Clinical trial: multispecies probiotic supplementation alleviates the symptoms of irritable bowel syndrome and stabilizes intestinal microbiota

Kajander, Kajsa; Myllyluoma, Eveliina; Rajilić‐Stojanović, Mirjana; Kyrönpalo, Sinikka; Rasmussen, Martin; Järvenpää, Salme; Zoetendal, Erwin G.; Vos, Willem M. de; Vapaatalo, Heikki; Korpela, Riitta

doi:10.1111/j.1365-2036.2007.03542.x

Cited by 310 publications

(265 citation statements)

References 40 publications

(75 reference statements)

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“…A recent Cochrane review of dietary intervention in functional bowel disorders in children has found insufficient evidence to support its use (64) . It should be noted that L. GG is a composite strain in one of the probiotic cocktails that have showed benefit in two larger trials (60,65) . (57) 12 L. plantarum 299V; 10 7 4 Failed to show reduction in GSS over placebo Niedzielin et al (55) 40 L. plantarum 299V; 10 7 4 PEP defined as resolution of pain; 100 % v. 55% (P < 0 .…”

Section: Lactobacillus Ggmentioning

confidence: 99%

“…These findings were confirmed by a follow-up study of eighty-six patients, with a difference in reduction in GSS of eleven points (P< 0 . 01) (60) . However, marked differences in baseline severity scores were found between treatment groups and controls, with the treatment group having greater symptom severity and therefore more likely to improve.…”

Section: Vsl#3mentioning

confidence: 99%

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Treating irritable bowel syndrome with probiotics: the evidence

2010

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Irritable bowel syndrome (IBS) is a disorder of chronic abdominal pain, altered bowel habit and abdominal distension. It is the commonest cause of referral to gastroenterologists in the developed world and yet current therapeutic strategies are often unsatisfactory. There is now increasing evidence linking alterations in the gastrointestinal (GI) microbiota and IBS. Changes in faecal and mucosa-associated microbiota, post-infectious IBS, a link with small intestinal bacterial overgrowth and an up-regulation of the GI mucosal immune system all suggest a role for the GI microbiota in the pathogenesis of IBS. Given this evidence, therapeutic alteration of the GI microbiota by probiotic bacteria could be beneficial. The present paper establishes an aetiological framework for the use of probiotics in IBS and comprehensively reviews randomised placebo-controlled trials of probiotics in IBS using multiple electronic databases. It highlights safety concerns over the use of probiotics and attempts to establish guidelines for their use in IBS in both primary and secondary care.Probiotics: Irritable bowel syndrome: Small bowel intestinal overgrowth: Gastrointestinal microbiota

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Section: Lactobacillus Ggmentioning

confidence: 99%

Section: Vsl#3mentioning

confidence: 99%

Treating irritable bowel syndrome with probiotics: the evidence

2010

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“…Two studies were performed by the same research group with the same preparation. 74,76 The use of Streptococcus thermophilus and Lactobacillus bulgaricus as starting cultures for yoghurt production is occasionally noted; in the remaining cases it remains unclear whether these strains were included. They were not regarded as probiotics until 2014, when the ISAPP consented that they are probiotics by definition.…”

Section: Bacterial Strain Combinationsmentioning

confidence: 99%

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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“…However, a limitation of this study was the small number of patients with samples who could be included in the analysis of gut microbiota (n = 20) [100].…”

Section: Other Multispecies Probioticsmentioning

confidence: 99%

“…However, further analyses are needed to definitively demonstrate this potential association between alterations in the gut microbiota and improvement in specific IBS symptoms. Kajander et al [100] reported that treatment with a multispecies probiotic stabilized the gut microbiota Kim et al R, DB, PBO-C Pts with IBS by self-report (Rome II criteria) LAB4 multistrain probiotic (Cultech Ltd., Port Talbot, UK)…”

Section: Other Multispecies Probioticsmentioning

confidence: 99%

Modulation of the gut microbiota: a focus on treatments for irritable bowel syndrome

Harris

Baffy

2017

Postgraduate Medicine

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Irritable bowel syndrome (IBS), which is characterized by recurrent abdominal pain and disordered bowel habits, is one of the most common functional bowel disorders. IBS is a substantial burden on both patient health-related quality of life and healthcare costs. Several pathophysiologic mechanisms have been postulated for the occurrence of IBS, including altered gastrointestinal motility, visceral hypersensitivity, changes in gut permeability, immune activation, gut-brain dysregulation, central nervous system dysfunction, and changes in the gut microbiota. Of note, both qualitative and quantitative differences have been observed in the gut microbiota of a population with IBS versus a healthy population. Because of the substantial interest in the gut microbiota and its role as a therapeutic target in IBS, this article provides an overview of specific interventions with the potential to modulate the gut microbiota in IBS, including elimination diets, prebiotics, probiotics, synbiotics, and nonsystemic antibiotics. Although probiotics and synbiotics are generally well tolerated, differences in the composition and concentration of different bacterial species and inclusion or exclusion of prebiotic components varies widely across studies and has prevented strong recommendations on their use in IBS. For nonsystemic antibiotics, rifaximin is indicated in the United States for the treatment of IBS with diarrhea in adults and has been shown to be efficacious and well tolerated in well-designed clinical trials. Overall, more consistent evidence is needed regarding the efficacy and safety of elimination diets, prebiotics, probiotics, and synbiotics for the treatment of patients with IBS. Furthermore, additional well-designed studies are needed that examine alterations in the gut microbiota that occur with these interventions and their potential associations with clinical symptoms of IBS. ARTICLE HISTORY

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Clinical trial: multispecies probiotic supplementation alleviates the symptoms of irritable bowel syndrome and stabilizes intestinal microbiota

Abstract: SUMMARY BackgroundIrritable bowel syndrome is the most common diagnosis in gastroenterology. Trials suggest certain probiotics to be beneficial.

Cited by 310 publications

References 40 publications

Treating irritable bowel syndrome with probiotics: the evidence

Treating irritable bowel syndrome with probiotics: the evidence

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

Modulation of the gut microbiota: a focus on treatments for irritable bowel syndrome

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