scholarly journals Efficacy of probiotics in irritable bowel syndrome: A randomized, double blind placebo-controlled study

2016 ◽  
Vol 6 (1) ◽  
pp. 21 ◽  
Author(s):  
Md. Zahidur Rahman ◽  
Mohammad Shoaib Chowdhury ◽  
Mohammad Asadur Rahman ◽  
Shohely Parveen ◽  
Rajib Barua ◽  
...  

<p><strong>Background:</strong> Gut flora have important trophic effects on intestinal epithelia and on immune structure and fonction.They also protect colonized host against invasion by alien microbes.Recent research suggests that an imbalance of the intestinal microbiota and a dysfunctional intestinal barrier might trigger irritable bowel syndrome (lBS). As probiotics have been reported to restore the intestinal microbiota and the gut barrier, the therapeutic potential of probiotics within IBS became of strong interest. <strong></strong></p><p><strong>Objectives: </strong>To assess the efficacy of probiotics in lBS. <strong></strong></p><p><strong>Methods: </strong>Patients of 15 to 60 years old and both sexes were included f om the out patient department (OPD) of gastroenterology, Bangabandhu Sheikh Mujib Medi­cal University (BSMMU). A validated lBS-QOL instmment consisted of 34 questions used to assess improvement of quality of Iife before and after treatment. A total of 65 diarrhoea predominant LBS patients were randomised to receive either probiotics(n-33) or placebo(n-32) twice daily frir 6 weeks.</p><p><strong>Results:</strong> At the end of 6 weeks therapy, improvement in various symptoms(abclominal pain, stool frequency, consistency and 11atulence) in probiotics group was statistically significant. Mean QOL score before treatment was 103 in probiotics group and I 06 in placebo group. After 6 weeks of treatment mean QOL score was 82 in probiotics group and I 02.58 in placebo group. No side effects of the therapeutic agents were observed in any patient during the trial. <strong></strong></p><p><strong>Conclusions:</strong> Probiotics effectively alleviates global IBS and improves TBS symptoms simultaneously with an improvement of quality of life.</p>

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1159 ◽  
Author(s):  
Erin D. Lewis ◽  
Joseph M. Antony ◽  
David C. Crowley ◽  
Amanda Piano ◽  
Renu Bhardwaj ◽  
...  

Specific probiotic strains can alleviate the gastrointestinal (GI) symptoms and psychiatric comorbidities of irritable bowel syndrome (IBS). In this randomized, double-blind, placebo-controlled study, the efficacy of Lactobacillus paracasei HA-196 (L. paracasei) and Bifidobacterium longum R0175 (B. longum) in reducing the GI and psychological symptoms of IBS was evaluated in 251 adults with either constipation (IBS-C), diarrhea (IBS-D), or mixed-pattern (IBS-M). Following a 2-week run-in period, participants were randomized to one of three interventions: L. paracasei (n = 84), B. longum (n = 83) or placebo (n = 81). IBS symptoms, stool frequency and consistency and quality of life were assessed by questionnaires. The differences from baseline in the severity of IBS symptoms at 4 and 8 weeks were similar between groups. Participants in this study were classified, after randomization, into subtypes according to Rome III. Within the L. paracasei group, complete spontaneous and spontaneous bowel movement frequency increased in participants with IBS-C (n = 10) after 8 weeks of supplementation (both p < 0.05) and decreased in participants with IBS-D (n = 10, p = 0.013). Both L. paracasei and B. longum supplementation improved the quality of life in emotional well-being and social functioning compared with baseline (all p < 0.05). In conclusion, L. paracasei and B. longum may reduce GI symptom severity and improve the psychological well-being of individuals with certain IBS subtypes.


