Page 79 - GALENIKA MEDICAL JOURNAL

Zaključak

Brojne studije su pokazale da crijevna mikrobiota igra glavnu ulogu u interakciji između crijeva i
nervnog sistema. Ovo je novi pristup u razumijevanju patogeneze funkcionalnih gastrointestinalnih
poremećaja. Sve češće se ističe da ova osovina ima centralnu ulogu u manifestaciji bolesti.

Patofiziologija bolesti je složena, uključujući disfunkciju crijevnog motiliteta, visceralnu preosjetljivost,
izmijenjenu funkciju sluzokože i imuniteta, izmijenjen crijevni mikrobiom. Ovi pacijenti imaju loš
kvalitet života i značajan uticaj na zdravstveni sistem u cjelini, zbog potrebe za brojnim i ponovljenim
pregledima, čestim ljekarskim konsultacijama i potrebe za propisivanjem lijekova. Opšti pristupi

liječenju zasnovani su na psihološkoj podršci pacijentima i osposobljavanju pacijenata da upravljaju
stresom i njegovim uticajem na simptome. Probiotici kao nepatološki mikroorganizmi, kao još jedna
opcija liječenja, pokazali su se zdravim i korisnim za domaćina kod pacijenata sa funkcionalnim
gastrointestinalnim oboljenjima. Izazov u liječenju funkcionalnih gastrointestinalnih bolesti je
modifikacija crijevne mikrobiote probioticima, prebioticima i ishranom koja utiče na odnos crijevne
mikrobiote sa mozgom. Svijest o odnosu između crijevnih bakterija i njihovih domaćina važna je u
razvoju terapijskih pristupa za FGID zasnovanih na mikrobima (pre/probioticima). Pitanje nutritivnog
pristupa kod pacijenata sa funkcionalnim gastrointestinalnim oboljenjima ostaje kontroverzno, iako
su se ishrana bez glutena i dijeta sa eliminacijom FODMAP pokazali korisnima.

Abstract

The relation between the intestinal microbiota and the brain is an important field of research in the pathophysiology of
functional gastrointestinal disorders (FGIDs). This group of diseases includes more than 40% of the population and is one
of the most common reasons for the need of consulting a gastroenterologist. The interaction between the gut microbiota
and the brain is a new terminology for defining functional gastrointestinal disorders, based on certain diagnostic criteria.
The ROMA IV classification of diagnostic criteria divides functional gastrointestinal diseases into five anatomical regions
including the esophagus, gastroduodenal tract, intestine, biliary tract, and anorectal region. Symptoms are usually
based on gastrointestinal dysfunction such as gastroesophageal reflux disease (GERD), functional dysphagia, functional
dyspepsia, gastroparesis, irritable bowel syndrome (IBS), functional constipation, diarrhea, and fecal incontinence. In this
study, we observe at the mechanisms of interaction between gut microbes and brain function. Enteric microbiota (non-
pathological microorganisms) has numerous synergistic actions with the human body. The microbiota can change and is
different in each individual, as each individual has their own specific microbiome. From digesting food to protecting against
pathogens, the intestinal microbiota plays an important role in maintaining immunity and homeostasis. Recently, studies
have shown that one of the main impeler of the interaction between the gut and the brain is precisely the microbiome, and
so the new term was created "axis of intestinal microbiota-brain". In the future, the general approach to the treatment of
functional gastrointestinal disorders tends to be personalized, not only based on symptoms, but also on the underlying
pathophysiology and psychology. Various mechanisms, including metabolic pathways, immune system, neural pathways,
are involved in the relationship between the gut microbiota axis and the brain. We also discuss some future challenges
in modifying the intestinal microbiota with probiotics, prebiotics and nutrition, precisely through this new relationship.
Awareness of the relationship between intestinal bacteria and their hosts is crucial in the development of modern
therapeutic strategies based on good microorganisms (pre/probiotics) for functional gastrointestinal disorders.

Keywords: intestinal microbiome, intestinal microbiota-gut-brain axis, functional gastrointestinal disorders, probiotics

REVIJALNI RADOVI Galenika Medical Journal, 2023; 2(5):74-79. 77