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GASTROINTENSTINAL DISEASE: Irritable bowel syndrome: the possible benefits of probiotics

Irritable bowel syndrome (IBS) is a common functional disorder usually defined by the coexistence of abdominal pain or discomfort and an alteration of bowel habit-either diarrhea or constipation. IBS constitutes a significant therapeutic challenge. Currently available therapies provide at best symptomatic relief, and none has been shown to alter the natural history of the disorder. While the cause of IBS remains to be determined, dysmotility and altered pain perception are currently the most popular hypotheses. However, more recently, roles for enteric infection and inflammation have been proposed based on studies that have documented the onset of IBS following bacterial gastroenteritis and low-grade mucosal inflammation. Even with the increasing understanding of gut flora-mucosa interactions and the significant number of studies supporting the role for inflammatory and immune processes in contributing to enteric neuromuscular dysfunction, the role of lumen-mucosa interactions in IBS has not really been explored. Recently, O'Mahony and colleagues (2005) examined the potential benefit of probiotics in IBS. Probiotics are defined as live or attenuated bacteria or bacterial products that confer significant health benefit to the host. This group of investigators felt there were several reasons why probiotics might prove to have beneficial effect in IBS. First, many probiotic organisms exert antibacterial and antiviral effects and could therefore prevent or modify the course of IBS. Second, probiotics have been found to exert anti-inflammatory effects at mucosal surfaces. Finally, probiotics could alter the composition of the gut flora and thus potentially influence gut function. Subjects with IBS were randomized to receive either Lactobacillus salivarius or BifidobacGASTROINTESTINAL DISEASE