Probiotics in the treatment of irritable bowel syndrome: a tribute to tradition or a necessity?
- Authors: Gaus O.V.1, Livzan M.A.1, Lisovsky M.A.1
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Affiliations:
- Omsk State Medical University
- Issue: Vol 31, No 4 (2024)
- Pages: 84-91
- Section: Gastroenterology/hepatology
- URL: https://journals.eco-vector.com/2073-4034/article/view/641658
- DOI: https://doi.org/10.18565/pharmateca.2024.4.84-91
- ID: 641658
Cite item
Abstract
The history of the discovery and use of probiotic strains in clinical medicine goes back more than a hundred years. Numerous studies in recent years have convincingly demonstrated that modulation of the intestinal microbiota (IM) is one of the key pathogenetic links in the formation and persistence of symptoms of irritable bowel syndrome (IBS), which makes the strategy of prescribing probiotics pathogenetically justified both for the improving the relief of symptoms and for the maintaining long-term remission of the disease. Targeted action and prolongation of the course of therapy to 8–12 weeks are considered as the main principles for prescribing probiotics for IBS, which allows increasing the effectiveness of therapy for patients. From this standpoint, the probiotic strain Bifidobacterium longum 35624® (Symbiosis Alflorex) with high proven efficacy and safety in the treatment of patients with IBS is of particular interest.
Full Text

About the authors
Olga V. Gaus
Omsk State Medical University
Author for correspondence.
Email: gaus_olga@bk.ru
ORCID iD: 0000-0001-9370-4768
Cand. Sci. (Med.), Associate Professor at the Department of Faculty Therapy and Gastroenterology
Russian Federation, OmskM. A. Livzan
Omsk State Medical University
Email: gaus_olga@bk.ru
ORCID iD: 0000-0002-6581-7017
Russian Federation, Omsk
M. A. Lisovsky
Omsk State Medical University
Email: gaus_olga@bk.ru
ORCID iD: 0000-0001-9674-0545
Russian Federation, Omsk
References
- World Gastroenterology Organisation Global Guidelines. Probiotics and prebiotics. URL: https://www.worldgastroenterology.org/UserFiles/file/guidelines/probiotics-and-prebiotics-english2023.pdf.
- Gasbarrini G., Bonvicini F., Gramenzi A. Probiotics History. J Clin Gastroenterol. 2016;50(Suppl. 2):116–19. doi: 10.1097/MCG.0000000000000697.
- Sperber A.D. Epidemiology and Burden of Irritable Bowel Syndrome: An International Perspective. Gastroenterol. Clin North Am. 2021;50(3):489–503. doi: 10.1016/j.gtc.2021.04.001.
- Stanghellini V., Chan F.K., Hasler W.L., et al. Gastroduodenal Disorders. Gastroenterol. 2016;150(6):1380–92. doi: 10.1053/j.gastro.2016.02.011.
- Ивашкин В.Т., Маев И.В., Шелыгин Ю.А. и др. Диагностика и лечение синдрома раздраженного кишечника (Клинические рекомендации Российской гастроэнтерологической ассоциации и Ассоциации колопроктологов России). Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2021;31(5):74–95. [Ivashkin V.T., Maev I.V., Shelygin Yu.A., et al. Diagnosis and Treatment of Irritable Bowel Syndrome: Clinical Recommendations of the Russian Gastroenterological Association and Association of Coloproctologists of Russia. Rossiiskii zhurnal gastroenterologii, gepatologii, koloproktologii=Rus J Gastroenterol Hepatol Coloproctol. 2021;31(5):74–95. (In Russ.)]. doi: 10.22416/1382-4376-2021-31-5-74-95.
- Лазебник Л.Б., Голованова Е.В., Волель Б.А. и др. Функциональные заболевания органов пищеварения. Синдромы перекреста Клинические рекомендации Российского научного медицинского общества терапевтов и Научного общества гастроэнтерологов России. Экспериментальная и клиническая гастроэнтерология. 2021;(8):5–117. [Lazebnik L.B., Golovanova E.V., et al. Functional gastrointestinal disorders. Overlap syndrome Clinical guidelines of the Russian Scientific Medical Society of Internal Medicine and Gastroenterological Scientific Society of Russia. Eksperimental’naya i klinicheskaya gastroenterologiya=Exp Clin Gastroenterol. 2021;(8):5–117. (In Russ.)]. doi: 10.31146/1682-8658-ecg-192-8-5-117.
