2015 James W. Freston Single Topic Conference: A Renaissance in the Understanding and Management of Irritable Bowel Syndrome

Deciphering the pathophysiology of irritable bowel syndrome and functional gastrointestinal disorders-an alternative model for pathogenesis: cytokine controlled transepithelial multi-feedback loop

A working theoretical model for irritable bowel syndrome (IBS) and other functional gastrointestinal disorders (FGIDs) does not exist, hampered by the lack of any clear cut invention that address all symptom and signs of the disease. Reports of cessation of symptom and signs of both major types of IBS have been published using a non-systemic, topically active agent-high potency polymerized cross-linked sucralfate (HPPCLS). The unique clinical effect of this non-systemic agent restricted to the luminal surface of the gut provides opportunity to elaborate on an alternative working model for the pathogenesis of IBS and FGIDs. While the chemical determinants of HPPCLS and the mucosal lining contribute to the clinical effects, the sequence of events resides in the functional interplay among elements within the mucosa itself. The proposed model assumes that failure of a pre-existing genomic-controlled surveillance of the epithelium localized to the luminal surface triggers primary and secondary immune activation of inflammation intent on restoring epithelial homeostasis. Delayed restoration of homeostasis results in all the symptoms, signs and likely molecular events that characterize IBS and FGIDs.

Effects of plant fermentation extract on intestinal microbiota in patients with irritable bowel syndrome

AIM: To investigate the effect of plant fermentation extracts (PFE) on intestinal microbiota in patients with irritable bowel syndrome (IBS), using high-throughput sequencing.

METHODS: The feces were collected from IBS patients before (day 0) and 30 days (day 30) after consumption of PFE, respectively. The community structure and abundance of the intestinal microbiota were examined via analyzing 16S rRNA high throughput sequencing using an Illumima System.

RESULTS: The overall diversity of the intestinal microbiota had no significant change on day 30. At the phylum level, the abundance of Firmicutes was significantly decreased (P < 0.05), while that of Bacteroidetes was significantly increased (P < 0.05). The ratio of Bacteroidetes/Firmicutes was greatly elevated. At the family level, Campylobacteraceae, Cryomorphaceae, Erysipelotrichaceae and Fibrobacteraceae were detected after the PFE consumption, and their abundance all significantly increased (P < 0.05).

CONCLUSION: PFE improves the abundance of intestinal microbiota in IBS patients, which may be utilized as a type of dietary intervention of IBS.