Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome

Yehuda Ringel*, Nitsan Maharshak

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


The pathophysiology of irritable bowel syndrome (IBS) is believed to involve alterations in the brain-gut axis; however, the etiological triggers and mechanisms by which these changes lead to symptoms of IBS remain poorly understood. Although IBS is often considered a condition without an identified "organic" etiology, emerging evidence suggests that alterations in the gastrointestinal microbiota and altered immune function may play a role in the pathogenesis of the disorder. These recent data suggest a plausible model in which changes in the intestinal microbiota and activation of the enteric immune system may impinge upon the brain-gut axis, causing the alterations in gastrointestinal function and the clinical symptoms observed in patients with IBS. This review summarizes the current evidence for altered intestinal microbiota and immune function in IBS. It discusses the potential etiological role of these factors, suggests an updated conceptual model for the pathogenesis of the disorder, and identifies areas for future research.

Original languageEnglish
Pages (from-to)G529-G541
JournalAmerican Journal of Physiology - Gastrointestinal and Liver Physiology
Issue number8
StatePublished - 15 Oct 2013


FundersFunder number
National Institute of Diabetes and Digestive and Kidney DiseasesK23DK075621, R03DK084294


    • Gastrointestinal
    • Inflammation
    • Microbiota


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