Bile acid-gut microbiota crosstalk in irritable bowel syndrome

Crit Rev Microbiol. 2023 May;49(3):350-369. doi: 10.1080/1040841X.2022.2058353. Epub 2022 Apr 7.

Abstract

Irritable bowel syndrome (IBS) is a common disorder of gut-brain interaction with an increasing prevalence, and its precise aetiology remains unclear. Gut microbiota dysbiosis has been found to be associated with IBS pathogenesis. In addition, a high incidence of bile acid diarrhoea and disturbed bile acid metabolism has been observed in IBS patients. The abundant microorganisms inhabited in human gut have essential functions in bile acid biotransformation, and can immensely affect the size and constitution of bile acid pool. Meanwhile, the alterations of bile acid profile can inversely interfere with the gut microbiota. This review discussed the role of intricate correlations between bile acids and gut microbiota in IBS pathogenesis and delineated the possible molecular mechanisms, mainly the signalling induced by farnesoid X receptor and transmembrane G protein-coupled receptor 5. Besides, some biomarkers for identifying bile acid diarrhoea in IBS population were listed, assisting the diagnosis and classification of IBS. Moreover, it also assessed some therapeutic strategies for IBS that regulate the bile acid-gut microbiota axis, such as dietary modulation, probiotics/prebiotics, faecal microbiota transplantation, and antibiotics. Collectively, this article illustrated the relationship between bile acids and gut microbiota in IBS pathophysiology and might offer some novel therapeutic options for IBS.

Keywords: Bile acid; farnesoid X receptor; gut microbiota; irritable bowel syndrome; transmembrane G protein-coupled receptor 5 (G protein-coupled bile acid receptor 1).

Publication types

  • Review

MeSH terms

  • Bile Acids and Salts / therapeutic use
  • Diarrhea
  • Gastrointestinal Microbiome*
  • Humans
  • Irritable Bowel Syndrome* / drug therapy
  • Probiotics*

Substances

  • Bile Acids and Salts