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Modification of the Gut Microbiome to Maintain Health or Treat Disease| Volume 146, ISSUE 6, P1554-1563, May 01, 2014

Manipulation of the Microbiota for Treatment of IBS and IBD—Challenges and Controversies

  • Fergus Shanahan
    Correspondence
    Reprint requests Address requests for reprints to: Fergus Shanahan, MD, DSc, Alimentary Pharmabiotic Centre, University College Cork, National University of Ireland, Cork, Ireland. fax: (353) 21-4345300.
    Affiliations
    Alimentary Pharmabiotic Centre, University College Cork, National University of Ireland, Cork, Ireland

    Department of Medicine, University College Cork, National University of Ireland, Cork, Ireland
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  • Eamonn M.M. Quigley
    Affiliations
    Alimentary Pharmabiotic Centre, University College Cork, National University of Ireland, Cork, Ireland

    Division of Gastroenterology and Hepatology, Houston Methodist, Houston, Texas
    Search for articles by this author
Published:January 30, 2014DOI:https://doi.org/10.1053/j.gastro.2014.01.050
      There is compelling rationale for manipulating the microbiota to treat inflammatory bowel diseases (IBDs). Although studies of animal models of intestinal inflammation produced promising results, trials in humans have been disappointing. In contrast to IBD, the role of the microbiota in the development of irritable bowel syndrome (IBS) only recently has been considered, but early stage results have been encouraging. As pharmaceutical companies develop fewer truly novel agents for treatment of these disorders, consumers seek safer, long-term strategies to deal with chronic symptoms. We assess the rationale for modulating the microbiota for treatment of IBD and IBS, and discuss whether current concepts are simplistic and overstated or simply under-researched. Are claims exaggerated and expectations unrealistic? Difficulties with microbiota terminology and technologies, as well as differences among patients and the heterogeneity of these diseases, pose additional challenges in developing microbiota-based therapies for IBD and IBS.

      Keywords

      Abbreviations used in this paper:

      IBD (inflammatory bowel disease), IBS (irritable bowel syndrome)
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