The Exploration of the Effects and Mechanisms of Antibiotics on Irritable Bowel Syndrome

Abstract

Antibiotics are one greatest medical discoveries in the 20th century, which are extensively used to treat a variety of pathogenic microbial infections, including irritable bowel syndrome (IBS) . Although antibiotics have proven to be partially effective in improving clinical symptoms of IBS by clinical practice and several clinical studies, and nonabsorbable rifaximin has been also recommended for treating IBS without diarrhea by relevant guidelines and consensuses, the indications for the use of antibiotics in IBS are not clear, and there are concerns about the adverse effects associated with long-term antibiotic use. Meanwhile, making the balance between adverse effects and clinical benefits is difficult. However, several studies have also found that antibiotic use contributes to the development of IBS. This paper reviews recent studies on the effects of antibiotics on IBS, and summarizes that antibiotics may trigger IBS in several ways, including reducing intestinal microbial diversity, impairing epithelial barrier function and affecting cytokine production. This paper also points out the uncertainty of the indications for antibiotic application in IBS from two aspects, and argues that clinicians should pay attention to the effects of antibiotics on the development of IBS, evaluate the pros and cons of antibiotic treatment for IBS, and use antibiotics rationally and cautiously. The purpose of this article is to provide some reference for explaining the pathogenesis of IBS induced by antibiotic treatment, and for clinical application of antibiotics in IBS.

Keywords

• irritable bowel syndrome|antibiotic|intestinal flora|intestinal mucosal barrier|review