Precision Treatment Offers Hope for IBS Patients with Gut Microbiome Therapy

Patients who are treated with a precision approach to post-infectious irritable bowel syndrome (IBS) reported improved symptoms in a pilot trial. The gut microbiomes of people with the condition were analyzed. These same people were treated with antibiotics for the growth of certain bacteria. It was found that over a third of those treated in this personalized way experienced complete remission of their symptoms 12 weeks after starting treatment. 

A team based in Italy conducted a pilot trial in which they sequenced the gut microbiome of patients with IBS and used an individualized combination of antibiotics, prebiotics, and probiotics to treat symptoms. 

Researchers used a stool test for 14 participants to detect the specific strains of bacteria that might be present in the microbiome of participants. Post that a specific regime of two antibiotics to treat pathogenic bacteria that existed at too high or low levels was prescribed. They also included prebiotics like inulin and psyllium for over two-thirds of participants.12 out of 14 participants experienced an improvement in symptoms after a 12-week follow up and symptoms like abdominal pain, bloating, diarrhea, constipation, weight loss and dyspepsia decreased. Five participants experienced total remission of symptoms. 

Gut microbiome testing shows low species diversity in 23% of participants along with a high abundance of Proteobacteria in 23% of the cohort, and a low abundance of Firmicutes in 38% of them. 

IBS is a chronic condition that affects a person’s digestive system. Symptoms include recurrent pain and changes to bowel habits. Post-infectious IBS is a form of IBS that occurs after a person has experienced some kind of gastric upset that was bacterial or viral, some doctors also say that most people accept that post-infectious IBS is the onset of symptoms compatible with irritable bowel syndrome that occurs at some period depending on who’s defining it, can be 2 years — after you have an infection, and it could be an infection with bacteria or it could be with viruses, such as norovirus or SARS-CoV-2, or even protozoa. 

The treatment with antibiotics and probiotics the researchers involved in the current study offered was fairly standard for people with post-infectious IBS. There is significant variation between even healthy individuals’ microbiomes; it was unclear whether the dysbiosis —the imbalance between different bacterial strains in the gut that occurs in people with post-infectious IBS had caused the symptoms they experienced. People should have their microbiomes sequenced when they are healthy for research in this area to advance, and causal factors to be identified.