Researchers are exploring personalized treatment options for post-infectious irritable bowel syndrome (IBS), which occurs after a person experiences a gastrointestinal infection like norovirus, food poisoning, or COVID-19. Treatments may involve antibiotics and probiotics. A team in Italy conducted a pilot trial where they sequenced the gut microbiome of IBS patients and used a personalized combination of antibiotics, prebiotics, and probiotics to alleviate symptoms. This approach led to improved symptoms in a small group of 13 participants with IBS in the trial.
The research team analyzed the gut microbiomes of individuals with post-infectious IBS and targeted the overgrowth of certain bacteria with antibiotics while addressing the deficiency of specific bacterial strains with tailored probiotics and prebiotics to promote a balanced gut environment. Over a third of participants who received this personalized treatment reported complete remission of symptoms 12 weeks after starting the regimen. The researchers presented their findings at the European Society of Clinical Microbiology and Infectious Diseases conference.
Symptoms reported by participants before treatment included abdominal pain, bloating, diarrhea, constipation, weight loss, and dyspepsia. After treatment, symptoms like abdominal pain, bloating, and diarrhea persisted, with five participants achieving total symptom remission. The analysis of gut microbiomes revealed low species diversity, high Proteobacteria levels, low Firmicutes levels, and low abundance of SCFA-producing bacteria, Akkermansia, and Bifidobacteria among participants. The research team plans to conduct a randomized trial comparing microbiota-driven therapy with standard care for IBS.
Post-infectious IBS is a form of the condition that emerges after a person experiences a bacterial or viral gastrointestinal infection like norovirus or SARS-CoV-2. The time frame for the onset of symptoms post-infection varies, but it is typically within 2 years. The microbiome testing conducted in the study allows for personalized treatment tailored to specific bacterial imbalances in the gut. However, experts point out that more research is needed to identify underlying dysbiosis in individuals with post-infectious IBS and to determine the causal factors behind their symptoms.
IBS is a chronic condition that affects the digestive system, leading to recurrent pain and changes in bowel habits. It can often be mistaken for other conditions like inflammatory bowel disease (IBD), which involves immune system attacks on intestinal cells. The treatment offered to post-infectious IBS patients in the study, consisting of antibiotics and probiotics, is standard in managing the condition. The need for a deeper understanding of microbiome imbalances in post-infectious IBS and the potential benefits of sequencing healthy individuals’ microbiomes for research purposes is emphasized by experts.
While the personalized treatment approach in the study showed promising results, the lack of controls complicates the ability to determine whether participants would have responded similarly to a standardized treatment. The research marks a positive step forward in personalized medicine for IBS treatment, but more comprehensive studies are necessary to advance understanding of dysbiosis and microbiome influences on symptoms. Moving forward, researchers aim to identify missing or excess elements in individual microbiomes to enhance treatment targeting with antibiotics, probiotics, and prebiotics in the context of personalized medicine.
