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Understanding the Gut Microbiota in Inflammatory and Functional Gastrointestinal Diseases

Journal article
Authors Johanna Sundin
Lena Öhman
Magnus Simrén
Published in Psychosomatic Medicine
Volume 79
Issue 8
Pages 857-867
ISSN 0033-3174
Publication year 2017
Published at Institute of Biomedicine, Department of Microbiology and Immunology
Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Pages 857-867
Language en
Keywords gastrointestinal microbiota, gut-brain axis, inflammatory bowel disease, irritable bowel syndrome, irritable-bowel-syndrome, intestinal bacterial overgrowth, polymerase-chain-reaction, clostridium-difficile infection, mucosa-associated microbiota, randomized controlled-trial, onset, crohns-disease, ulcerative-colitis, fecal microbiota, healthy controls
Subject categories Gastroenterology and Hepatology


Objective: During the last decade, experimental and observational studies have shown that patients with inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) may have an altered intestinal microbial composition compared with healthy individuals. However, no uniform microbial signature has as yet been detected for either IBD or IBS. This review summarizes the current knowledge of microbial dysbiosis and its potential relationship to the pathophysiology in IBD and IBS. Methods: A selective review was conducted to summarize the current knowledge of gut microbiota in the pathophysiology of IBD and IBS. Results: Experimental and observational studies provide good evidence for intestinal microbial dysbiosis in subgroups of IBD and IBS. Still, no uniform disease pattern has been detected. This is most likely due to the heterogeneous nature of IBD and IBS, in combination with the effects of intrinsic and extrinsic factors. Such intrinsic factors include genetics, the gastrointestinal environment, and the host immune system, whereas extrinsic factors include early life diet, breastfeeding, and method of infant delivery. Conclusions: Recent and ongoing work to define microbial dysbiosis in IBD and IBS shows promise, but future well-designed studies with well-characterized study individuals are needed. It is likely that the microbial dysbiosis in IBD and IBS is dependent on the natural disease course of IBD and symptom pattern in IBS. Therefore, assessment of the entire microbiota along the gastrointestinal tract, in relationship to confounding factors, symptom fluctuations, and other pathophysiological factors, is needed for further understanding of the etiology of these common diseases.

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