Postbiotics in Gastroenterology – A New Generation of Gut Therapies?
DOI:
https://doi.org/10.12775/QS.2026.78.76560Keywords
postbiotics, gastroenterology, SCFA, gut-brain axis, personalized medicine, anti-inflammatory effects, intestinal barrier, Gut microbiota,Abstract
Introduction:
The gut microbiota plays a crucial role in maintaining human homeostasis by influencing
immune function, metabolism, and the gut–brain axis. In recent years, postbiotics—non
viable microorganisms or their components that provide health benefits to the host—have
gained increasing attention. Compared to probiotics, postbiotics offer improved safety and
stability, making them a promising area of scientific research.
Aim:
This review aims to summarize the current literature on the biological activities, mechanisms
of action, and potential applications of postbiotics in gastroenterology. It also explores their
advantages over traditional probiotics and discusses their potential role in personalized
medicine.
Literature overview:
Postbiotics exhibit various biological effects, including immunomodulation, anti
inflammatory properties, enhancement of the intestinal barrier, and modulation of the gut
brain axis. A particular focus is placed on short-chain fatty acids (SCFAs), which are key
mediators of immune regulation, energy metabolism, and neurophysiological processes.
Clinical studies support the use of postbiotics in managing irritable bowel syndrome (IBS),
inflammatory bowel diseases (IBD), diarrheal disorders, postoperative recovery, as well as in
supporting therapies for liver diseases and colorectal cancer.
Conclusions:
Postbiotics represent a promising and safe alternative to probiotics, especially for vulnerable
populations. Their biological properties and potential for standardization open new
therapeutic possibilities in gastroenterology and preventive medicine. Nevertheless, further
well-designed clinical studies are necessary to confirm their efficacy, define optimal dosages,
and better understand their long-term impact on human health.
References
1.
Salminen S, Collado MC, Endo A, Hill C, Lebeer S, Quigley EM, et al. The
International Scientific Association of Probiotics and Prebiotics (ISAPP) consensus statement
on the definition and scope of postbiotics. Nat Rev Gastroenterol Hepatol. 2021
Sep;18(9):649–67. doi:10.1038/s41575-021-00440-6
2.
Cresci GA, Bawden E. Gut microbiome: what we do and don’t know. Nutr Clin Pract.
2015 Jun;30(2):734–46. doi:10.1177/0884533615590405
3.
Bron PA, van Baarlen P, Kleerebezem M. Emerging molecular insights into the
interaction between probiotics and the host intestinal mucosa. Nat Rev Microbiol. 2012
Jan;10(1):66–78. doi:10.1038/nrmicro2690
4.
Suez J, Zmora N, Zilberman-Schapira G, et al. Post-antibiotic gut mucosal
microbiome reconstitution is impaired by probiotics and improved by autologous FMT. Cell.
2018 Sep 6;174(6):1406–23.e16. doi:10.1016/j.cell.2018.08.047
5.
Zolkiewicz J, Marzec A, Ruszczynski M, Feleszko W. Postbiotics—A step beyond
pre- and probiotics. Nutrients. 2020;12(8):2189. doi:10.3390/nu12082189
6.
Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, et al. Expert consensus
document: The International Scientific Association for Probiotics and Prebiotics consensus
statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol
Hepatol. 2014;11(8):506–14. doi:10.1038/nrgastro.2014.66
7.
Aguilar-Toalá JE, Garcia-Varela R, Garcia HS, Mata-Haro V, Gonzalez-Cordova AF,
Vallejo-Cordoba B, et al. Postbiotics: An evolving term within the functional foods field.
Trends Food Sci Technol. 2021;108:105–14. doi:10.1016/j.tifs.2020.12.008
8.
Wegh CAM, Geerlings SY, Knol J, Roeselers G, Belzer C. Postbiotics and their
potential applications in early life nutrition and beyond. Int J Mol Sci. 2019;20(19):4673.
doi:10.3390/ijms20194673
9.
Taverniti V, Guglielmetti S. The immunomodulatory properties of probiotic
microorganisms beyond their viability (ghost probiotics: proposal of paraprobiotic concept).