- Drossman D.A. Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV. Gastroenterology. 2016:S0016-5085(16)00223-7. doi: 10.1053/j.gastro.2016.02.032.
- Martinez C., Gonzalez-Castro A., Vicario M., Santos J. Cellular and molecular basis of intestinal barrier dysfunction in the irritable bowel syndrome. Gut Liver. 2012;6(3):305–15. doi: 10.5009/gnl.2012.6.3.305.
- Mizrahi-Man O., Davenport E.R., Gilad Y. Taxonomic classification of bacterial 16S rRNA genes using short sequencing reads: evaluation of effective study designs. PLoS One. 2013;8(1):e53608. doi: 10.1371/journal.pone.0053608.
- Poretsky R., Rodriguez-R L.M., Luo C., et al. Strengths and limitations of 16S rRNA gene amplicon sequencing in revealing temporal microbial community dynamics. PLoS One. 2014;9(4):e93827. doi: 10.1371/journal.pone.0093827.
- Rinninella E., Raoul P., Cintoni M., et al. What is the Healthy Gut Microbiota Composition? A Changing Ecosystem across Age, Environment, Diet, and Diseases. Microorganisms. 2019;7(1):14. doi: 10.3390/microorganisms7010014.
- Шевелева С.А., Куваева И.Б., Ефимочкина Н.Р. и др. Микробиом кишечника: от эталона нормы к патологии. Вопросы питания. 2020;89(4):35–51. [Sheveleva S.A., Kuvaeva I.B., Efimochkina N.R., et al. Gut microbiome: from the reference of the norm to pathology. Voprosy pitaniya=Probl Nutrit. 2020;89(4):35–51. (In Russ.)]. doi: 10.24411/0042-8833-2020-10040.
- Tyakht A.V., Kostryukova E.S., Popenko A.S., et al. Human gut microbiota community structures in urban and rural populations in Russia. Nat Commun. 2013;4:2469. doi: 10.1038/ncomms3469.
- Klimenko N.S., Tyakht A.V., Popenko A.S., et al. Microbiome Responses to an Uncontrolled Short-Term Diet Intervention in the Frame of the Citizen Science Project. Nutrients. 2018;10(5):576. doi: 10.3390/nu10050576.
- Almeida A., Mitchell A.L., Boland M., et al. A new genomic blueprint of the human gut microbiota. Nature. 2019;568(7753):499–504. doi: 10.1038/s41586-019-0965-1.
- Qin J., Li R., Raes J., et al. A human gut microbial gene catalogue established by metagenomic sequencing. Nature. 2010;464(7285):59–65. doi: 10.1038/nature08821.
- Campaniello D., Corbo M.R., Sinigaglia M., et al. How Diet and Physical Activity Modulate Gut Microbiota: Evidence, and Perspectives. Nutrients. 2022;14(12):2456. doi: 10.3390/nu14122456.
- Vich Vila A., Collij V., Sanna S., et al. Impact of commonly used drugs on the composition and metabolic function of the gut microbiota. Nat Commun. 2020;11(1):362. doi: 10.1038/s41467-019-14177-z.
- Singh R.K., Chang H.W., Yan D., et al. Influence of diet on the gut microbiome and implications for human health. J Transl Med. 2017;15(1):73. doi: 10.1186/s12967-017-1175-y.
- Prakash S., Rodes L., Coussa-Charley M., Tomaro-Duchesneau C. Gut microbiota: next frontier in understanding human health and development of biotherapeutics. Biologics. 2011;5:71–86. doi: 10.2147/BTT.S19099.
- Neish A.S. Microbes in gastrointestinal health and disease. Gastroenterol. 2009;136(1):65–80. doi: 10.1053/j.gastro.2008.10.080.
- Pimentel M., Lembo A. Microbiome and Its Role in Irritable Bowel Syndrome. Dig Dis Sci. 2020;65(3):829–39. doi: 10.1007/s10620-020-06109-5.
