Beyond probiotics: targeting the microbiota-metabolite axis in radiation-induced diarrhea

Abstract

Radiation-induced diarrhea remains a common complication of pelvic radiotherapy, with limited preventive strategies available. Although probiotics have been investigated as a potential supportive intervention, current evidence is heterogeneous and insufficient to support their routine use. Emerging data suggest that radiation-induced gut microbiota alterations and disruption of microbiota-derived metabolites, including short-chain fatty acids, may play a critical role in intestinal injury. Targeting the microbiota–metabolite axis may represent a promising future approach for personalized prevention and management of radiation-induced gastrointestinal toxicity.