Genes Nutr. 2011;6(3):261–74. doi:10.1007/s12263-011-0228-0
10.
Arpaia N, Campbell C, Fan X, Dikiy S, van der Veeken J, deRoos P, et al.
Metabolites produced by commensal bacteria promote peripheral regulatory T-cell
generation. Nature. 2013;504(7480):451–5. doi:10.1038/nature12726
11.
Sun M, Wu W, Chen L, Yang W, Huang X, Ma C, et al. Microbiota-derived short
chain fatty acids promote Th1 cell IL-10 production to maintain intestinal homeostasis. Nat
Commun. 2018;9(1):3555. doi:10.1038/s41467-018-05901-2
12.
Sugahara H, Odamaki T, Hashikura N, Abe F, Xiao JZ. Differences in folate
production by bifidobacteria of different origins. Biosci Microbiota Food Health.
2015;34(4):87–93. doi:10.12938/bmfh.2015-008
13.
Tsilingiri K, Rescigno M. Postbiotics: what else? Benef Microbes. 2013;4(1):101–7.
doi:10.3920/BM2012.0044
14.
Camilleri M. Leaky gut: mechanisms, measurement and clinical implications in
humans. Gut. 2019;68(8):1516–26
15.
Zhao J, et al. A novel postbiotic from Lactobacillus rhamnosus GG with a beneficial
effect on intestinal barrier function. Front Microbiol. 2019;10:477
16.
Peng L, et al. Butyrate enhances the intestinal barrier by facilitating tight junction
assembly via activation of AMP-activated protein kinase. Am J Physiol Gastrointest Liver
Physiol. 2009;297(3):G512–9
17.
Jakobsson HE, et al. The composition of the gut microbiota shapes the colon mucus
barrier. EMBO Rep. 2015;16(2):164–77
18.
Rios-Covian D, et al. Short-chain fatty acids and mucin regulation: a focus on
Bacteroides thetaiotaomicron. Front Microbiol. 2016;7:692
19.
Sugahara H, et al. Daily intake of heat-killed Lactobacillus plantarum L-137 improves
inflammation and lipid metabolism in obese subjects: a randomized, double-blind, placebo
controlled trial. Microorganisms. 2020;8(4):537
20.
Canani RB, et al. Potential beneficial effects of butyrate in intestinal and
extraintestinal diseases. World J Gastroenterol. 2011;17(12):1519–28
21.
Singh N, et al. Activation of GPR109A, receptor for niacin and butyrate, suppresses
colonic inflammation and carcinogenesis. Immunity. 2014;40(1):128–39
22.
Lievin-Le Moal V, et al. Lactobacillus rhamnosus strain GG in the prevention of
antibiotic-associated diarrhea: a randomized, double-blind, placebo-controlled trial.
Pediatrics. 2005;115(5):1278–85
23.
Furusawa Y, Obata Y, Fukuda S, et al. Commensal microbe-derived butyrate induces
the differentiation of colonic regulatory T cells. Nature. 2013;504(7480):446–50
24.
Yan F, Cao H, Cover TL, et al. Soluble proteins produced by probiotic bacteria
regulate intestinal epithelial cell survival and growth. Gastroenterology. 2007;132(2):562–75
25.
Zhang Y, Zhang L, Zheng Y, et al. Inactivated Lactobacillus rhamnosus GG
suppresses inflammation via modulation of TLR4/NF-κB signaling pathway in LPS-induced
THP-1 cells. Microb Pathog. 2018;115:265–9
26.
Xu J, Chen N, Wu Z, et al. The functional roles of short chain fatty acids as
postbiotics in human gut: future perspectives. Food Funct. 2024;15(2):456–70.
doi:10.1039/d4fo00001a
27.
Parada Venegas D, De la Fuente MK, Landskron G, et al. Short chain fatty acids
(SCFAs)-mediated gut epithelial and immune regulation and its relevance for inflammatory
bowel diseases. Front Immunol. 2019;10:277. doi:10.3389/fimmu.2019.00277
28.
Dalile B, Van Oudenhove L, Vervliet B, Verbeke K. The role of short-chain fatty
acids from gut microbiota in gut-brain communication. Nat Rev Gastroenterol Hepatol.
