Effect of probiotic species on irritable bowel syndrome symptoms: A bring up to date meta-analysis

Abstract

Background and objectives: immune system alteration in irritable bowel syndrome (IBS) patients may be modulated by probiotics. We assessed the efficacy of some probiotic species in alleviating characteristic IBS symptoms.Material and methods: a meta-analysis of all identified randomized controlled trials comparing probiotics with placebo in treating IBS symptoms was performed with continuous data summarized using standardized mean differences (SMDs) with 95% confidence intervals (95% CIs), where appropriate. The random-effects model was employed in cases of heterogeneity; otherwise, fixed-effects models were used.Results: meta-analysis was performed with 10 of 24 studies identified as suitable for inclusion. Probiotics improved pain scores if they contained Bifidobacterium breve (SMD, -0.34; 95% CI, -0.66; -0.02), Bifidobacterium longum (SMD, -0.48; 95% CI, -0.91; -0.06), or Lactobacillus acidophilus (SMD, -0.31; 95% CI, -0.61; -0.01) species. Distension scores were improved by probiotics containing B. breve (SMD, 95% CI, Conclusions: some probiotics are an effective therapeutic option for IBS patients, and the effects on each IBS symptom are likely species-specific. Future studies must focus on the role of probiotics in modulating intestinal microbiota and the immune system while considering individual patient symptom profiles. INTRODUCTIONDefining and treating irritable bowel syndrome (IBS) can be challenging. Among the wide variety of treatment options, probiotics appear to be one of the best options (1). Recently, growing evidence has suggested an alteration in the immune system cell profile of IBS patients and a close relationship between the immune and nervous systems (2,3). Furthermore, several authors have studied the relationship between probiotic intake and blood cytokine levels (4) or changes in fecal microbiota (5,6). Several reviews and meta-analyses that have evaluated the role of probiotics in IBS therapy have concluded that probiotics appear to improve overall IBS symptoms (7-12). However, a meta-analysis that includes any probiotic in the evaluation of symptom relief may not be the best method for assessing the efficacy of specific probiotics (11-13). Therefore, we assessed the efficacy of each specific probiotic species in alleviating characteristic IBS symptoms. Effect of probiotic species on irritable bowel ORIGINAL PAPERSOrtiz-Lucas M, Tobias A, Saz P, Sebastián JJ. Effect of probiotic species on irritable bowel syndrome symptoms: A bring up to date meta-analysis. Rev Esp Enferm

Emerging role of probiotics and antimicrobials in the management of irritable bowel syndrome

“…None of the species tested demonstrated significant improvements in stool frequency or consistency, straining during stool evacuation, sense of incomplete evacuation, or fecal urgency. Overall, the probiotic safety profile was similar to that observed with placebo 43 .…”

Pharmacotherapy for irritable bowel syndrome in the context of evidence-based medicine

“…Поэтому экстраполировать положительные результаты отдельных исследований на всю группу пробиотиков, широко пред-ставленную на фармакологическом рынке в нашей стра-не, неправомочно. Что касается доказательной базы тера-пии СРК пробиотиками, то в настоящее время доступны данные метаанализов РКИ, подтверждающих эффектив-ность препаратов этой группы в лечении функциональ-ных заболеваний органов пищеварения у детей [29], для редукции симптомов СРК у взрослых [30,31]. Однако к данным этих метаанализов необходимо относится с пони-манием того, что не все штаммы не у всех пациентов и не всегда облегчают симптомы СРК [30].…”

Microbiota–host symbiosis in the pathophysiology and treatment of irritable bowel, irritable eye and irritable mind syndrome

“…A jogszabályok ma még csak ezt a mechanizmust ismerik el, ezért jelenleg az élő probiotikumok megengedett indikációja a "bélfl óra fi ziológiás egyensúlyának helyreállítása" például antibiotikus kúra után [30]. A klinikai tapasztalatok azonban ellentmondásosak [31]. Több klinikai vizsgálat kedvező hatásról számolt be, míg mások ezt nem erősítették meg.…”