Côlon & Rectum

, Volume 8, Issue 3, pp 153–156

Microbiote et intestin irritable

Dossier Thématique / Thematic File
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Résumé

La complexité des pistes physiopathologiques rend la compréhension des mécanismes impliquant le microbiote dans l’intestin irritable très ambitieuse — même si les preuves de son implication s’accumulent. Les grands axes de recherche qui se dégagent — à savoir les rôles des métabolites bactériens issus de l’alimentation, de la micro-inflammation et probablement des acides biliaires — font réfléchir à des axes thérapeutiques : probiotiques et antibiotiques restent peu intéressants en termes de résultats mais « pratiques », et une avancée récente et relativement simple s’est cristallisée à travers le régime d’éviction des FODMAPS (fermentable oligosaccharides, disaccharides, monosaccharides and polyols). Un avenir proche nous dira si la transplantation fécale constituera une alternative thérapeutique intéressante ou non au cours du SII.

Mots clés

FODMAPS Acides biliaires Pullulation Intestin irritable Transplantation fécale 

Microbiota and irritable bowel syndrome

Abstract

The complexity of pathophysiological tracks makes the mechanisms involving the microbiota in irritable bowel syndrome hard to decypher- even if the evidence of his involvement accumulate. The main emerging lines of research — namely the roles of bacterial metabolites from food fermentation, micro-inflammation and bile acids — are sobering therapeutic areas: probiotics and antibiotics are moderately interesting, but “convenient”, and a recent and relatively simple advance is to propose an impoverich diet in FODMAPS. Near future will tell if the fecal transplantation constitute an interesting therapeutic alternative or not in the SII.

Keywords

Bile Acids Irritable Bowel Syndrome FODMAPS Small Intestine Bacterial Overgrowth Fecal Transplantation 

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Références

  1. 1.
    Simrén M, Barbara G, Flint HJ, et al (2013) Intestinal microbiota in functional bowel disorders: a Rome foundation report. Gut 62:159–76PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Husebye E, Hellström PM, Sundler F, et al (2001) Influence of microbial species on small intestinal myoelectric activity and transit in germ-free rats. Am J Physiol Gastrointest Liver Physiol 280:G368–80Google Scholar
  3. 3.
    Roscher R, Oettinger W, Beger HG (1988) Bacterial microflora, endogenous endotoxin, and prostaglandins in small bowel obstruction. Am J Surg 155:348–55PubMedCrossRefGoogle Scholar
  4. 4.
    Hooper LV, Wong MH, Thelin A, et al (2001) Molecular analysis of commensal host-microbial relationships in the intestine. Science 291:881–4PubMedCrossRefGoogle Scholar
  5. 5.
    Verdú EF, Bercik P, Verma-Gandhu M, et al (2006) Specific probiotic therapy attenuates antibiotic induced visceral hypersensitivity in mice. Gut 55:182–90PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Mendall MA, Kumar D (1998) Antibiotic use, childhood affluence and irritable bowel syndrome (IBS). Eur J Gastroenterol Hepatol 10:59–62PubMedCrossRefGoogle Scholar
  7. 7.
    Crouzet L, Gaultier E, Del’homme C, et al (2013) The hypersensitivity to colonic distension of IBS patients can be transferred to rats through their fecal microbiota. Neurogastroenterol Motil 25:e272–82CrossRefGoogle Scholar
  8. 8.
    Barouei J, Moussavi M, Hodgson DM (2012) Effect of maternal probiotic intervention on HPA axis, immunity and gut microbiota in a rat model of irritable bowel syndrome. PloS One 7:e46051CrossRefGoogle Scholar
  9. 9.
    Collins SM (2014) A role for the gut microbiota in IBS. Nat Rev Gastroenterol Hepatol. (ahead of print)Google Scholar
  10. 10.
    Shepherd SJ, Lomer MCE, Gibson PR (2013) Short-chain carbohydrates and functional gastrointestinal disorders. Am J Gastroenterol 108:707–17PubMedCrossRefGoogle Scholar
  11. 11.
    Gwee KA, Collins SM, Read NW, et al (2003) Increased rectal mucosal expression of interleukin 1beta in recently acquired postinfectious irritable bowel syndrome. Gut 2:523–6CrossRefGoogle Scholar
  12. 12.
    Duboc H, Taché Y, Hofmann AF (2014) The bile acid TGR5 membrane receptor: from basic research to clinical application. Dig Liver Dis Off J Ital Soc Gastroenterol Ital Assoc Study Liver 46:302–12CrossRefGoogle Scholar
  13. 13.
    Duboc H, Rainteau D, Rajca S, et al (2012) Increase in fecal primary bile acids and dysbiosis in patients with diarrheapredominant irritable bowel syndrome. Neurogastroenterol Motil Off J Eur Gastrointest Motil Soc 24:513–20CrossRefGoogle Scholar
  14. 14.
    Pimentel M, Lembo A, Chey WD, et al (2011) Rifaximin therapy for patients with irritable bowel syndrome without constipation. N Engl J Med 364:22–32PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag France 2014

Authors and Affiliations

  1. 1.INSERM UMR 1149, Equipe BADO : Physiologie et endocrinologie digestiveFaculté de Médecine Paris 7 — Denis Diderot — Site BichatParisFrance

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