The effectiveness of a probiotic containing Bifidobacterium longum BB-46 and Enterococcus faecium ENCfa-68 in the treatment of post-infectious irritable bowel syndrome. Prospective randomized comparative study

Abstract

Background. In the treatment of post-infectious irritable bowel syndrome (PI-IBS), the leading role belongs to the normalization of the composition of the intestinal microbiome, the disturbances of which are associated with previous intestinal infections.
 Aim. To study the effectiveness of the drug Bifiform in the treatment of PI-IBS.
 Materials and methods. An open, prospective, comparative, randomized study included 62 patients with PI-IBS. The diagnosis was confirmed by the results of clinical, laboratory and endoscopic examination of the intestine and met the diagnostic criteria for IBS of the Rome Consensus IV. The patients were randomized into 2 groups depending on the therapy. The patients of the main group received an antispasmodic drug (mebeverin 200 mg 2 times a day or trimebutin 200 mg 3 times a day for 4 weeks), an antibiotic (rifaximin 400 mg 3 times a day or nifuroxazide 400 mg 2 once a day for 1 week), a drug that normalizes the consistency of feces (dioctahedral smectite or macrogol 4000) and Bifiform 2 capsules 2 times a day for 2 weeks. For patients of control group similar therapy was performed without the Bifiform. Evaluation of the effectiveness of treatment was carried out at the end of the course of therapy and 6 months after its termination.
 Results. All included patients with PI-IBS had abdominal pain, flatulence and tenderness to palpation along the bowel, most of them had diarrhea. Disorders of the intestinal microbiota were detected in 77.4% of patients, while excessive bacterial growth in the small intestine occurred in 72.6%, disorders of the colon microbiocenosis with the presence of opportunistic bacteria in 62.9% of patients. A significant part of the patients had a combination of small and large intestinal dysbiosis. Histological examination of the colon mucosa showed signs of low degree of inflammation activity in all patients. The moderate increase in the level of fecal calprotectin was found in 62.2% of patients with colonic dysbiosis. The majority of patients in the main group showed a pronounced positive dynamics of clinical manifestations of the disease, restoration of the normal composition of the intestinal microbiota and normalization of the content of fecal calprotectin at the end of the course therapy. The good result was observed much more often in the main group at the end of the course of treatment and 6 months after its termination.
 Conclusion. The inclusion of Bifiform in the complex therapy of PI-IBS significantly increases its effectiveness both in arresting the clinical manifestations of the disease, and in restoring the normal composition of the intestinal microbiome and reducing the inflammatory process in the intestinal mucosa. In the majority of patients receiving Bifiform, the remission of the disease achieved at the end of the course of treatment and persisted even 6 months after its termination.

Role of probiotics in managing various human diseases, from oral pathology to cancer and gastrointestinal diseases

“…The results affirmed that the probiotic product enhanced clinical symptoms of the disease, reinstated the natural balance of the intestinal microbiota, and alleviated inflammation in the intestinal mucosa. In most patients receiving probiotics, the remission of the disease was achieved at the end of the course of treatment and persisted even 6 months after its termination (Yakovenko et al, 2022). A clinical trial conceptualized by Bamola and collaborators assessed the impact of B. clausii UBBC-07 probiotic strain on gut microbiota and cytokines in IBD patients.…”

Prebiotics and Probiotics for Gastrointestinal Disorders

“…Pooled analysis of combinations of probiotics demonstrated a benefit for this outcome, with VSL#3 ® showing a trend towards benefit [ 107 ]. Another small RCT demonstrated that a combination probiotic, Bifiform (containing Enterococcus faecium and Bifidobacterium longum) , was more effective in treating post-infectious IBS compared to standard complex therapy alone, which included an antispasmodic drug, an antibiotic, and a drug to normalize the consistency of feces [ 108 ].…”

Evaluation of Enterococcal Probiotic Usage and Review of Potential Health Benefits, Safety, and Risk of Antibiotic-Resistant Strain Emergence

“…However, when treated with Bifiform ® , a probiotic containing E. faecium ENCfa68, a moderate increase in the level of fecal calprotectin was found in 62.2% of patients with colonic dysbiosis. Most patients in the treatment group showed favorable clinical outcomes such as restoration of the normal composition of intestinal microbiota and normalization of fecal calprotectin content at the end of course therapy and 6 months post-treatment [ 29 ].…”