Innovative Gut Microbiome-targeted Strategies: A Promising Frontier for Pediatric Inflammatory Bowel Disease

Background: Pediatric inflammatory bowel disease [IBD] impacts affected children with many diagnostic, therapeutic, and life challenges. The traditional drugs used for induction and maintenance of remission had many unwanted side effects. Therefore, there was an urgent need for safer, more effective therapeutic strategies. Hence, modifying the gut microbiota [GM] was proposed as an innovative approach based on the theory that restoring the disturbed GM harmony will have a positive impact on IBD activity and remission. Aim: This review aimed to examine each modality used to modify the gut microbiota in children with IBD, addressing their action mode, effectiveness, limitations, and side effects for a more holistic approach to children with IBD. Methods: Four electronic databases were searched, including WOS, Cochrane Library, PubMed, and Scopus, for articles that investigated modulating GM via exclusive enteral nutrition, prebiotics, dietary fiber, probiotics, fecal microbiota transplantation, and antibiotics. Results: The available evidence was encouraging regarding their effectiveness and safety; however, those studies were hindered by their small sampling size and inconsistency in recruiting cases. Conclusion: Further work should identify other therapeutic and prognostic avenues for modulating GM for these vulnerable groups.