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It is suggested that daily environmental and emotional stressful life events contribute to the development and reactivation of intestinal inflammation in chronic inflammatory bowel disease (IBD), to the clinical manifestations of irritable bowel syndrome (IBS) and to the development of food allergies by sensitisation of intestinal tissue to oral antigens through an increase of transepithelial permeability and luminal antigen uptake.1–3 In animal models of IBD, stress increases the severity of colitis and lowers the threshold for reactivation of mucosal inflammation.4 Stressful stimuli are known to affect gastrointestinal functions such as gut motility and secretion, and to increase paracelullar permeability. Defective epithelial barrier function, which can be measured as increased intestinal permeability, has been implicated in IBS and in IBD, in which it can predict relapse during clinical remission.5 6 In animal models, both acute (partial restraint stress) and chronic (neonatal) stress enhance luminal bacterial adherence and internalisation,7 increase bacterial translocation8 and activate immune reactions within the gut resulting from alterations in gut paracellular permeability.9 Recently, it was also shown that acute stress-induced hypersensitivity to distension results from an alteration of colonic paracellular permeability.10
PROBIOTICS CORRECTING GUT MICROBIOTA AND GUT PERMEABILITY DISTURBANCES INDUCED BY STRESS
Figure 1 (points 1 and 2) illustrates the following reactions.
Numerous abnormalities of the gut flora have been described in patients with IBD and IBS. The presence of bacterial overgrowth in some patients with IBS and the improvement of their symptoms by oral antibiotics illustrate an enteric microbiota involvement in the genesis of the disease.11 12 Recent data support a potential role of probiotics for in alleviating IBS symptoms and suggest that the effects are strain-dependent. For example, a dietary administration of Lactobacillus plantarum 299 V …
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