Despite the widespread impact of disorders of gut-brain interaction (DGBI), their pathophysiology remains elusive. Postprandial or meal-related symptoms are common in DGBI and a novel theory by which meal-related gastrointestinal symptoms occur in a subset of patients with irritable bowel syndrome (IBS) or functional dyspepsia (FD) is through a localized immune activation in the small intestine involving eosinophils and mast cells.

This immune response can be secondary to a loss of tolerance to oral food antigens triggered by an acute gastroenteritis or a psychological insult. As a result, the gut microbiome interacts with food antigens and the immune system, causing a localized allergy-like response in the gut1.

The microbiome-gut-brain axis contribution to symptom generation in DGBI is gaining momentum, with specific microbial signatures being explored for novel diagnostic approaches and personalized therapeutic interventions2.

As a consequence, the modulation of gut microbiome imbalance through the use of “the biotics family” (probiotics, prebiotics, and synbiotics) could represent an effective and safe therapeutic strategy, acting on gut-brain axis dysregulation, microbiota imbalance, intestinal barrier dysfunction, and immune dysfunction, which are DGBI pathophysiological mechanisms3. Despite a lack of established “normal” or “healthy” ranges for gut microbial abundances and microbial-derived metabolites, available research suggests that deviations from the desired gut microbiome balance could have potentially negative effects on gastrointestinal function4.

In this new interview, Javier Santos, MD, PhD, head of Clinical and Research Gastroenterology, Vall d’Hebron Hospital Universitari and member of CIBERehd, Instituto de Salud Carlos III, Madrid, shares emerging research and clinical insights on the mechanisms behind meal-related gastrointestinal symptoms, the role of “biotics” in patients with DGBI and what will the next 10 years of DGBI and gut microbiome research and clinical applications look like.

Whether you are a healthcare professional, researcher, or advocate for patient-centered care, this interview is worth watching.

Watch the full interview below:

References:

  1. Ford AC, Staudacher HM, Talley NJ. Postprandial symptoms in disorders of gut-brain interaction and their potential as a treatment target. Gut. 2024; 73(7):1199-1211. doi: 10.1136/gutjnl-2023-331833.
  2. Grover M, Barbara G, Chey W, et al. The intestinal microenvironment and disorders of gut-brain interactions. Gastroenterology. 2026. doi: 10.1053/j.gastro.2026.02.015.
  3. Marasco G, Cremon C, Salvi D, et al. Functional foods and nutraceuticals in irritable bowel syndrome. J Clin Med. 2025; 14(6):1830. doi: 10.3390/jcm14061830.
  4. Gawey BJ, Mars RA, Kashyap PC. The role of the gut microbiome in disorders of gut-brain interaction. FEBS J. 2025; 292(6):1357-1377. doi: 10.1111/febs.17200.