Clinical guidelines in the use of fibre supplementation for patients with IBS provide one-size-fits-all advice, which has limited value. This narrative review addresses data and concepts around the functional characteristics of fibre and subsequent physiological responses induced in patients with IBS with a view to exploring the application of such knowledge to the precision use of fibre supplements. The key findings are that first, individual fibres elicit highly distinct physiological responses that are associated with their functional characteristics rather than solubility. Second, the current evidence has focused on the use of fibres as a monotherapy for IBS symptoms overall without attempting to exploit these functional characteristics to elicit specific, symptom-targeted effects, or to use fibre types as adjunctive therapies. Personalisation of fibre therapies can therefore target several therapeutic goals. Proposed goals include achieving normalisation of bowel habit, modulation of gut microbiota function towards health and correction of microbial effects of other dietary therapies. To put into perspective, bulking fibres that are minimally fermented can offer utility in modulating indices of bowel habit; slowly fermented fibres may enhance the activities of the gut microbiota; and the combination of both fibres may potentially offer both benefits while optimising the activities of the microbiota throughout the different regions of the colon. In conclusion, understanding the GI responses to specific fibres, particularly in relation to the physiology of the individual, will be the future for personalising fibre therapy for enhancing the personalised management of patients with IBS.

中文翻译：

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膳食纤维和肠易激综合征：在个性化医疗时代将功能特征转化为临床价值

为 IBS 患者补充纤维的临床指南提供了一刀切的建议，但价值有限。这篇叙述性综述讨论了围绕纤维功能特征的数据和概念以及 IBS 患者引起的后续生理反应，以探索将这些知识应用于纤维补充剂的精确使用。主要研究结果是，首先，单个纤维引发高度不同的生理反应，这些反应与其功能特性相关，而不是溶解度。其次，目前的证据集中在使用纤维作为 IBS 症状的单一疗法，而不是试图利用这些功能特征来引发特定的、针对症状的效果，或使用纤维类型作为辅助疗法。因此，纤维疗法的个性化可以针对几个治疗目标。提议的目标包括实现肠道习惯的正常化、调节肠道微生物群功能以促进健康以及纠正其他饮食疗法的微生物效应。从长远来看，发酵程度最低的膨化纤维可用于调节排便习惯指数；缓慢发酵的纤维可以增强肠道微生物群的活性；两种纤维的组合可能会同时提供两种益处，同时优化结肠不同区域的微生物群的活动。总之，了解 GI 对特定纤维的反应，特别是与个体生理有关的反应，