Probiotic Fermented Milk Containing Dietary Fiber Has Additive Effects in IBS with Constipation Compared to Plain Probiotic Fer-mented Milk

Abstract

Background/Aims: Although controversial, probiotics and dietary fiber are commonly used for patients with irritable bowel syndrome (IBS). We evaluated the effects of multistrain probiotics on the symptoms of IBS to determine whether the addition of dietary fi ber had an additive effect on constipation-predominant IBS. Methods: A total of 142 participants who met the Rome III criteria were recruited and randomized into a control group or a test group. Participants in the control group received multistrain probiotic fermented milk with Streptococcus thermophilus, Lactobacillus acidophilus and Bifi dobacterium infantis; the participants in the test group received the same probiotic fermented milk mixed with dietary fi ber such as sea tangle extracts, radish extracts and glasswort extracts. The patients were treated for four weeks. Results: Most of the symptoms of IBS, with the exception of fl atulence, stool consistency, and frequency of defecation, signifi cantly improved in both groups. In the analysis of IBS subtypes, especially constipation-predominant IBS, the frequency and duration of defecation and straining at stool were improved more in the test group than in the control group. Conclusions: Dietary fiber had additive benefits for the symptoms of constipation, especially in constipationpredominant IBS. (Gut Liver 2011;5:22-28)

Combination of bulk laxative along with probiotics and prebiotics in the management of irritable bowel syndrome with constipation: A safe & effective option

“…15 In a study by Choi SC, et al it was observed that probiotic fermented milk containing dietary fiber was more effective particularly in those patients with the constipation-predominant IBS. 16 The said study confirmed the available evidence that fiber appears to play a role in the management of patients with IBS, especially if constipation is the primary concern. Although insoluble fiber is not better than placebo but soluble fiber in particular showed favourable results in IBS related constipation.…”

Review article: probiotics for the treatment of irritable bowel syndrome – focus on lactic acid bacteria

“…A number of multispecies LAB preparations (see Table S1 for list of LAB in mixtures), including VSL #3, have also demonstrated efficacy in the alleviation of abdominal pain . In contrast, many multispecies LAB trials, again including VSL #3, have not been able to demonstrate an effect of the LAB on abdominal pain …”

“…Of the multispecies LAB trials, VSL #3 has proved effective at reducing bloating in both adults (12 point improvement over placebo on 100 mm VAS) and children (0.55 point improvement over placebo on 0–4 Likert scale) although the benefit in adults was not demonstrated in a subsequent study . Of the other trials of multispecies bacteria where bloating/distension were assessed, two demonstrated positive effects, whereas another showed no improvement on this particular symptom …”

“…Although VSL #3 had no effect on urgency, it did retard colonic transit (0.56 points over placebo on scintigraphy score) suggesting a possible role in the treatment of diarrhoea‐predominant IBS (D‐IBS). Of the other multispecies LAB preparations, benefits were found for stool frequency in a C‐IBS subgroup (45% increase in stool frequency over placebo at 3 weeks), as well as defecation duration, urgency, straining and feelings of incomplete evacuation although the latter trial was designed to assess the additive benefits of dietary fibre rather than the benefits of probiotics per se .…”

Primary Care Management of Chronic Constipation in Asia: The ANMA Chronic Constipation Tool

“…During the first week of treatment, consumption of the test product appeared to be associated with a superior improvement in stool frequency and consistency, but during the second week of treatment, both treatments appeared to produce improvement in stool consistency. In South Korea, Choi et al46 randomly allocated 142 patients with constipation predominant IBS to receive either a multi-strain probiotic fermented milk with Streptococcus thermophilus , Lactobacillus acidophilus and Bifidobacterium infantis mixed with dietary fiber or the same probiotic fermented milk without fiber for 4 weeks. Superior improvement in stool frequency and straining were reported for the fiber-enhanced treatment.…”