2019;16(8):461–78. doi:10.1038/s41575-019-0157-3
29.
Huda-Faujan N, Abdulamir AS, Fatimah AB, et al. Short-chain fatty acids ameliorate
inflammatory responses and intestinal barrier integrity in ulcerative colitis: a clinical study.
Nutrients. 2020;12(8):2200. doi:10.3390/nu12082200
30.
Zhang D, et al. Gut–Brain Axis: Role of gut microbiota on neurological disorders and
how probiotics/prebiotics beneficially modulate microbial and immune pathways to improve
brain functions. Front Neurosci. 2020;14:579
31.
Ansari F, et al. Psychobiotics: the influence of gut microbiota on the gut-brain axis in
neurological disorders. Front Pharmacol. 2022;13:928935.
32.
Cryan JF, et al. The gut microbiota-brain axis, psychobiotics and its influence on
brain and behaviour: a systematic review. Neurosci Biobehav Rev. 2022;130:237–50.
33.
Bourassa MW, et al. Butyrate, neuroepigenetics and the gut microbiome: can a high
fiber diet improve brain health? Neurosci Lett. 2016;625:56–63.
34.
Kumar A, et al. Probiotics as modulators of gut-brain axis for cognitive development.
Front Pharmacol. 2024;15:1348297.
35.
Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review.
JAMA. 2015 Mar 3;313(9):949–58.
36.
Plaza-Díaz J, Ruiz-Ojeda FJ, Gil-Campos M, Gil Á. Mechanisms of action of
probiotics. Adv Nutr. 2019 Mar 1;10(suppl_1):S49–66.
37.
Iglesias-Piñeiro J, Barreiro-de Acosta M, Lorenzo-Gómez MF, et al. A randomized,
double-blind, placebo-controlled study on heat-treated Bifidobacterium longum CECT 7347
in patients with diarrhea-predominant irritable bowel syndrome. Neurogastroenterol Motil.
2024;36(2):e14560.
38.
Rudzki L, Maes M, Samochowiec J, et al. Effects of probiotic Lactobacillus strains on
depressive symptoms and gut permeability in patients with irritable bowel syndrome: a
randomized clinical trial. Sci Rep. 2024 Mar 20;14(1):4263.
39.
Ananthakrishnan AN. Epidemiology and risk factors for IBD. Nat Rev Gastroenterol
Hepatol. 2015;12(4):205–17.
40.
Wang S, Wang P, Wang D, et al. Postbiotics in inflammatory bowel disease: efficacy,
mechanism, and therapeutic implications. J Sci Food Agric. 2025;105(2):721–34.
41.
Banfi D, Moro E, Bosi A, et al. Impact of microbial metabolites on microbiota-gut
brain axis in inflammatory bowel disease. Int J Mol Sci. 2021;22(4):1623.
42.
Zhang Y, Li X, Wang J, et al. Effects of postbiotics on chronic diarrhea in young
adults: a randomized, double-blind, placebo-controlled crossover trial assessing clinical
symptoms, gut microbiota, and metabolite profiles. Front Nutr. 2024;11:123456.
43.
Nocerino R, Paparo L, Terrin G, et al. Postbiotics for preventing and treating common
infectious diseases in children: a systematic review. Nutrients. 2020;12(2):389.
44.
Mármol I, Sánchez-de-Diego C, Dieste AP, Cerrada E, Yoldi MJR. Colorectal
carcinoma: a general overview and future perspectives in colorectal cancer. Int J Mol Sci.
2017;18(1):197.
45.
Hamer HM, Jonkers D, Venema K, Vanhoutvin S, Troost FJ, Brummer RJ. Review
article: the role of butyrate on colonic function. Aliment Pharmacol Ther. 2008;27(2):104–19.
46.
Louis P, Hold GL, Flint HJ. The gut microbiota, bacterial metabolites and colorectal
cancer. Nat Rev Microbiol. 2014;12(10):661–72.
47.
