Manipulation of the microbiota for treatment of IBS and IBD - Challenges and controversies

Fergus Shanahan, Eamonn M.M. Quigley

    Research output: Contribution to journalArticlepeer-review

    153 Scopus citations

    Abstract

    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.

    Original languageEnglish (US)
    Pages (from-to)1554-1563
    Number of pages10
    JournalGastroenterology
    Volume146
    Issue number6
    DOIs
    StatePublished - May 2014

    Keywords

    • Fecal Transplantation
    • Pharmabiotic
    • Prebiotic
    • Probiotic

    ASJC Scopus subject areas

    • Gastroenterology

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