- Bhattarai Y., Muniz Pedrogo D.A., Kashyap P.C. Irritable bowel syndrome: a gut microbiota-related disorder? Am J Physiol Gastrointest Liver Physiol. 2017;312(1):G52–62. doi: 10.1152/ajpgi.00338.2016.
- Fukui H., Xu X., Miwa H. Role of Gut Microbiota-Gut Hormone Axis in the Pathophysiology of Functional Gastrointestinal Disorders. J Neurogastroenterol Motil. 2018;24(3):367–86. doi: 10.5056/jnm18071.
- Simren M., Barbara G., Flint H.J., et al. Intestinal microbiota in functional bowel disorders: a Rome foundation report. Gut. 2013;62(1):159–76. doi: 10.1136/gutjnl-2012-302167.
- Jadhav A., Bajaj A., Xiao Y., et al. Role of Diet-Microbiome Interaction in Gastrointestinal Disorders and Strategies to Modulate Them with Microbiome-Targeted Therapies. Ann Rev Nutr. 2023;43:355–83. doi: 10.1146/annurev-nutr-061121-094908.
- Гаус О.В., Ливзан М.А. Модуляция микробиоты кишечника как ведущий фактор патогенеза формирования фенотипов синдрома раздраженного кишечника. Русский медицинский журнал. 2023;5:12–9. [Gaus O.V., Livzan M.A. Gut microbiota modulation as a leading factor in the pathogenesis of the IBS phenotypes. Russkii meditsinskii zhurnal=Rus Med J2023;5:12–9. (In Russ.)].
- Гаус О.В., Ливзан М.А. Фенотипы синдрома раздраженного кишечника и стратегии пациентоориентированной курации больного. Лечащий врач. 2023;7–8(26):36–44. [Gaus O.V., Livzan M.A. Phenotypes of irritable bowel syndrome and strategies for patient-oriented curation of patient. Lechashchii vrach. 2023;7–8(26):36–44. (In Russ.)]. doi: 10.51793/OS.2023.26.8.006.
- Pittayanon R., Lau J.T., Yuan Y., et al. Gut Microbiota in Patients With Irritable Bowel Syndrome-A Systematic Review. Gastroenterol. 2019;157(1):97–108. doi: 10.1053/j.gastro.2019.03.049.
- Rodino-Janeiro B.K., Vicario M., Alonso-Cotoner C., et al. A Review of Microbiota and Irritable Bowel Syndrome: Future in Therapies. Adv Ther. 2018;35(3):289–310. doi: 10.1007/s12325-018-0673-5.
- Carroll I.M., Ringel-Kulka T., Siddle J.P., Ringel Y. Alterations in composition and diversity of the intestinal microbiota in patients with diarrhea-predominant irritable bowel syndrome. Neurogastroenterol Motil. 2012 Jun;24(6): 521-30, e248.
- Maccaferri S., Candela M., Turroni S., et al. IBS-associated phylogenetic unbalances of the intestinal microbiota are not reverted by probiotic supplementation. Gut Microbes. 2012; 3:406–413.
- Ringel-Kulka T., Benson A.K., Carroll I.M., et al. Molecular characterization of the intestinal microbiota in patients with and without abdominal bloating. Am J Physiol Gastrointest Liver Physiol. 2016;310:G417–G426.
- Chung C.S., Chang P.F., Liao C.H., et al. Differences of microbiota in small bowel and faeces between irritable bowel syndrome patients and healthy subjects. Scand J Gastroenterol. 2016; 51:410–419.
- Barbara G., Grover M., Bercik P., et al. Rome Foundation Working Team Report on Post-Infection Irritable Bowel Syndrome. Gastroenterol. 2019;156(1):46–58.e7. doi: 10.1053/j.gastro.2018.07.011.
- Wang C., Fang X. Inflammation and Overlap of Irritable Bowel Syndrome and Functional Dyspepsia. J Neurogastroenterol Motil. 2021;27(2):153–64. doi: 10.5056/jnm20175.
- Fukudo S., Okumura T., Inamori M., et al. Evidence-based clinical practice guidelines for irritable bowel syndrome 2020. J Gastroenterol. 2021;56(3):193–217. doi: 10.1007/s00535-020-01746-z.
