Changes in the intestinal microbiome in patients with post­­infectious irritable bowel syndrome and current possibilities of their correction

Objective — to analyze the clinical peculiarities, psycho­­emotional state, quality of life and changes in the intestinal microbiome in patients with post­­infectious IBS (PI ‑ IBS) and to study the clinical and microbiological efficacy of the Neoflorum probiotic in the treatment of these patients. Materials and methods. An open randomized multicenter comparative study has been conducted in parallel groups. Examinations involved 62 patients with PI ‑IBS, aged 22 to 70 years (the mean age 43.0±4.5years), who were randomized into 2 groups: the main group included 11 men and 19 women who took Neoflorum; the comparison group consisted of 14 men and 18 women who received the standard therapy. All patients underwent physical examination and polymerase chain reaction‑based analysis of intestinal microbiota. The HADS scale was used to study the psycho­­emotional status, and the quality of life was assessed using the «MOS 36 ‑ Item Short­­Form Health Status Survey» (SF­­36) questionnaire. Results. The clinical course of PI ‑ IBS has some peculiarities. Subjects with diarrhea and flatulence who had complaints of loss of appetite and changes in food preferences prevailed among the patients. Based on HADS scale data, at PI ‑ IBS presence, clinical or subclinical manifestations of anxiety were revealed in every second patient, and clinically expressed depression was diagnosed in every fourth patient, this correlated with the decrease in quality of life indicators. Clinical and psycho­­emotional manifestations were associated with the changes in the bowel microbiome, characterized with the relative increase in the bacterial mass of opportunistic flora, decrease in Bifidobacterium spp., Enterococcus spp., and increase in the levels of Clostridium difficile, Citrobacter spp., Klebsiella pneumonia, and Parvimonas micra. Conclusions. The use of the Neoflorum medication in patients with PI ‑ IBS was effective in both reducing abdominal pain, normalizing bowel movements and in the tendency to increase of the quality of life indicators and reducing psycho­­emotional disorders. Moreover, it was effective in terms of microbiota correction with the normalization of the bacterial mass of obligate and opportunistic flora, quantitative and qualitative composition of the intestinal microbiome.