The Effectiveness of Synbiotic Preparation Containing Lactobacillus and Bifidobacterium Probiotic Strains and Short Chain Fructooligosaccharides in Patients with Diarrhea Predominant Irritable Bowel Syndrome—A Randomized Double-Blind, Placebo-Controlled Study

Abstract

<jats:p>The purpose of the randomized double-blind placebo-controlled trial was to assess the effectiveness of synbiotic preparation containing probiotic Lactobacillus rhamnosus FloraActive™ 19070-2, Lactobacillus acidophilus DSMZ 32418, Bifidobacterium lactis DSMZ 32269, Bifidobacterium longum DSMZ 32946, Bifidobacterium bifidum DSMZ 32403 and fructooligosaccharides in adult patients with diarrhea-dominant IBS (IBS-D). The study included eighty patients with moderate and severe IBS-D who were randomized to receive synbiotics or placebo for eight weeks. Finally, a total of sixty-eight patients finished the study. The primary endpoints included the assessment of the symptoms’ severity with IBS symptom severity scale (IBS-SSS), an improvement of IBS global symptoms with Global Improvement Scale (IBS-GIS) and adequate relief of symptoms after four and eight weeks of therapy. Secondary endpoints, which were collected by telephone interviewers three times a week included the assessment of individual IBS symptoms and adverse events. Synbiotic treatment in comparison to placebo significantly improved IBS-GIS (p = 0.043), and IBS-SSS score inducing a decrease in the total IBS-SSS (p = 0.042) and in domain-specific scores related to flatulence (p = 0.028) and bowel habit (p = 0.028) after four and eight weeks. Patients treated with synbiotics reported in weekly observations a significant amelioration in a feeling of incomplete bowel movements, flatulence, pain, stool pressure and diarrheal stools compared to those receiving placebo. There were no differences in adverse events between both groups. Concluding, the multi-strain synbiotic preparation was associated with a significant improvement in symptoms in IBS-D patients and was well-tolerated. These results suggest that the use of synbiotics offers a benefit for IBS-D patients. [Clinicaltrials.gov NCT04206410 registered 20 December 2019].</jats:p>

The Emerging Role of Gut Microbiota in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Current Evidence and Potential Therapeutic Applications

“…Lactobacilli spp., E. coli -Nisle 1917, Bifodobacteria spp., some Streptococcus types, and the yeast Saccharomyces boulardii are all considered probiotics [ 60 ]. Recently, their application as adjuvant therapy in IBS treatment mostly showed positive results [ 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 ]. In addition, administration of Akkermansia muciniphila and Lactobacillus sakei OK67 to high-fat diet (HFD) fed mice were independently able to enhance tight-junction function, increasing occludin gene expression and decreasing intestinal permeability [ 125 , 126 ].…”

Bioactive Compounds in Food as a Current Therapeutic Approach to Maintain a Healthy Intestinal Epithelium

“…Synbiotics have demonstrated potential as a promising approach for the treatment of functional bowel disorders, including IBS. A recent randomized, double-blind, placebo-controlled study of adult IBS patients indicated that a synbiotic preparation of probiotic strains of Lactobacillus ( L. rhamnosus FloraActive™19070-2, L. acidophilus DSMZ 32418) and Bifidobacterium ( B. lactis DSMZ 32269, B. longum DSMZ 32946, B. bifidum DSMZ 32403) together with short-chain FOS (scFOS) had beneficial effects in the treatment of IBS-D [ 96 ]. The primary endpoints considered were assessments of symptom severity with IBS-SSS, an improvement of IBS symptoms using the global improvement scale (IBS-GIS), and adequate relief of symptoms after four and eight weeks of therapy.…”

Probiotics, Prebiotics, and Synbiotics in the Irritable Bowel Syndrome Treatment: A Review

“…rhamnosus FloraActive 19070-2, Lb. acidophilus DSMZ 32418, B. lactis DSMZ 32269, B. longum DSMZ 32946, B. bifidum DSMZ 32403 strains, and scFOS as a prebiotic compound [ 143 ]. Last but not least, in 2020, Seong et al described a synbiotic, containing Lb.…”

“…Most of the cited research [54,[134][135][136][137]140,142,143] was conducted as double-blind, placebo-controlled, except from Moser et al (2019) [139], as well as Seong et al (2020) [144], who performed the animal study. Two studies were conducted on people suffering from the IBS-C subtype [136,142], and the other two on subjects with IBS-D [139,143].…”

“…Most of the cited research [54,[134][135][136][137]140,142,143] was conducted as double-blind, placebo-controlled, except from Moser et al (2019) [139], as well as Seong et al (2020) [144], who performed the animal study. Two studies were conducted on people suffering from the IBS-C subtype [136,142], and the other two on subjects with IBS-D [139,143]. Four studies did not differentiate subtypes of the disease [54,134,135,137], whereas the rest of mentioned research focused on all subtypes [140,141].…”