- Гаус О.В., Ливзан М.А. Фенотипы синдрома раздраженного кишечника: ведущие факторы генетики и эпигенетики, механизмы формирования. Терапевтический архив. 2023;95(2):164–72. [Gaus O.V., Livzan M.A. Irritable bowel syndrome phenotypes: leading factors of genetics and epigenetics, mechanisms of formation. Terapevticheskii arkhiv. 2023;95(2):164–72. (In Russ.)]. doi: 10.26442/00403660.2023.02.202111.
- Stanzel R.D, Lourenssen S., Blennerhassett M.G. Inflammation causes expression of NGF in epithelial cells of the rat colon. Exp Neurol. 2008;211(1):203–13. doi: 10.1016/j.expneurol.2008.01.028.
- Naveed M., Zhou Q.G., Xu C., et al. Gut-brain axis: A matter of concern in neuropsychiatric disorders! Prog Neuropsychopharmacol Biol Psych. 2021;104:110051. doi: 10.1016/j.pnpbp.2020.110051.
- Fobofou S.A., Savidge T. Microbial metabolites: cause or consequence in gastrointestinal disease? Am J Physiol Gastrointest Liver Physiol. 2022;322(6):G535–52. doi: 10.1152/ajpgi.00008.2022.
- Ивашкин В.Т., Маев И.В., Абдулганиева Д.И. и др. Практические рекомендации Научного сообщества по содействию клиническому изучению микробиома человека (НСОИМ) и Российской гастроэнтерологической ассоциации (РГА) по применению пробиотиков для лечения и профилактики заболеваний гастроэнтерологического профиля у взрослых. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2020;30(2):76–89. [Ivashkin V.T., Mayev I.V., Abdulganieva D.I., et al. Practical Recommendations of Scientific Society for the Study of Human Microbiome and Russian Gastroenterological Association (RGA) for Probiotics in Treatment and Prevention of Gastroenterological Diseases in Adults. Rossiiskii zhurnal gastroenterologii, gepatologii, koloproktologii=Rus J Gastroenterol Hepatol Coloproctol. 2020;30(2):76–89. (In Russ.)]. doi: 10.22416/1382-4376-2020-30-2-76–89.
- Hungin A.P., Mulligan C., Pot B., et al. Systematic review: probiotics in the management of lower gastrointestinal symptoms in clinical practice – an evidence-based international guide. Aliment Pharmacol Ther. 2013;38(8):864–86. doi: 10.1111/apt.12460.
- Инструкция к препарату симбиозис-альфлорекс. [Instructions for the drug symbiosis-alflorex. (In Russ.)]. URL: https://drive.google.com/file/d/1uITRL1fKSOZiRAt_zubSBwNDOh-W3buI/view.
- Sabate J.M., Iglicki F. Effect of Bifidobacterium longum35624 on disease severity and quality of life in patients with irritable bowel syndrome. W J Gastroenterol. 2022;28(7):732–44. doi: 10.3748/wjg.v28.i7.732.
- O’Mahony L., McCarthy J., Kelly P., et al. Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles. Gastroenterol. 2005;128(3):541–51. doi: 10.1053/j.gastro.2004.11.050.
- Whorwell P.J., Altringer L., Morel J., et al. Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome. Am J Gastroenterol. 2006;101(7):1581–90. doi: 10.1111/j.1572-0241.2006.00734.x.
- Vasant D.H., Paine P.A., Black C.J., et al. British Society of Gastroenterology guidelines on the management of irritable bowel syndrome. Gut. 2021;70(7):1214–40. doi: 10.1136/gutjnl-2021-324598.
- Соловьева О.И., Некрасова А.С., Топалова Ю.Г. и др. Пролонгированное назначение пробиотиков при синдроме раздраженного кишечника: осознанная необходимость. Терапевтический архив. 2023;95(8):679–85. 8. [Solovyeva O.I., Nekrasova A.S., Topalova Iu.G., et al. Long-term probiotic administration for irritable bowel syndrome: a legal need. Terapevticheskii arkhiv. 2023;95(8):679–85. (In Russ.)]. doi: 10.26442/00403660.2023.08.20237
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