S.S. Belous, I.L. Khalif, T.K. Koreneva, E.A. Konovich

FSBI State Scientific Center of Coloproctology n.a. A.N.Ryzhih of RMPH, Moscow
The article presents the results of the study aimed to the evaluation of the characteristics of the composition of the intestinal microflora and immune status in patients with various forms of irritable bowel syndrome (IBS) during therapy with multistrain probiotic complexes. After treatment, there was an increase of levels of both pro- and anti-inflammatory cytokines. These changes may reflect the fact that the appearance of a large number of microorganisms in the intestinal lumen activates the local immune system. The clinical picture was characterized by the decrease of duration and intensity of symptoms such as abdominal pain and bloating. In this connection, it seems appropriate to recommend multistrain probiotics in combination therapy with drugs that normalize the peristaltic activity of the intestine.


  1. Camilleri M., Lasch K., Zhou W. Irritable bowel syndrome: methods, mechanisms, and pathophysiology. The confluence of increased permeability, inflammation, and pain in irritable bowel syndrome. Am. J. Physiol. Gastrointest. Liver Physiol. 2012;303:G775–85.
  2. Ballou S.K., Keefer L. Multicultural considerations in the diagnosis and management of irritable bowel syndrome: a selective summary. Eur. J. Gastroenterol. Hepatol. 2013;25:1127–33.
  3. Ивашкин В.Т., Шелыгин Ю.А., Баранская Е.К., Белоусова Е.А., Васильев С.В.,Головенко О.В., Головенко А.О., Григорьев Е.Г., Костенко Н.В., Кашников В.Н., Куликовский В.Ф., Лапина Т.Л., Маев И.В., Полуэктова Е.А., Румянцев В.Г.,Тимербулатов В.М., Тихонов А.А., Трухманов А.С., Фоменко О.Ю., Халиф И.Л.,Хубе-зов Д.А., Чашкова Е.Ю., Чибисов Г.И., Шептулин А.А., Шифрин О.С., Яновой В.В. Клинические рекомендации Российской гастроэнтерологической ассоциации, Ассоциации колопроктологов России по диагностике и лечению больных с синдромом раздраженного кишечника. Российский журнал гастроэнтерол., гепатол., колопроктол. 201;24(2):92–101.
  4. Маев И.В., Черемушкин СВ. Синдром раздраженного кишечника. Римские критерии III. Consilium medicum. 20071:29–34.
  5. Минушкин О.Н. функциональные расстройства желудочно-кишечного тракта. Consilium medicum. 2004;6(6):376–81.
  6. Симаненков В.И., Лутаенко Е.А. Лечение синдрома раздраженной кишки с позиций доказательной медицины. Пособие для врачей и клинических фармакологов. СПб., 2008. 108 с.
  7. Longstreth G.F., Wilson A., Knight K., Wong J., Chiou C.F., Barghout V., Frech F., Ofman J.J. Irritable bowel syndrome, health care use, and costs: a U.S. managed care perspective. Am. J. Gastroenterol. 2003;98:600–07.
  8. Talley N.J., Spiller R. Irritable bowel syndrome: a little understood organic bowel disease? Lancet. 2002;360:555–64.
  9. Martinez C., Lobo B., Pigrau M., Ramos L., Gonzalez-Castro A.M., Alonso C., Guilarte M., Guila M., de Torres I., Azpiroz F., Santos J., Vicario M. Diarrhoea-predominant irritable bowel syndrome: an organic disorder with structural abnormalities in the jejunal epithelial barrier. Gut. 2013;62:1160–68.
  10. Mearin F., Perez-Oliveras M., Perello A., Vinyet J., Ibanez A., Coderch J., Perona M. Dyspepsia and irritable bowel syndrome after a Salmonella gastroenteritis outbreak: one-year follow-up cohort study. Gastroenterology. 2005;129:98–104.
  11. van der Veek P.P., van den Berg M., de Kroon Y.E., Verspaget H.W., Masclee A.A. Role of tumor necrosis factor-alpha and interleukin- 10 gene polymorphisms in irritable bowel syndrome. Am. J. Gastroenterol. 2005;100:2510–16.
  12. Simren M., Barbara G., Flint H.J., Spiegel B.M., Spiller R.C., Vanner S., Verdu E.F., Whorwell P.J., Zoetendal E.G. Intestinal microbiota in functional bowel disorders: a Rome foundation report. Gut. 2013;62:159–76.
  13. Dinan T.G., Clarke G., Quigley E.M., Scott L.V., Shanahan F., Cryan J., Cooney J., Keeling P.W. Enhanced cholinergic-mediated increase in the pro-inflammatory cytokine IL-6 in irritable bowel syndrome: role of muscarinic receptors. Am. J. Gastroenterol. 2008;103(10):2570–76.
  14. Cario E., Podolsky D.K. Differential alteration in intestinal epithelial cell expression of toll-like receptor 3 (TLR3) and TLR4 in inflammatory bowel disease. Infect. Immun. 2000;68:7010–17.
