The gut microbiota actively participates in the conversion of primary bile acids to secondary bile acids and plays a crucial role in the enterohepatic circulation of bile acids.155 It exerts regulatory control over glucose homeostasis, lipid metabolism, insulin signaling, and inflammation through the FXR and TGR5 receptors.156 Abnormalities in bile acid metabolism have been implicated in several diseases, including irritable bowel syndrome (IBS), colorectal cancer, neuroinflammation, and non-alcoholic fatty liver disease.155–157. This evidence concerns the gene NR1H4 and irritable bowel syndrome.