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Tong-Xie-Yao-Fang (TXYF) has been widely used for the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D) in traditional Chinese medicine. However, its mechanism of action in the treatment of IBS-D remains to be fully understood. Recent reports have shown that  Clostridium  species in the gut can induce  5-HT  production in the colon, which then contributes to IBS-D. Due to the wide use of TXYF in the clinical treatment of IBS-D and the close relationship between gut microbiota and IBS-D, we hypothesize that TXYF treats IBS-D by modulating gut microbiota and regulating colonic  5-HT  levels. In this study, variation analysis of 16S rRNA was conducted to evaluate changes in the distribution of gut microbiota in IBS-D model rats after TXYF treatment. Moreover, we investigated whether TXYF could affect colonic  5-HT  levels in IBS-D model rats. We then performed fecal transplantation experiments to confirm the effects of TXYF on gut microbiota and  5-HT  levels. We found that TXYF treatment can ameliorate IBS-D and regulate  5-HT  levels in colon tissue homogenates. TXYF treatment also affected the diversity of gut microbiota and altered the relative abundance of  Akkermansia  and  Clostridium sensu stricto 1  in gut flora populations. Finally, we showed that fecal transplantation from TXYF-treated rats could relieve IBS-D and regulate  5-HT  levels in colon tissue homogenates. In conclusion, the present study demonstrates that TXYF treatment diminishes colonic  5-HT  levels and alleviates the symptoms of IBS-D by favorably affecting microbiota levels in gut flora communities.

Tong-Xie-Yao-Fang Regulates 5-HT Level in Diarrhea Predominant Irritable Bowel Syndrome Through Gut Microbiota Modulation