  15. Belmonte L., Beutheu Youmba S., Bertiaux-Vandaёle N., Antonietti M., Lecleire S., Zalar A., Gourcerol G., Leroi A.M., Dechelotte P., Coёf-fier M.,Ducrotte P. Role of toll like receptors in irritable bowel syndrome: differential mucosal immune activation according to the disease subtype. PLoS One. 2012;7:e42777.
  16. Villani A.C., Lemire M., Thabane M., Belisle A., Geneau G., Garg A.X., Clark W.F., Moayyedi P., Collins S.M., Franchimont D., Marshall J.K. Genetic risk factors for post-infectious irritable bowel syndrome following a waterborne outbreak of gastroenteritis. Gastroenterology. 2010;138:1502–13.
  17. Bashashati M., Rezaei N., Andrews C.N., Chen C.Q., Daryani N.E., Sharkey K.A., Storr M.A. Cytokines and irritable bowel syndrome: where do we stand? Cytokine. 2012;57:201–9.
  18. Akiho H., Deng Y., Blennerhassett P., Kanbayashi H., Collins S.M. Mechanisms underlying the maintenance of muscle hypercontractility in a model of postinfective gut dysfunction. Gastroenterology. 2005;129:131–41.
  19. Al-Sadi R., Boivin M., Ma T. Mechanism of cytokine modulation of epithelial tight junction barrier. Front. Biosci. (Landmark Ed). 2009;14:2765–78.
  20. Rugtveit J., Brandtzaeg P., Halstensen T.S., Fausa O., Scott H. Increased macrophage subset in inflammatory bowel disease: apparent recruitment from peripheral blood monocytes. Gut. 1994;35:669–74.
  21. Bixquert Jimenez M. Treatment of irritable bowel syndrome with probiotics. An etiopathogenic approach at last? Rev. Esp. Enferm. Dig. 2009;101:553–64.
  22. Brandt L.J., Chey W.D., Foxx-Orenstein A.E., Schiller L.R., Schoenfeld P.S., Spiegel B.M., Talley N.J., Quigley E.M. American College of Gastroenterology Task Force on Irritable Bowel Syndrome. An evidence-based position statement on the management of irritable bowel syndrome. Am. J. Gastroenterol. 2009;104(Suppl. 1):S1–35.
  23. Spiller R., Garsed K. Postinfectious irritable bowel syndrome. Gastroenterology. 2009;136:1979–88.
  24. Moayyedi P., Ford A.C., Talley N.J., Cremonini F., Foxx-Orenstein A.E., Brandt L.J., Quigley E.M. The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut. 2010;59:325–32.
  25. Яковенко Э.П., Аникина Е.В., Яковенко А.В., Агафонова Н.А., Ковтун А.В., Каграманова А.В., Иванов А.Н. Инновационные многовидовые мультиштаммовые пробиотики в клинической практике. Лечащий врач. 2014;5:77–82.
  26. Jeon S.G., Kayama H., Ueda Y., Takahashi T., Asahara T., Tsuji H., Tsuji N.M., Kiyono H., Ma J.S., Kusu T., Okumura R., Hara H., Yoshida H., Yamamoto M., Nomoto K., Takeda K. Probiotic Bifidobacterium breve induces IL-10-producing Tr1 cells in the colon. PLoS Pathog. 2012;8(5):e1002714.
  27. Michail S., Kenche H. Gut microbiota is not modified by Randomized, Double-blind, Placebo-controlled Trial of VSL#3 in Diarrhea-predominant Irritable Bowel Syndrome. Probiotics Antimicrob. Proteins. 2011;3(1):1–7.
  28. Altamura A.L., Boin F., Maes M. HPA axis and cytokines dysregulation in schizophrenia: potential implications for the antipsychotic treatment. Eur. Neuropsychopharmacol. 1999;10:1:1–4.
  29. Thomas A.J., Davis S., Morris C., Jackson E, Harrison R, O’Brien JT.. Increase in interleukin-1β in late-life depression. Am. J. Psychiat. 2005;162:1:175–77.
  30. Canavan C., Card T., West J. The Incidence of Other Gastroenterological Disease following Diagnosis of Irritable Bowel Syndrome in the UK: A Cohort Study. PLoS One. 2014;9(9):e106478.
  31. Shah E., Rezaie A., Riddle M., Pimentel M. Psychological disorders in gastrointestinal disease: epiphenomenon, cause or consequence? Ann. Gastroenterol. 2014;27(3):224–30.
  32. Наврузов С.Н., Наврузов Б.С., Пазылова Д.У. и др. Роль пробиотиков в лечении воспалительно-язвенного процесса культи прямой кишки. Колопроктология. 2015;1(51):104–5.

About the Autors

S.S. Belous - Gastroenterologist, Junior Researcher at the Department for the Study of Inflammatory and Functional Bowel Diseases FSBI SSCC n.a. A.N. Ryzhih of RMPH, Moscow
I.L. Khalif – Doctor of Medical Sciences, Prof., Gastroenterologist, Head of the Department for the Study of Inflammatory and Functional Bowel Diseases FSBI SSCC n.a. A.N. Ryzhih of RMPH, Moscow
T.K. Koreneva - FSBI SSCC n.a. A.N. Ryzhih of RMPH, Moscow
E.A. Konovich - FSBI SSCC n.a. A.N. Ryzhih of RMPH, Moscow

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