Modulação intestinal na Síndrome do Intestino Irritável: uma revisão narrativa

Abstract

Irritable Bowel Syndrome (IBS) is a disorder of the gut-brain interaction, characterized by recurrent abdominal pain associated with changes in bowel movement frequency and stool form. The intestinal microbiota in IBS is considered a central factor in the pathophysiology and differs from that of healthy individuals. Modulation of the intestinal microbiota through probiotics, prebiotics or synbiotics has been a potential ally in reducing symptoms. The research aims to summarize evidence from clinical trials in humans on the effect of probiotic, prebiotic and synbiotic supplementation on the modulation of the intestinal microbiota and the management of gastrointestinal symptoms in people with IBS. This is a narrative review of randomized clinical trials based on articles published between 2021 and 2023 and indexed in PubMed/MEDLINE. The studies demonstrated improvements after interventions with probiotics and synbiotics in abdominal pain, bowel habits, quality of life, and global symptoms. Only one study highlighted changes in the intestinal microbiota. Probiotics considered as treatment options for diarrhea-predominant IBS, with the best evidence of their beneficial effects, include the use of isolated probiotics of Bifidobacterium, multi-strain combinations with Bifidobacterium, Lactobacillus, Streptococcus, Bacillus cereus, Enterococcus faecalis and Escherichia coli. Saccharomyces cerevisiae also showed benefits for other classifications, mainly for IBS with a predominance of constipation. Prebiotics may be beneficial depending on the patient's sensitivity and predominant bowel habits. Synbiotics are considered an option for treating IBS symptoms, especially for elderly individuals with diarrhea- and constipation-predominant bowel movements, but they may also be beneficial for adults with diarrhea-predominant bowel movements.