Published online Feb 21, 2016. doi: 10.3748/wjg.v22.i7.2219
Peer-review started: June 1, 2015
First decision: October 14, 2015
Revised: December 5, 2015
Accepted: December 30, 2015
Article in press: December 30, 2015
Published online: February 21, 2016
Core tip: In the last decade, the gut microbiota has provided support to the concept that a disturbed intestinal ecology could promote development and maintenance of symptoms in irritable bowel syndrome (IBS). As a correlate, manipulation of gut microbiota represents a new strategy for the treatment of this multifactorial disease. Probiotics appear an attractive option in terms of both efficacy and safety, while prebiotics, synbiotics and antibiotics still need formation. Fecal transplant has recently gained a new life as therapeutic option for those patients with an altered gut ecosystem, but data on IBS are scanty and randomized, placebo-controlled studies are required.