Gut bless you: The microbiota-gut-brain axis in irritable bowel syndrome

World J Gastroenterol. 2022 Jan 28;28(4):412-431. doi: 10.3748/wjg.v28.i4.412.


Eline Margrete Randulff Hillestad 1Aina van der Meeren 2Bharat Halandur Nagaraja 3Ben René Bjørsvik 2Noman Haleem 2Alfonso Benitez-Paez 4Yolanda Sanz 5Trygve Hausken 1Gülen Arslan Lied 2Arvid Lundervold 3Birgitte Berentsen 1


Author information

1Department of Clinical Medicine, University of Bergen, Bergen 5021, Norway.

2National Center for Functional Gastrointestinal Disorders, Department of Medicine, Haukeland University Hospital, Bergen 5021, Norway.

3Mohn Medical Imaging and Visualization Center, Department of Radiology, Haukeland University Hospital, Bergen 5021, Norway.

4Host-Microbe Interactions in Metabolic Health Laboratory, Principe Felipe Research Center, Valencia 46012, Spain.

5Microbial Ecology, Nutrition and Health Research Unit, Institute of Agrochemistry and Food Technology, National Research Council, Paterna-Valencia 46980, Spain.


Irritable bowel syndrome (IBS) is a common clinical label for medically unexplained gastrointestinal symptoms, recently described as a disturbance of the microbiota-gut-brain axis. Despite decades of research, the pathophysiology of this highly heterogeneous disorder remains elusive. However, a dramatic change in the understanding of the underlying pathophysiological mechanisms surfaced when the importance of gut microbiota protruded the scientific picture. Are we getting any closer to understanding IBS' etiology, or are we drowning in unspecific, conflicting data because we possess limited tools to unravel the cluster of secrets our gut microbiota is concealing? In this comprehensive review we are discussing some of the major important features of IBS and their interaction with gut microbiota, clinical microbiota-altering treatment such as the low FODMAP diet and fecal microbiota transplantation, neuroimaging and methods in microbiota analyses, and current and future challenges with big data analysis in IBS.

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