Research is being done on personalized treatment approaches for post-infectious irritable bowel syndrome (IBS). This condition arises after a person experiences a gastric infection, such as norovirus, food poisoning, or COVID-19, and can be treated with antibiotics and probiotics. In a pilot trial conducted in Italy, researchers analyzed the gut microbiomes of patients with post-infectious IBS and used a personalized combination of antibiotics, prebiotics, and probiotics to treat symptoms. Over a third of patients treated this way reported complete remission of symptoms 12 weeks after starting treatment. Results were presented at a conference in Barcelona.
Symptoms reported before treatment included abdominal pain, bloating, diarrhea, constipation, weight loss, and dyspepsia. After treatment, symptoms experienced were abdominal pain, bloating, and diarrhea, with five participants achieving total remission of symptoms. Gut microbiome testing showed low species diversity, high abundance of Proteobacteria, low abundance of Firmicutes, and low levels of short-chain fatty acid-producing bacteria, Akkermansia, and Bifidobacteria in various percentages of the cohort. The research team plans to conduct a randomized trial to further investigate the effectiveness of microbiota-driven therapy.
Post-infectious IBS is a form of IBS that occurs after a person has experienced a bacterial or viral gastric infection like norovirus or COVID-19. It is characterized by symptoms similar to IBS, such as recurrent pain and changes in bowel habits. Differentiating IBS from inflammatory bowel disease (IBD) is important, as IBS does not cause visible damage to the gastrointestinal tract, while IBD involves the immune system attacking cells in the intestines. Post-infectious IBS can have a poorly understood pathogenesis, with nociceptive receptors in the gut remaining active after the initial infection.
Research suggests that post-infectious IBS may be linked to sensitization of nociceptive receptors in the gut, leading to persistent symptoms like abdominal pain and discomfort. Treatment for post-infectious IBS typically involves antibiotics and probiotics to balance the gut microbiome. The personalized approach used in the pilot trial showed promising results, with a significant number of participants experiencing symptom improvement or remission. Researchers emphasize the need for further studies to understand the underlying dysbiosis in the gut and develop more targeted treatments for post-infectious IBS based on individual microbiome profiles.
While the pilot trial showed positive outcomes for patients with post-infectious IBS, there is still a need for more research to determine the effectiveness of personalized treatment approaches compared to standard care. Identifying the specific dysbiosis in the gut microbiome and its role in the development of post-infectious IBS is crucial for advancing personalized medicine in this field. Sequencing the microbiome of healthy individuals and comparing it to those with post-infectious IBS could provide valuable insights into causal factors and inform targeted treatment strategies using antibiotics, probiotics, and prebiotics. Additional studies are needed to further investigate the microbiota-driven therapy for post-infectious IBS and its potential benefits for patients.
