A Randomized, Double-blind, Placebo-controlled Multicenter Trial of Saccharomyces boulardii in Irritable Bowel Syndrome

Choi, Chang Hwan; Jo, Sun Young; Park, Hyojin; Chang, Sae Kyung; Byeon, Jeong Sik; Myung, Seung‐Jae

doi:10.1097/mcg.0b013e318204593e

Cited by 120 publications

(128 citation statements)

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“…Similarly, the range of included IBS patients ranged from 12 to 362. Two trials included IBS-C 99,101 and 3 trials only IBS-D patients, 84,96,97 while 2 studies stratified the patients into IBS-C and IBS-D 85 or into IBS-D and IBS-M. 95 Only one study addressed another subgroup of patients who may benefit from probiotics: patients with post-infectious IBS. 110 Unfortunately, the researchers did this post-hoc rather than prospectively (see below).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Studies that noted an improvement of QoL without changes in abdominal symptoms (pain, stool frequency, and bloating), 84,95,101 were labelled as "negative except QoL," since it is against all recommendations (Rome criteria and FDA/EMA) to use QoL as a primary endpoint in IBS treatment studies. Three more studies were identified as negative, contrary to the evaluation of the respective authors: one found a significant effect on abdominal pain, but not on other IBS symptoms.…”

Section: Global Outcomementioning

confidence: 99%

“…Individual trials have used Bifidobacterium bifidum (MIMBb75), 94 Bifidobacterium lactis, 99 Bifidobacterum animalis, 101 and Bifidobacterium infants. 88,102 A number of studies have used the yeast Saccharomyces boulardi; 84,93,95 however, it is unclear whether they used the same strain, produced and/or distributed by different companies. A novel study used a variant, Saccharomyces cerevisiae.…”

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confidence: 99%

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Probiotic Therapy of the Irritable Bowel Syndrome: Why Is the Evidence Still Poor and What Can Be Done About It?

Mazurak

Broelz²,

Storr

et al. 2015

J Neurogastroenterol Motil

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Background/AimsDespite numerous randomized clinical trials and meta-analyses, there is no increased evidence for the efficacy of probiotics in the treatment of irritable bowel syndrome (IBS). We review this evidence, identify and analyse the reasons for this lack of evidence and propose methodological improvements for future studies. MethodsBased on a literature search, we identified 56 papers that matched the purpose of our analyses. Twenty-seven studies used multi-species bacterial preparations and 29 used single-strain probiotics. They were analysed regarding patients included, treatment duration, probiotic dosage, and outcome measures. ResultsTrials in both groups suffered from heterogeneity with respect to probiotic concentration, duration of treatment, and other methodological issues (crossover design and underpowered studies). This heterogeneity did not allow the application of a meta-analytic approach and a systematic review was therefore performed instead. Multi-strain preparations combined 2 to 8 different bacterial subspecies, mostly lactobacilli or bifidobacteria, and used variable lengths of treatments. Overall, more than 50% of trials presented negative outcomes. The majority of the single-strain probiotic trials employing lactobacilli or Saccharomyces were negative, whereas trials employing bifidobacteria showed positive results. ConclusionsThe heterogeneity of the studies of probiotics in IBS questions the value of meta-analyses. The use of different bacterial strains and different mixtures of these strains, as well as different dosages, are the main contributors to this heterogeneity. Current data provides limited evidence for the efficacy of a small number of single-strain probiotics in IBS (mostly bifidobacteria) and

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Global Outcomementioning

confidence: 99%

mentioning

confidence: 99%

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Probiotic Therapy of the Irritable Bowel Syndrome: Why Is the Evidence Still Poor and What Can Be Done About It?

Mazurak

Broelz²,

Storr

et al. 2015

J Neurogastroenterol Motil

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“…En ambos trabajos concluyeron que se observa una mejoría clínica significativa luego del consumo de probióticos, teniendo en cuenta el dolor abdominal y diarrea al comparar con el consumo de placebo (27)(28)(29)(30)(31)(32). La Tabla 1 resume los hallazgos de los estudios clínicos incluidos en los metaná-lisis previamente mencionados.…”

Section: Síndrome De Intestino Irritableunclassified

Uso de probióticos en síndrome de intestino irritable y enfermedad inflamatoria intestinal: una revisión de la literatura

Gil-Tamayo

et al. 2017

Rev. Colomb. Gastroenterol.

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Introducción: El síndrome de intestino irritable (SII) y la enfermedad inflamatoria intestinal (EII), son motivos de consulta frecuente. Usualmente su tratamiento se hace en primer nivel de atención, con ajuste de estilo de vida y cambios dietarios. Los tratamientos farmacológicos tienen eficacia limitada e importantes efectos secundarios, por lo que existe un interés creciente en terapias diferentes como el uso de probióticos.Métodos: Se realizó una revisión de la literatura en las bases de datos Medline y Embase buscando estudios que asociaran suplementos nutricionales, con SII o EII, haciendo énfasis en probióticos.Resultados: De un total de 1598 referencias, 43 cumplieron criterios finales de inclusión. El uso de probióticos en SII y EII sugiere ser una terapia que ayuda a mantener los periodos de remisión de enfermedad, mejorar la calidad de vida y atenuar el proceso fisiopatológico.Conclusiones: El uso de probióticos y prebióticos podría ser una alternativa de soporte nutricional en pacientes seleccionados.

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“…A metaanalysis of 20 RCTs including 1404 subjects found a pooled RR for improvement in global IBS symptoms in 14 probiotic treatment arms (RR = 0.77, 95% CI 0.62-0.94) [McFarland and Dublin, 2008]. In a double-blind trial of S. boulardii versus placebo in the treatment of IBS patients, the probiotic agent significantly improved the quality of life, but did not improve intestinal symptoms [Choi et al 2011]. These findings are inconsistent with those reported in double-blind, RCTs performed earlier in France [Bennani, 1990;Maupas et al 1983].…”

Section: Irritable Bowel Syndromementioning

confidence: 99%

Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders

Kelesidis

Pothoulakis

2011

Therap Adv Gastroenterol

262

166

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Several clinical trials and experimental studies strongly suggest a place for Saccharomyces boulardii as a biotherapeutic agent for the prevention and treatment of several gastrointestinal diseases. S. boulardii mediates responses resembling the protective effects of the normal healthy gut flora. The multiple mechanisms of action of S. boulardii and its properties may explain its efficacy and beneficial effects in acute and chronic gastrointestinal diseases that have been confirmed by clinical trials. Caution should be taken in patients with risk factors for adverse events. This review discusses the evidence for efficacy and safety of S. boulardii as a probiotic for the prevention and therapy of gastrointestinal disorders in humans.

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A Randomized, Double-blind, Placebo-controlled Multicenter Trial of Saccharomyces boulardii in Irritable Bowel Syndrome

Abstract: S. boulardii improved IBS-QOL better than placebo but was not superior for individual symptoms in patients with diarrhea-predominant IBS or mixed-type IBS.

Cited by 120 publications

References 0 publications

Probiotic Therapy of the Irritable Bowel Syndrome: Why Is the Evidence Still Poor and What Can Be Done About It?

Probiotic Therapy of the Irritable Bowel Syndrome: Why Is the Evidence Still Poor and What Can Be Done About It?

Uso de probióticos en síndrome de intestino irritable y enfermedad inflamatoria intestinal: una revisión de la literatura

Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders

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