Abstract |
Over the past two decades, there has been significant progress in understanding the
pathogenesis of IBD. Nowadays, it is thought that IBD are complex, multifactorial disorders,
in which genetic factors, environment and microbiota lead to an aberrant response of the
immune system. Advances in genomic sequencing technology has facilitated the evaluation of
gut microbiota in health and disease. Multiple studies have documented differences in the
composition of the gut microbiota between patients with IBD and healthy individuals,
particularly with respect to microbial diversity and the relative abundance of specific bacterial
taxa. This condition has been defined as "dysbiosis" and is a constant finding in IBD patients,
suggesting that scientists could modify the microbiota in order to prevent the disease itself
and its relapses. Strategic interventions to be studied in this review include diet, probiotics,
prebiotics and symbiotics, as well as antibiotics and faecal transplantation. Indeed, diet is one
of the main regulators of microbiota. Today, due to the increased prevalence of the disease in
the Western world, many researchers support the possible correlation of diet in disease
development. They also examine whether the partial enteral nutrition, following the
spectacular effects of exclusive enteral nutrition in the induction of remission, is effective in
maintaining remission in patients with Crohn's disease. Besides, probiotics, prebiotics and
synbiotics are reasonably considered as a possible intervention because of their ability to
promote the growth of beneficial bacteria in the intestinal microflora. However, so far, their
results are limited to patients with ulcerative colitis and pouchitis. In addition, antibiotics can
cause dysbiosis or eubiosis of the intestinal microflora. Over the last decade, many studies
have linked increased antibiotic use to the development of IBD and, at the same time, some
antibiotics are being studied to maintain remission, although they pose safety issues. Finally,
faecal transplantation is a promising method that has been used for 60 years in the treatment
of pseudomembranous colitis and is now being studied in IBD. Modification of microflora is
a promising option for maintaining and restoring intestinal homeostasis. So far, its results are
variable, but at the same time they raise many concerns that form the basis for understanding
its role in the prevention of IBD. .
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