2021 ◽  
pp. 134-140
Author(s):  
E. V. Golovanova

This article discusses ways to improve the effectiveness of treatment of irritable bowel syndrome (IBS), one of the most common functional gastrointestinal disorders (FGID). The significance of this issue is caused by high frequency of pathology detection among the young employable population and the difficulties in choosing an effective treatment that relieves not only the symptom severity, but also the frequency of relapses. Inadequate therapy reduces patients’ compliance with treatment and significantly worsens their quality of life. The choice of a drug that fails to provide a positive effect on all factors that form the pain syndrome is the most common reason for ineffective treatment. In addition, the measures aimed at managing such pathogenic factors as intestinal microbiota dysbiosis are often not taken. Meanwhile, numerous studies have shown that the intestinal microbiota imbalance is accompanied by increased intestinal permeability, which leads to the penetration of aggressive agents through extended intercellular spaces. This is accompanied by the occurrence of subclinical inflammation in the submucosal layer, which results in impaired motor function and increased visceral sensitivity. Thus, the intestinal microflora imbalance is one of the most important factors that form clinical symptoms of IBS. The article substantiates the advantages of using trimebutin, a gastrointestinal tract motility regulator, in functional gastrointestinal diseases from the standpoint of evidence-based medicine. The modern scientific knowledge on the  effectiveness of  microbiota  adjustment in  alleviating IBS symptoms is presented. In  particular, the  double-blind, placebo-controlled study has shown the efficacy of a multi-strain probiotic complex in relieving clinical symptom severity of IBS. The optimal treatment regimen for a patient with IBS should include a drug regulating the gastrointestinal motility and reducing visceral hypersensitivity and a probiotic complex containing bacterial strains that have proved their efficacy in this group of patients. 


Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 756
Author(s):  
Barbara Skrzydło-Radomańska ◽  
Beata Prozorow-Król ◽  
Halina Cichoż-Lach ◽  
Emilia Majsiak ◽  
Joanna Beata Bierła ◽  
...  

The aim of this randomized double-blind placebo-controlled study was to evaluate the effectiveness and safety of multi-strain probiotic in adults with diarrhea-predominant irritable bowel syndrome (IBS-D). The patients were randomized to receive a mixture of Lactobacillus, Bifidobacterium, and Streptococcus thermophilus strains or placebo for eight weeks. Primary endpoints included changes in symptom severity and improvement assessed with the IBS Severity Scoring System (IBS-SSS) and Global Improvement Scale (IBS-GIS). The probiotic in comparison with placebo significantly improved the IBS symptom severity (the change of total IBS-SSS score from baseline −165.8 ± 78.9 in the probiotic group and −105.6 ± 60.2 in the placebo group, p = 0.005) and in the specific scores related to the severity of pain (p = 0.015) and the quality of life (p = 0.016) after eight weeks of intervention. The probiotic group indicated an improvement in symptoms with the use of the IBS-GIS compared with the placebo group after four (p = 0.04) and eight weeks (p = 0.003). The occurrence of adverse events did not differ between study groups. In conclusion, the multi-strain probiotic intervention resulted in a significant improvement in IBS symptoms evaluated with the use of both IBS-SSS and IBS-GIS scales. The results suggest that the studied probiotic preparation is well tolerated and safe and can offer benefits for patients with IBS-D. (registration number in Clinicaltrials.gov NCT 04662957).


2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
H. A. Hutchings ◽  
K. Wareham ◽  
J. N. Baxter ◽  
P. Atherton ◽  
J. G. C. Kingham ◽  
...  

Background. Irritable bowel syndrome (IBS) is a chronic, difficult to treat condition. The efficacy of Aloe vera in treating IBS symptoms is not yet proven. The purpose of this study was to determine if Aloe vera is effective in improving quality of life. Methods. A multicentre, randomised, double-blind, cross-over placebo controlled study design. Patients were randomised to Aloe vera, wash-out, placebo or placebo, washout, Aloe vera. Each preparation (60 mL) was taken orally twice a day. Patient quality of life was measured using the Gastrointestinal Symptoms Rating Score, Irritable Bowel Syndrome Quality of Life, EuroQol and the Short-Form-12 at baseline and treatment periods 1 and 2. Results. A total of 110 patients were randomised, but only 47 completed all questionnaires and both study arms. Statistical analysis showed no difference between the placebo and Aloe vera treatment in quality of life. Discussion. This study was unable to show that Aloe vera was superior to placebo in improving quality of life. Drop outs and other confounding factors may have impacted on the power of the study to detect a clinically important difference. Conclusion. This study failed to find Aloe vera superior to placebo in improving quality of life proven Irritable Bowel Syndrome patients.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Alireza Khalilian ◽  
Davoud Ahmadimoghaddam ◽  
Shiva Saki ◽  
Younes Mohammadi ◽  
Maryam Mehrpooya

