Randomised clinical trial: a liquid multi-strain probiotic vs. placebo in the irritable bowel syndrome - a 12 week double-blind study

Sisson, Guy; Ayis, Salma; Sherwood, Roy; Bjarnason, Ingvar

doi:10.1111/apt.12787

Cited by 117 publications

(148 citation statements)

References 43 publications

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“…115 On the contrary, in a randomized, double-blind, placebocontrolled setting, Roberts et al 116 could not find a significant change in overall outcomes of constipation-predominant IBS and mixed stool form-IBS patients using a multispecies probiotic mixture. In a systematic review of Moayyedi et al, 117 it is mentioned that in animal studies it was proposed a positive role for probiotics to reduce VH; though there are still controversial data on the potential of probiotics which requires high quality clinical trials to provide enough evidence.…”

mentioning

confidence: 94%

The Role of Visceral Hypersensitivity in Irritable Bowel Syndrome: Pharmacological Targets and Novel Treatments

Farzaei

Bahramsoltani

Abdollahi

et al. 2016

J Neurogastroenterol Motil

151

122

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Irritable bowel syndrome (IBS) is the most common disorder referred to gastroenterologists and is characterized by altered bowel habits, abdominal pain, and bloating. Visceral hypersensitivity (VH) is a multifactorial process that may occur within the peripheral or central nervous systems and plays a principal role in the etiology of IBS symptoms. The pharmacological studies on selective drugs based on targeting specific ligands can provide novel therapies for modulation of persistent visceral hyperalgesia. The current paper reviews the cellular and molecular mechanisms underlying therapeutic targeting for providing future drugs to protect or treat visceroperception and pain sensitization in IBS patients. There are a wide range of mediators and receptors participating in visceral pain perception amongst which substances targeting afferent receptors are attractive sources of novel drugs. Novel therapeutic targets for the management of VH include compounds which alter gut-brain pathways and local neuroimmune pathways. Molecular mediators and receptors participating in pain perception and visceroperception include histamine-1 receptors, serotonin (5-hydrodytryptamine) receptors, transient receptor potential vanilloid type I, tachykinins ligands, opioid receptors, voltage-gated channels, tyrosine receptor kinase receptors, protease-activated receptors, adrenergic system ligands, cannabinoid receptors, sex hormones, and glutamate receptors which are discussed in the current review. Moreover, several plant-derived natural compounds with potential to alleviate VH in IBS have been highlighted. VH has an important role in the pathology and severity of complications in IBS. Therefore, managing VH can remarkably modulate the symptoms of IBS. More preclinical and clinical investigations are needed to provide efficacious and targeted medicines for the management of VH. (J Neurogastroenterol Motil 2016;22:558-574)

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mentioning

confidence: 94%

The Role of Visceral Hypersensitivity in Irritable Bowel Syndrome: Pharmacological Targets and Novel Treatments

Farzaei

Bahramsoltani

Abdollahi

et al. 2016

J Neurogastroenterol Motil

151

122

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“…18 Dietary intervention by probiotics can also be used in the manipulation of intestinal microbiota. A growing body of clinical trials suggests that probiotic treatment may improve IBS symptoms 19,20 but their role in the criterion of visceral pain remains unknown. Interestingly, in IBS-like animal models, probiotics such as bifidobacterium or lactobacillus species are able to reduce visceral pain through the regulation of the neural function [21][22][23] and normalize the HPA function.…”

mentioning

confidence: 99%

Bifidobacterium longum and Lactobacillus helveticus Synergistically Suppress Stress-related Visceral Hypersensitivity Through Hypothalamic-Pituitary-Adrenal Axis Modulation

Ait-Belgnaoui

Payard

Rolland

et al. 2018

J Neurogastroenterol Motil

100

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Background/AimsVisceral pain and hypothalamic-pituitary-adrenal axis (HPA) dysregulation is a common characteristic in irritable bowel syndrome (IBS) patients. Previously, we reported that a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) prevents chronic stress-mediated brain function abnormalities by attenuating the HPA axis response. Here, we compared the effect between different probiotic treatments on the perception of visceral pain during colorectal distension (CRD) following a chronic stress and the consequences to the activity of the HPA axis. MethodsAfter a 2-week treatment with a combined probiotic formulation, or L. helveticus or B. longum alone in stressed mice, the visceral pain in response to CRD was recorded. The expression of glucocorticoid receptors was determined in the different brain areas involved in the stress response (hypothalamus, hippocampus, and prefrontal cortex). The plasma levels of stress hormones were also measured. ResultsA pretreatment using the combination of probiotic formulation significantly reduces the chronic stress-induced visceral hypersensitivity respectively at 0.06, 0.08, and 0.10 mL CRD volume. However, a single probiotic (B. longum or L. helveticus) administration is less effective in reducing visceral pain in stressed mice. Moreover, the expression of the glucocorticoid receptor mRNA was consistently up-regulated in several brain areas after pretreatment with a combined probiotic, which correlated with the normalization of stress response compared to the inconsistent effects of a single probiotic. ConclusionThe combination of L. helveticus and B. longum is more effective in regulating glucocorticoid negative feedback on the HPA axis than probiotic alone and subsequently in treating stress-induced visceral pain.

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“…and Lactobacillus spp. has been shown to have a positive effect on IBS symptoms [18]. Probiotics stimulate goblet cells to mucus production, what reduces visceral hypersensitivity, enhances the intestinal barrier function and normalizes bowel movements [19].…”

Section: Intestinal Microfloramentioning

confidence: 99%

IBS Patient’s Guide

Zielińska

2016

Introduction to Gastrointestinal Diseases Vol. 1

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In this chapter, we will discuss the role of intestinal microbiota, lifestyle and eating habits in IBS patients. Before pharmacological treatment patients should consider changing lifestyle and diet, as they may be potential triggers for IBS symptoms. We will indicate which daily products are proper and which should be avoided by IBS patients because of exacerbation of disease symptoms. We will shortly describe how to lead healthy life and what the impact of physical activity on IBS symptoms is. We will explain that control, but not treatment, is the key management concept in IBS patients. Finally, we will define psychological aspects of IBS development and how important is to maintain psychological homeostasis. The continuous control of the doctor and regular good contact between the doctor and the patient play an important role in the disease remission.

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Randomised clinical trial: a liquid multi-strain probiotic vs. placebo in the irritable bowel syndrome - a 12 week double-blind study

Cited by 117 publications

References 43 publications

The Role of Visceral Hypersensitivity in Irritable Bowel Syndrome: Pharmacological Targets and Novel Treatments

The Role of Visceral Hypersensitivity in Irritable Bowel Syndrome: Pharmacological Targets and Novel Treatments

Bifidobacterium longum and Lactobacillus helveticus Synergistically Suppress Stress-related Visceral Hypersensitivity Through Hypothalamic-Pituitary-Adrenal Axis Modulation

IBS Patient’s Guide

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