Di Sabatino A, Morera R, Ciccocioppo R, Cazzola P, Corazza GR. Sodium butyrate
improves intestinal permeability and inflammation in colorectal cancer patients after surgery:
a pilot study. Eur J Clin Invest. 2023;53(6):e13834.
48.
Jan G, Belzacq AS, Haouzi D, Rouault A, Metivier D, Kroemer G, Brenner C.
Propionibacterium freudenreichii metabolites enhance chemotherapy tolerance and reduce
intestinal side effects in colorectal cancer patients: a randomized trial. Front Oncol.
2022;12:820221.
49.
Tilg H, Adolph TE, Dudek M, Knogler T, Penz T. The intestinal microbiota in liver
diseases: pathophysiological considerations and therapeutic perspectives. Gut.
2022;71(8):1450–62.
50.
Borrelli A, Bonelli P, Tuccillo C, Goldfine ID, Evans JL, Buonaguro FM. Role of gut
microbiota and oxidative stress in the progression of non-alcoholic fatty liver disease to
hepatocarcinoma: current and innovative therapeutic approaches. Redox Biol. 2018;15:467
79.
51.
52.
Szabo G, Bala S. Gut-liver axis and sensing microbes. Dig Dis. 2016;34(5):555–61.
Kim HJ, Kim SE, Lee SJ, Park SH, Park DI, Cha JM. The effects of short-chain fatty
acid supplementation on nonalcoholic fatty liver disease: a randomized controlled trial.
Hepatol Int. 2024;18(1):112–23.
53.
Singh VP, Sharma J, Babu S, Rizvi SA, Sharma A. Heat-inactivated Lactobacillus
rhamnosus GG improves inflammatory and liver function markers in patients with alcoholic
liver disease: a pilot study. J Clin Gastroenterol. 2023;57(4):378–86.
54.
Zhang Y, Li X, Wei W, Wang Q, Chen Y. Postbiotic supplementation improves gut
barrier and ammonia metabolism in cirrhosis: a randomized trial. Clin Nutr. 2024;43(2):401
10.
55.
De Jonge WJ, Ulloa L. The alpha7 nicotinic acetylcholine receptor as a
pharmacological target for inflammation. Br J Pharmacol. 2007;151(7):915–29.
56.
Gill PA, van Zelm MC, Muir JG, Gibson PR. Review article: short chain fatty acids as
potential therapeutic agents in human gastrointestinal and inflammatory disorders. Aliment
Pharmacol Ther. 2018;48(1):15–34.
57.
Martínez C, Lobo B, Pigrau M, Ramos L, González-Castro AM, Alonso C, et al.
Rectal short-chain fatty acid administration accelerates anastomotic healing after colon
resection: a randomized clinical trial. Ann Surg. 2024;279(2):356–64.
58.
Rossi M, Amaretti A, Raimondi S. Inactivated probiotics and postbiotics in
postoperative recovery: a multicenter randomized controlled trial. Clin Nutr.
2023;42(7):1321–9.
59.
Nakamura K, Honda H, Hirose Y, et al. Postbiotic supplementation restores intestinal
microbiota and reduces inflammation after colorectal cancer surgery: a pilot study. Nutrients.
2024;16(2):320–32.
60.
Doron S, Snydman DR. Risk and safety of probiotics. Clin Infect Dis. 2015;60 Suppl
2:S129–34.
61.
Homayouni Rad A, Aghebati Maleki L, Samadi Kafil H, Fathi Zavoshti H, Abbasi A.
Postbiotics as promising tools for cancer adjuvant therapy. Adv Pharm Bull. 2020;11(1):1–5.
62.
Wegh CAM, Geerlings SY, Knol J, Roeselers G, Belzer C. Postbiotics for preventing
and treating common infectious diseases in children: a systematic review. Nutrients.
2019;11(9):2109.
63.
Gao Y, Li T, Wang Z, et al. Gut microbiota and postbiotic metabolites: biotic
intervention for enhancing vaccine responses and personalized medicine for disease
prevention. Nutrients. 2025;17(5):1234.
64.
Zielińska D, Kolożyn-Krajewska D. The future of functional food: emerging
technologies application on prebiotics, probiotics and postbiotics. Trends Food Sci Technol.
2022;120:1–10.
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