Abstract Background Ample evidence indicates the efficacy of serotonin type 3 (5-HT3) receptor antagonists in the treatment of patients with diarrhea-predominant irritable bowel syndrome (IBS-D). Mirtazapine is an atypical antidepressant with a well-known 5-HT3 receptor antagonist property. This study, therefore, was undertaken to investigate whether compared to placebo, mirtazapine would be efficacious and safe in the treatment of patients with IBS-D. Methods From November 2019 until July 2020, 67 patients meeting Rome IV criteria for IBS-D were randomized in a double-blind fashion into either the mirtazapine treatment group (n = 34) or the placebo treatment group (n = 33). Patients started with mirtazapine 15 mg/day at bedtime for one-week; after which the dose was increased to 30 mg/day for an additional 7-week. Outcomes included changes in the total IBS symptom severity score (IBS-SSS), Hospital anxiety and depression scale score (HADS), and IBS Quality of Life. Additionally, changes in the diary-based symptoms scores including pain, urgency of defecation, bloating, stool frequency, and stool consistency based on the 7-point Bristol Stool Form Scale (BSFS), and a number of days per week with pain, urgency, diarrhea, or bloating, once during the 1-week run-in period, and once during the last week of treatment were recorded. Results All analyses were performed on an Intention-to-Treat (ITT) analysis data set. The results showed compared to placebo, mirtazapine is more efficacious in decreasing the severity of IBS symptoms (P-value = 0.002). Further, at the end of the treatment period, all diary-derived symptoms except bloating showed significantly more improvement in the mirtazapine-treated subjects compared to the placebo-treated subjects. While was well-tolerated, mirtazapine also significantly improved the patients’ quality of life (P-value = 0.04) and anxiety symptoms (P-value = 0.005). Conclusions Overall, mirtazapine seems to have a potential benefit in the treatment of patients with IBS-D, particularly those with concomitant psychological symptoms. However, further studies are warranted to determine whether these findings are replicated. Trial registration Trial registration: Registration number at Iranian Registry of Clinical Trials: IRCT20120215009014N311. Registration date: 2019-10-21.


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Dong Woo Shin ◽  
Hyuk Yoon ◽  
Hyun Soo Kim ◽  
Yoon Jin Choi ◽  
Cheol Min Shin ◽  
...  

Objectives. The purpose of this study was to investigate whether the ingestion of alkaline-reduced water (ARW) is helpful in improving the symptoms of diarrhea-predominant irritable bowel syndrome (IBS). Methods. Twenty-seven patients (male, 25.9%; mean, 41.7 years old) with diarrhea-predominant IBS were randomly allocated to two groups. For eight weeks, the ARW group (n=13) ingested at least 2 liters/day of ARW, while the control group (n=14) ingested placebo water. IBS symptom scores (quality-of-life, abdominal pain/discomfort), stool form, and frequency were assessed before and after treatment via questionnaires. Results. Eight patients (61.5%) in the ARW group and six patients (42.9%) in the control group indicated that their symptoms had improved in more than four out of the eight weeks of treatment (p=0.449). The IBS quality-of-life score significantly improved from 57.2 to 30.8 in the ARW group; this improvement was significantly greater than the slight improvement from 48.7 to 42.2 observed in the control group (p=0.029). The abdominal pain score improved from 1.8 to 0.9 in the ARW group and from 1.8 to 1.1 in the control group, with no significant group difference (p=0.232). Conclusions. Drinking ARW for eight weeks improves the quality of life in patients with diarrhea-predominant IBS.


2015 ◽  
Vol 24 (3) ◽  
pp. 275-280 ◽  
Author(s):  
Stine Størsrud ◽  
Irina Pontén ◽  
Magnus Simrén

Background & Aims: Few effective treatment options exist for patients with irritable bowel syndrome (IBS), and many patients state the use of aloe vera products reduce their symptoms. The aim of this pilot study was to investigate the effect of Aloe barbadensis Mill. Extract (AVH200®) in adult patients with IBS in a randomized, double-blind, placebo controlled study. Methods: Sixty-eight adult patients diagnosed with IBS according to the Rome III criteria were randomized to receive AVH200® or matching placebo for four weeks. Symptom questionnaires were completed on a weekly basis and the patients were asked if they had had adequate relief of their gastrointestinal symptoms. Results: A tendency towards a higher proportion of responders in the aloe vera group (55%) vs. placebo (31%), (p=0.09) was observed, and the proportion of subjects who reported adequate relief at least 50% of the weeks during the treatment period tended to be larger in the aloe vera vs. placebo group (33% vs. 14%; p=0.12). The overall severity of the gastrointestinal symptoms was reduced in the aloe vera group (314±83 vs. 257±107; p=0.003) but not the placebo group (276±88 vs. 253±100; NS), without difference between the groups (p=0.10). AVH200® was well tolerated and no serious adverse events were observed. Conclusion: Even though the primary endpoint was not met, AVH200® seems to be a promising treatment option for patients with IBS owing to the positive results seen within the secondary endpoints. This study may have been underpowered to detect a clinically meaningful difference between the treatment groups, and therefore larger randomized, controlled studies are required to confirm these results and to elucidate potential mechanisms explaining its effect.


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