This past April, I presented my research with Dr. Suzanne Neubauer on
Treatment of Irritable Bowel Syndrome with Probiotics at the
Massachusetts Dietetic Association's
Annual Nutrition Convention and Exposition. This research was a part of the Seminar in Clinical Nutrition course that I took in
Framingham State University's Coordinated Program in Dietetics. Below is a summary of my findings.
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Presenting Treatment of Irritable Bowel Syndrome with Probiotics at MDA's ANCE |
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain or discomfort and abnormal bowel habits, with an estimated global prevalence of 11%. It has unclear causes and is diagnosed based on symptoms rather than structural abnormalities. Probiotic supplementation has been proposed to treat IBS, because the fecal microbiota composition of patients with IBS has been found to be significantly different compared to healthy patients.
A review of 21 primary studies was performed to examine the efficacy of probiotic treatment on IBS symptoms in subjects over 16 years old. Most of the studies reviewed were double-blind, placebo-controlled, randomized controlled trials. While some trials examined multi-strain probiotics, others assessed the influence of individual probiotic strains.
The results suggest abdominal pain, bloating, stool frequency, stool consistency, adequate relief, and quality of life are not adequately addressed with multi-strain probiotics in patients with all types of IBS. Different dosages, compositions of probiotic mixtures, treatment lengths, and subtypes of IBS studied make trials on probiotics hard to compare. The results were also impacted by the placebo effect, which may be a common occurrence in IBS trials, because IBS has unclear etiologies and is diagnosed based on subjective report of symptoms.
Meanwhile, impacts of single strains of Escherichia, Bifidobacterium, Saccharomyces, and Lactobacillus were limited and varied according to specific strains. Drawing general conclusions from the studies on single-strain probiotics is not straightforward, as outcomes were strain specific, and some results were only observed in one bacterial strain in one trial.
Due to the inadequate number of studies that demonstrate substantial benefits of probiotics, single- and multi-strain probiotic supplements are not recommended for IBS treatment. However, if patients with IBS are interested, taking up to 8 strains of probiotics and up to 9x10^11 CFU per day has been shown to be safe.
Treatment of Irritable Bowel Syndrome with Probiotics Research Sources
1. Begtrup et al. Scand J Gastroenterol. 2013;48(10)1127-1135.
2. Cha et al. J Clin Gastroenterol. 2012;46(3):220-227.
3. Ford et al. Am J Gastroenterol. 2014;109(10):1547-1561.
4. Jafari et al. Arch Iran Med. 2014;17(7):466-470.
5. Ludidi et al. Neurogastroenterol Motil. 2014;26(5):705-714.
6. Roberts et al. BMC Gastroenterol. 2013;13:45.
7. Shavakhi et al. Adv Biomed Res. 2014;3:140.
8. Simrén M et al. Aliment Pharmacol Ther. 2010;31(2):218-227.
9. Sisson et al. Aliment Pharmacol Ther. 2014;40(1)51-62.
10. Søndergaard et al. Scand J Gastroenterol. 2011;46(6):663-672.
11. Wong et al. Dig Dis Sci. 2015;60(1):186-194.
12. Yoon et al. J Gastroenterol Hepatol. 2014;29(1):52-59.
13. Kruis et al. Int J Colorectal Dis. 2012;27(4):467-474.
14. Choi et al. J Clin Gastroenterol. 2011;45(8):679-683.
15. Dapoigny et al. World J Gastroenterol. 2012;18(17):2067-2075.
16. Ducrotté et al. World J Gastroenterol. 2012;18(30):4012-4018.
17. Ligaarden et al. BMC Gastroenterol. 2010;10:16.
18. Stevenson et al. Nutrition. 2014;30(10):1151-1157.
19. Guglielmetti et al. Aliment Pharmacol Ther. 2011;33(10): 1123-1132.
20. Charbonneau et al. Gut Microbes. 2013;4(3):201-211.
21. Pineton de Chambrun et al. Dig Liver Dis. 2015;47(2):119-124.