK
*
*Corresponding author: Dr J. O. Hunter, fax +44 1223 211443, email john.hunter@addenbrookes.nhs.uk
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Abstract

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Irritable bowel syndrome (IBS) is a multi-factorial gastrointestinal condition affecting 8–22 % of the population with a higher prevalence in women and accounting for 20–50 % of referrals to gastroenterology clinics. It is characterised by abdominal pain, excessive flatus, variable bowel habit and abdominal bloating for which there is no evidence of detectable organic disease. Suggested aetiologies include gut motility and psychological disorders, psychophysiological phenomena and colonic malfermentation. The faecal microflora in IBS has been shown to be abnormal with higher numbers of facultative organisms and low numbers of lactobacilli and bifidobacteria. Although there is no evidence of food allergy in IBS, food intolerance has been identified and exclusion diets are beneficial to many IBS patients. Food intolerance may be due to abnormal fermentation of food residues in the colon, as a result of disruption of the normal flora. The role of probiotics in IBS has not been clearly defined. Some studies have shown improvements in pain and flatulence in response to probiotic administration, whilst others have shown no symptomatic improvement. It is possible that the future role of probiotics in IBS will lie in prevention, rather than cure.

Keywords

Gut microfloraIrritable bowel syndromeProbioticsFermentation
Type
Research Article
Information
British Journal of Nutrition , Volume 88 , Issue S1 , September 2002 , pp. s67 - s72
Copyright
Copyright © The Nutrition Society 2002

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