MODIFICATION OF THE GUT MICROBIOME TO MAINTAIN Manipulation of the Microbiota for Treatment of IBS and

There is compelling rationale for manipulating the micro- biota to treat inflammatory bowel diseases (IBDs). Although studies of animal models of intestinal inflam- mation produced promising results, trials in humans have been disappointing. In contrast to IBD, the role of the microbiota in the development of irritable bowel syn- drome (IBS) only recently has been considered, but early stage results have been encouraging. As pharmaceutical companies develop fewer truly novel agents for treatment of these disorders, consumers seek safer, long-term stra- tegies to deal with chronic symptoms. We assess the rationale for modulating the microbiota for treatment of IBD and IBS, and discuss whether current concepts are simplistic and overstated or simply under-researched. Are claims exaggerated and expectations unrealistic? Diffi- culties with microbiota terminology and technologies, as well as differences among patients and the heterogeneity of these diseases, pose additional challenges in developing microbiota-based therapies for IBD and IBS. Keywords: