Effect of Probiotic Administration Immediately and 1 Month after Colonoscopy in Diarrhea-predominant Irritable Bowel Syndrome Patients

Khodadoostan, Mahsa; Shavakhi, Ahmad; Sherafat, Zahra; Shavakhi, Alireza

Effect of Probiotic Administration Immediately and 1 Month after Colonoscopy in Diarrhea-predominant Irritable Bowel Syndrome Patients

Authors

¹ Department of Gastroentrology and Hebatology, Isfahan University of Medical Sciences, Isfahan, Iran

² Department of Internal Medicine School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran

Abstract

Background: Irritable bowel syndrome (IBS) is one of the most common disorders among young adults. Various studies have demonstrated that the use of probiotics can reduce the overall symptom of IBS, and thus, our aim was to evaluate the efficacy of probiotic products in the reduction of IBS syndrome after colonoscopy. Materials and Methods: Our patients were divided among three groups, including immediate probiotic users, start use of probiotics 1 month after colonoscopy, and placebo group. All the patients were interviewed for having common IBS symptoms (stool consistency and frequency, gas, abdominal pain, and flatulence) at baseline, 3^rd month of follow-up, and 6^th month of follow-up. Results: The mean reduction in abdominal pain was 3.05 ± 1.21, 3.86 ± 0.94, and 3.82 ± 0.63 in the control group, immediate probiotic users, and 1 month after colonoscopy, respectively (P < 0.001). The symptoms of the disease, such as stool consistency, the frequency of defecation, and flatulence (except gas) in the first quarter, in the two treatment groups were significantly improved more than in the control group (P < 0.05). In contrast, the frequency of defecation was not significantly different in the treatment group receiving the probiotics month after colonoscopy compared to the placebo users (P > 0.05). Conclusion: According to our results, the use of probiotics had the beneficial effect on IBS symptoms. Furthermore, it can be said that reductions in symptoms and pain in the two treatment groups were not significantly different, but after 6 months of treatment, the effect of probiotics in patients who immediately use it after colonoscopy was more visible and more stable.

