Abstract
Irritable bowel syndrome (IBS) is a complex gut-brain interaction illness characterized by recurring stomach pain and abnormal bowel habits, with the gut micro-biota playing an increasingly important role in disease genesis and progression. This review critically reviews the current information on the gut-brain micro-biome axis in IBS and investigates potential microbiome-targeted therapy options. A thorough literature search was carried out using PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, and Google Scholar to locate relevant peer-reviewed articles published between 2010 and May 2026. Clinical trials, observational studies, systematic reviews, meta-analyses, and narrative reviews on gut microbial dysbiosis, neuroimmune interactions, intestinal barrier dysfunction, microbial metabolites, and therapeutic treatments in IBS were all considered eligible papers. The available evidence consistently shows that microbial dysbiosis is a central feature of IBS and is linked to decreased microbial diversity, depletion of beneficial bacterial taxa, impaired intestinal barrier integrity, chronic low-grade inflammation, altered neurotransmitter signalling, and visceral hypersensitivity. Different microbial fingerprints were found among IBS subtypes, indicating subtype-specific pathogenic processes and potential options for personalized treatment. Current therapeutic approaches, such as low-FODMAP dietary intervention, probiotics, prebiotics, synbiotics, rifaximin, cognitive behavioral therapy, gut directed hypnotherapy, and multimodal treatment strategies, have varying degrees of efficacy in relieving symptoms by modulating the gut-brain micro-biome axis. However, variations in study demographics, micro-biome profiling techniques, and clinical procedures continue to restrict the consistency of results. Future research that combines micro-biomics, metabolomics, immunological profiling, and precision medicine methods will be critical for identifying accurate biomarkers and generating tailored therapy options. The gut-brain micro-biome axis offers a promising mechanistic framework and therapeutic target for better IBS diagnosis and therapy