From clinical uncertainties to precision medicine: the emerging role of the gut barrier and microbiome in small bowel functional diseases. (3rd October 2017)

• Record Type: Journal Article
• Authors: Marlicz, Wojciech; Yung, Diana E; Skonieczna-Żydecka, Karolina; Loniewski, Igor; van Hemert, Saskia; Loniewska, Beata; Koulaouzidis, Anastasios
• Is Part Of: Expert review of gastroenterology & hepatology. Volume 11:Number 10(2017)
• Page Start: 961
• Page End: 978
• Publication Date: 2017-10-03
• Subjects: Microbiota -- small bowel -- gut barrier -- irritable bowel syndrome -- functional dyspepsia -- FGIDs -- microbiome -- capsule endoscopy -- clinical uncertainty; Gastroenterology -- Periodicals; Liver -- Diseases -- Periodicals; 616.3
• DOI: 10.1080/17474124.2017.1343664
• Languages: English
• ISSNs: 1747-4124

Abstract

ABSTRACT: Introduction : Over the last decade, remarkable progress has been made in the understanding of disease pathophysiology. Many new theories expound on the importance of emerging factors such as microbiome influences, genomics/omics, stem cells, innate intestinal immunity or mucosal barrier complexities. This has introduced a further dimension of uncertainty into clinical decision-making, but equally, may shed some light on less well-understood and difficult to manage conditions. Areas covered : Comprehensive review of the literature on gut barrier and microbiome relevant to small bowel pathology. A PubMed/Medline search from 1990 to April 2017 was undertaken and papers from this range were included. Expert commentary : The scenario of clinical uncertainty is well-illustrated by functional gastrointestinal disorders (FGIDs). The movement towards achieving a better understanding of FGIDs is expressed in the Rome IV guidelines. Novel diagnostic and therapeutic protocols focused on the GB and SB microbiome can facilitate diagnosis, management and improve our understanding of the underlying pathological mechanisms in FGIDs.