Keywords

References

1.	Mugie SM, Benninga MA, Di Lorenzo C. Epidemiology of constipation in children and adults: A systematic review. Best Pract Res Clin Gastroenterol 2011;25:3-18. [PUBMED]
2.	Maxion-Bergemann S, Thielecke F, Abel F, Bergemann R. Costs of irritable bowel syndrome in the UK and US. Pharmacoeconomics 2006;24:21-37.
3.	Mönnikes H. Quality of life in patients with irritable bowel syndrome. J Clin Gastroenterol 2011;45:S98-101.
4.	Mullin GE, Shepherd SJ, Chander Roland B, Ireton-Jones C, Matarese LE. Irritable bowel syndrome: Contemporary nutrition management strategies. JPEN J Parenter Enteral Nutr 2014;38:781-99. [PUBMED]
5.	Drossman DA, Chang L, Bellamy N, Gallo-Torres HE, Lembo A, Mearin F, et al. Severity in irritable bowel syndrome: A Rome foundation working team report. Am J Gastroenterol 2011;106:1749-59. [PUBMED]
6.	Hasler WL. Traditional thoughts on the pathophysiology of irritable bowel syndrome. Gastroenterol Clin North Am 2011;40:21-43. [PUBMED]
7.	Camilleri M, Katzka DA. Irritable bowel syndrome: Methods, mechanisms, and pathophysiology. Genetic epidemiology and pharmacogenetics in irritable bowel syndrome. Am J Physiol Gastrointest Liver Physiol 2012;302:G1075-84. [PUBMED]
8.	Eswaran S, Tack J, Chey WD. Food: The forgotten factor in the irritable bowel syndrome. Gastroenterol Clin North Am 2011;40:141-62. [PUBMED]
9.	Rosania R, Giorgio F, Principi M, Amoruso A, Monno R, Di Leo A, et al. Effect of probiotic or prebiotic supplementation on antibiotic therapy in the small intestinal bacterial overgrowth: A comparative evaluation. Curr Clin Pharmacol 2013;8:169-72. [PUBMED]
10.	NIH HMP Working Group, Peterson J, Garges S, Giovanni M, McInnes P, Wang L, et al. The NIH human microbiome project. Genome Res 2009;19:2317-23. [PUBMED]
11.	Collins SM. A role for the gut microbiota in IBS. Nat Rev Gastroenterol Hepatol 2014;11:497-505. [PUBMED]
12.	Hong SN, Rhee PL. Unraveling the ties between irritable bowel syndrome and intestinal microbiota. World J Gastroenterol 2014;20:2470-81. [PUBMED]
13.	Whelan K, Quigley EM. Probiotics in the management of irritable bowel syndrome and inflammatory bowel disease. Curr Opin Gastroenterol 2013;29:184-9. [PUBMED]
14.	Whelan K. Probiotics and prebiotics in the management of irritable bowel syndrome: A review of recent clinical trials and systematic reviews. Curr Opin Clin Nutr Metab Care 2011;14:581-7. [PUBMED]
15.	Dalrymple J, Bullock I. Diagnosis and management of irritable bowel syndrome in adults in primary care: Summary of NICE guidance. BMJ 2008;336:556-8. [PUBMED]
16.	Church J. Complications of colonoscopy. Gastroenterol Clin North Am 2013;42:639-57. [PUBMED]
17.	Didari T, Solki S, Mozaffari S, Nikfar S, Abdollahi M. A systematic review of the safety of probiotics. Expert Opin Drug Saf 2014;13:227-39. [PUBMED]
18.	Drago L, Toscano M, De Grandi R, Casini V, Pace F. Persisting changes of intestinal microbiota after bowel lavage and colonoscopy. Eur J Gastroenterol Hepatol 2016;28:532-7. [PUBMED]
19.	Dapoigny M, Piche T, Ducrotte P, Lunaud B, Cardot JM, Bernalier-Donadille A, et al. Efficacy and safety profile of LCR35 complete freeze-dried culture in irritable bowel syndrome: A randomized, double-blind study. World J Gastroenterol 2012;18:2067-75.
20.	Whorwell PJ, Altringer L, Morel J, Bond Y, Charbonneau D, O'Mahony L, et al. Efficacy of an encapsulated probiotic bifidobacterium infantis 35624 in women with irritable bowel syndrome. Am J Gastroenterol 2006;101:1581-90.
21.	Guyonnet D, Chassany O, Ducrotte P, Picard C, Mouret M, Mercier CH, et al. Effect of a fermented milk containing bifidobacterium animalis DN-173 010 on the health-related quality of life and symptoms in irritable bowel syndrome in adults in primary care: A multicentre, randomized, double-blind, controlled trial. Aliment Pharmacol Ther 2007;26:475-86. [PUBMED]
22.	Lasser RB, Bond JH, Levitt MD. The role of intestinal gas in functional abdominal pain. N Engl J Med 1975;293:524-6. [PUBMED]
23.	O'Sullivan MA, O'Morain CA. Bacterial supplementation in the irritable bowel syndrome. A randomised double-blind placebo-controlled crossover study. Dig Liver Dis 2000;32:294-301.
24.	Rousseaux C, Thuru X, Gelot A, Barnich N, Neut C, Dubuquoy L, et al. Lactobacillus acidophilus modulates intestinal pain and induces opioid and cannabinoid receptors. Nat Med 2007;13:35-7. [PUBMED]
25.	Kajander K, Myllyluoma E, Rajilić-Stojanović M, Kyrönpalo S, Rasmussen M, Järvenpää S, et al. Clinical trial: Multispecies probiotic supplementation alleviates the symptoms of irritable bowel syndrome and stabilizes intestinal microbiota. Aliment Pharmacol Ther 2008;27:48-57.
26.	Elsenbruch S. Abdominal pain in irritable bowel syndrome: A review of putative psychological, neural and neuro-immune mechanisms. Brain Behav Immun 2011;25:386-94. [PUBMED]
27.	Cui S, Hu Y. Multistrain probiotic preparation significantly reduces symptoms of irritable bowel syndrome in a double-blind placebo-controlled study. Int J Clin Exp Med 2012;5:238-44. [PUBMED]
28.	Simrén M, Ohman L, Olsson J, Svensson U, Ohlson K, Posserud I, et al. Clinical trial: The effects of a fermented milk containing three probiotic bacteria in patients with irritable bowel syndrome – A randomized, double-blind, controlled study. Aliment Pharmacol Ther 2010;31:218-27.
29.	Didari T, Mozaffari S, Nikfar S, Abdollahi M. Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis. World J Gastroenterol 2015;21:3072-84. [PUBMED]
30.	Azpiroz F, Bouin M, Camilleri M, Mayer EA, Poitras P, Serra J, et al. Mechanisms of hypersensitivity in IBS and functional disorders. Neurogastroenterol Motil 2007;19:62-88. [PUBMED]

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