Common mental disorders in irritable bowel syndrome: pathophysiology, management, and considerations for future randomised controlled trials

Probiotics are viable non-pathogenic micro-organisms which, when ingested, exert a positive influence on host health or physiology. We have critically analysed the evidence for the efficacy of specific probiotic strains in human gastrointestinal diseases. The best evidence can be obtained with randomised controlled trials which avoid bias. Good evidence has been obtained with several strains in the prevention or treatment of antibiotic-associated disorders, in the treatment (and to a lesser extent prevention) of gastroenteritis and acute diarrhoea and in the alleviation of lactose intolerance. We also analysed the recent randomised controlled trials performed in patients with Clostridium difficile or Helicobacter pylori, inflammatory bowel disease, irritable bowel syndrome, non-ulcer dyspepsia and colon cancer.

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Review of randomised controlled trials of Internet interventions for mental disorders and related conditions

Clinical Psychologist ◽

10.1080/13284200500378696 ◽

2006 ◽

Vol 10 (1) ◽

pp. 16-29 ◽

Cited By ~ 143

Author(s):

Kathleen M. Griffiths ◽

Helen Christensen

Keyword(s):

Mental Disorders ◽

Randomised Controlled Trials ◽

Controlled Trials ◽

Internet Interventions ◽

Randomised Controlled

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Effectiveness and cost-effectiveness of Self-Help Plus (SH+) for preventing mental disorders in refugees and asylum seekers in Europe and Turkey: study protocols for two randomised controlled trials

BMJ Open ◽

10.1136/bmjopen-2019-030259 ◽

2019 ◽

Vol 9 (5) ◽

pp. e030259 ◽

Cited By ~ 1

Author(s):

Marianna Purgato ◽

Kenneth Carswell ◽

Ceren Acarturk ◽

Teresa Au ◽

Sena Akbai ◽

...

Keyword(s):

Cost Effectiveness ◽

Mental Disorders ◽

Asylum Seekers ◽

Randomised Controlled Trials ◽

Controlled Trials ◽

Link Type ◽

Self Help ◽

Intervention Cost ◽

Randomised Controlled ◽

Asylum Seekers And Refugees

IntroductionThis article describes two randomised controlled trials that will evaluate the effectiveness and cost-effectiveness of Self-Help Plus (SH+), a group self-help intervention developed by the WHO to reduce distress. In these trials SH+ is being tested as a preventative intervention to lower the incidence of mental disorders in asylum seekers and refugees with psychological distress resettled in Europe and Turkey.Methods and analysisTwo prospective, multicentre, randomised, rater-blinded, parallel-group studies will follow participants over a period of 12 months. One trial will be conducted in Europe and one in Turkey. In each trial, 600 asylum seekers and refugees screening positive on the General Health Questionnaire (≥3), but without a formal diagnosis of any mental disorders according to the Mini International Neuropsychiatric Interview, will be randomly allocated to SH+or to enhanced treatment-as-usual. The primary outcome will be a lower incidence of mental disorders at 6 month follow-up. Secondary outcomes will include the evaluation of psychological symptoms, functioning, well-being, treatment acceptability and indicators of intervention cost-effectiveness.Ethics and disseminationThe two trials received ethical clearance from the local Ethics Committees of the participating sites (seven sites), as well as from the WHO Ethics Committee. All participants will provide informed consent before screening and before study inclusion (a two-step procedure). The results of the trials will be disseminated in agreement with a dissemination plan that includes publication(s) in peer-reviewed journals and presentations at relevant national and international conferences and meetings.Trials registration numbersNCT03571347,NCT03587896.

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The Effect of Bifidobacterium on Reducing Symptomatic Abdominal Pain in Patients with Irritable Bowel Syndrome: A Systematic Review

Probiotics and Antimicrobial Proteins ◽

10.1007/s12602-019-09609-7 ◽

2019 ◽

Vol 12 (3) ◽

pp. 834-839 ◽

Cited By ~ 4

Author(s):

Charlotte Pratt ◽

Matthew D. Campbell

Keyword(s):

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Fermented Milk ◽

Controlled Trials ◽

Inclusion Criteria ◽

Delivery Method ◽

Double Blind ◽

Irritable Bowel ◽

Dose Response Effect ◽

Randomised Controlled

AbstractProbiotics, specifically Bifidobacteria, may improve abdominal pain in patients with irritable bowel syndrome (IBS); however, results from randomised controlled trials (RCTs) are conflicting. Here, we systematically reviewed the efficacy of Bifidobacteria on abdominal pain in IBS. We searched MEDLINE, EMBASE and the Cochrane Controlled Trials Register from inception to 20 May 2019, without language or date restrictions. The search strategy comprised of the combination of three concepts: supplementation, abdominal pain, and IBS. Inclusion criteria included double-blind placebo-controlled RCTs featuring Bifidobacteria supplementation in Rome-diagnosed IBS patients. A total of 8 RCTs involving a total of 1045 patients with Rome diagnosed IBS were included. The dose of total Bifidobacteria ranged from 106 to > 1011 cfu (colony-forming unit) and duration of supplementation ranged between 2 and 8 weeks. Bifidobacteria was delivered through either intake of fermented milk products, encapsulation or via a malted milk beverage, with all studies assessing abdominal pain via a visual analogue Likert scale. From the studies included, 50% (n = 4) of studies found a statistically significant improvement in abdominal pain following Bifidobacteria supplementation compared to placebo, 38% (n = 3) of studies found non-significant improvements and 12% (n = 1) showed a statistically significant dose-response effect of improvement. The evidence shows a heterogeneity of effect for Bifidobacteria dependent upon strain, dosage and delivery method. While not all studies demonstrate significant improvements in abdominal pain, none of the selected studies reported an increase in pain or other adverse effects.

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