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Peer-reviewedCC BY-NC-NDJournal of the anus, rectum and colon

Gut Microbiota Profiles in Diarrhea-Predominant Irritable Bowel Syndrome and Their Relationship to Clinical Efficacy of Hangeshashinto: The GMIBS-HA Study.

4 affiliations
  1. 1Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
  2. 2Department of Gastroenterology, Nishijin Hospital, Kyoto, Japan.
  3. 3Department of Gastroenterology, Hakuaikai Hospital, Kyoto, Japan.
  4. 4Department of Infectious Disease, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.

Abstract

This study aimed to identify specific microbiota associated with diarrhea-predominant irritable bowel syndrome (IBS-D) and to evaluate clinical improvement in IBS-D according to changes in gut microbiota abundance following treatment with Hangeshashinto (HST), an anti-inflammatory Kampo medicine. This post-hoc retrospective analysis included 20 IBS-D patients from a previous study in whom gut microbiota had been analyzed. Patients were enrolled at two affiliated institutions between March and December 2023 and received HST 7.5 g/day for 2-3 weeks. Gut microbiota of IBS-D patients were compared with those of 20 age- and sex-matched healthy controls. Differences in microbiota before and after HST administration between effective and non-effective cases were also analyzed. Compared with healthy controls, IBS-D patients showed significant differences in alpha diversity (Faith's PD, p=0.016) and beta diversity (unweighted p=0.006; weighted p=0.031). Taxonomic analysis demonstrated increased Escherichia-Shigella (p=0.003, q (Benjamini-Hochberg false discovery rate correction)=0.035) and decreased Faecalibacterium (p=0.005, q=0.035). In the comparison of pre-HST microbiota between 14 effective and 6 non-effective cases, significant increase of Escherichia-Shigella (p<0.001, q=0.014) and significant decrease of Fusobacterium (p=0.004, q=0.019) and Lactobacillus (p=0.002, q=0.014) were observed in non-effective cases. Regarding changes in bacterial abundance from pre- to post-HST administration, differences at the nominal p-value were observed for a decrease in Escherichia-Shigella (p=0.049, q=0.343) and an increase in Faecalibacterium (p=0.012, q=0.168) in non-effective cases compared with effective cases. Characteristic microbiota profiles of IBS-D were identified. Significant differences in bacterial abundance before HST administration were observed between effective and non-effective cases.

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BibTeX
@article{yoshida2026microbiota,
  title = {{Gut Microbiota Profiles in Diarrhea-Predominant Irritable Bowel Syndrome and Their Relationship to Clinical Efficacy of Hangeshashinto: The GMIBS-HA Study.}},
  author = {Naohisa Yoshida and Takeshi Yasuda and Yoshikazu Inagaki and Yuri Tomita and Ryohei Hirose and Reo Kobayashi and Naoto Iwai and Ken Inoue and Osamu Dohi and Kazuhiko Uchiyama and Tomohisa Takagi},
  journal = {Journal of the anus, rectum and colon},
  year = {2026},
  month = oct,
  doi = {10.23922/jarc.2026-037},
  url = {https://europepmc.org/article/MED/42952886},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Gut Microbiota Profiles in Diarrhea-Predominant Irritable Bowel Syndrome and Their Relationship to Clinical Efficacy of Hangeshashinto: The GMIBS-HA Study.
AU  - Naohisa Yoshida
AU  - Takeshi Yasuda
AU  - Yoshikazu Inagaki
AU  - Yuri Tomita
AU  - Ryohei Hirose
AU  - Reo Kobayashi
AU  - Naoto Iwai
AU  - Ken Inoue
AU  - Osamu Dohi
AU  - Kazuhiko Uchiyama
AU  - Tomohisa Takagi
PY  - 2026
DA  - 2026/10/25
JO  - Journal of the anus, rectum and colon
DO  - 10.23922/jarc.2026-037
UR  - https://europepmc.org/article/MED/42952886
AB  - This study aimed to identify specific microbiota associated with diarrhea-predominant irritable bowel syndrome (IBS-D) and to evaluate clinical improvement in IBS-D according to changes in gut microbiota abundance following treatment with Hangeshashinto (HST), an anti-inflammatory Kampo medicine. This post-hoc retrospective analysis included 20 IBS-D patients from a previous study in whom gut microbiota had been analyzed. Patients were enrolled at two affiliated institutions between March and December 2023 and received HST 7.5 g/day for 2-3 weeks. Gut microbiota of IBS-D patients were compared with those of 20 age- and sex-matched healthy controls. Differences in microbiota before and after HST administration between effective and non-effective cases were also analyzed. Compared with healthy controls, IBS-D patients showed significant differences in alpha diversity (Faith's PD, p=0.016) and beta diversity (unweighted p=0.006; weighted p=0.031). Taxonomic analysis demonstrated increased Escherichia-Shigella (p=0.003, q (Benjamini-Hochberg false discovery rate correction)=0.035) and decreased Faecalibacterium (p=0.005, q=0.035). In the comparison of pre-HST microbiota between 14 effective and 6 non-effective cases, significant increase of Escherichia-Shigella (p<0.001, q=0.014) and significant decrease of Fusobacterium (p=0.004, q=0.019) and Lactobacillus (p=0.002, q=0.014) were observed in non-effective cases. Regarding changes in bacterial abundance from pre- to post-HST administration, differences at the nominal p-value were observed for a decrease in Escherichia-Shigella (p=0.049, q=0.343) and an increase in Faecalibacterium (p=0.012, q=0.168) in non-effective cases compared with effective cases. Characteristic microbiota profiles of IBS-D were identified. Significant differences in bacterial abundance before HST administration were observed between effective and non-effective cases.
SN  - 2432-3853
ER  -