Advanced Biomedical Research

The effects of multi-strain probiotic compound on symptoms and quality-of-life in patients with irritable bowel syndrome: A randomized placebo-controlled trial

Authors

Department of Internal Medicine, and 1Medical Students' Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Evidence has shown beneficial effects of probiotics in the treatment of irritable bowel syndrome (IBS); however, there is still a lack of data in this regard. We evaluated the efficacy of a multi-strain probiotic compound on IBS symptoms and quality-of-life (QOL).
Materials and Methods: Adult IBS patients (n0=132) were randomized to receive a probiotic compound containing seven bacteria species including Lactobacillus strains, Bifidobacterium strains and Streptococcus thermophiles or similar placebo, twice daily after a meal for 14 consecutive days. Improvement of IBS symptoms was assessed in categories of abdominal pain and distension and improvement of bowel habit. Improvement in patients QOL was assessed by the IBS-QOL instrument. Patients were evaluated for symptoms and QOL at baseline and then 1 month after completion of the treatment.
Results: After treatment, there was a decrease in abdominal pain and distension severity in both probiotic and the placebo groups ( P<0.001), but there was no difference between the two groups in this regard ( P>0.05). Improvement in bowel habit was observed in 33.3% of the probiotic and 36.5% of the placebo group (P =0.910). There was no significant difference between the two groups in QOL after the treatment (P >0.05).
Conclusions: We found no beneficial effects over placebo for a 2-week treatment with the above mentioned multi-strain probiotic compound in the treatment of IBS. Further, trials are yet required before a clear conclusion in this regards.

Keywords

1. Cremonini F, Talley NJ. Irritable bowel syndrome: Epidemiology, natural history, health care seeking and emerging risk factors. Gastroenterol Clin North Am 2005;34:189-204.  Back to cited text no. 1
    
2. Chang L. Review article: Epidemiology and quality of life in functional gastrointestinal disorders. Aliment Pharmacol Ther 2004;20 Suppl 7:31-9.  Back to cited text no. 2
    
3. Chang JY, Talley NJ. Current and emerging therapies in irritable bowel syndrome: From pathophysiology to treatment. Trends Pharmacol Sci 2010;31:326-34.  Back to cited text no. 3
    
4. Camilleri M, Lasch K, Zhou W. Irritable bowel syndrome: Methods, mechanisms, and pathophysiology. The confluence of increased permeability, inflammation, and pain in irritable bowel syndrome. Am J Physiol Gastrointest Liver Physiol 2012;303:G775-85.  Back to cited text no. 4
    
5. American College of Gastroenterology Task Force on Irritable Bowel Syndrome, Brandt LJ, Chey WD, Foxx-Orenstein AE, Schiller LR, Schoenfeld PS, et al. An evidence-based position statement on the management of irritable bowel syndrome. Am J Gastroenterol 2009;104 Suppl 1:S1-35.  Back to cited text no. 5
    
6. Parkes GC, Brostoff J, Whelan K, Sanderson JD. Gastrointestinal microbiota in irritable bowel syndrome: Their role in its pathogenesis and treatment. Am J Gastroenterol 2008;103:1557-67.  Back to cited text no. 6
    
7. Moayyedi P, Ford AC, Talley NJ, Cremonini F, Foxx-Orenstein AE, Brandt LJ, et al. The efficacy of probiotics in the treatment of irritable bowel syndrome: A systematic review. Gut 2010;59:325-32.  Back to cited text no. 7
    
8. Hoveyda N, Heneghan C, Mahtani KR, Perera R, Roberts N, Glasziou P. A systematic review and meta-analysis: Probiotics in the treatment of irritable bowel syndrome. BMC Gastroenterol 2009;9:15.  Back to cited text no. 8
    
9. Brenner DM, Moeller MJ, Chey WD, Schoenfeld PS. The utility of probiotics in the treatment of irritable bowel syndrome: A systematic review. Am J Gastroenterol 2009;104:1033-49.  Back to cited text no. 9
    
10. 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.  Back to cited text no. 10
    
11. Chapman CM, Gibson GR, Rowland I. Health benefits of probiotics: Are mixtures more effective than single strains? Eur J Nutr 2011;50:1-17.  Back to cited text no. 11
    
12. Chapman CM, Gibson GR, Rowland I. In vitro evaluation of single-and multi-strain probiotics: Inter-species inhibition between probiotic strains, and inhibition of pathogens. Anaerobe 2012;18:405-13.  Back to cited text no. 12
    
13. Ghoshal UC, Park H, Gwee KA. Bugs and irritable bowel syndrome: The good, the bad and the ugly. J Gastroenterol Hepatol 2010;25:244-51.  Back to cited text no. 13
    
14. Ursell LK, Clemente JC, Rideout JR, Gevers D, Caporaso JG, Knight R. The interpersonal and intrapersonal diversity of human-associated microbiota in key body sites. J Allergy Clin Immunol 2012;129:1204-8.  Back to cited text no. 14
    
15. Simrén M, Barbara G, Flint HJ, Spiegel BM, Spiller RC, Vanner S, et al. Intestinal microbiota in functional bowel disorders: A Rome foundation report. Gut 2013;62:159-76.  Back to cited text no. 15
    
16. Clarke G, Cryan JF, Dinan TG, Quigley EM. Review article: Probiotics for the treatment of irritable bowel syndrome: Focus on lactic acid bacteria. Aliment Pharmacol Ther 2012;35:403-13.  Back to cited text no. 16
    
17. Patrick DL, Drossman DA, Frederick IO, DiCesare J, Puder KL. Quality of life in persons with irritable bowel syndrome: Development and validation of a new measure. Dig Dis Sci 1998;43:400-11.  Back to cited text no. 17
    
18. Gholamrezaei A, Zolfaghari B, Farajzadegan Z, Nemati K, Daghaghzadeh H, Tavakkoli H, et al. Linguistic validation of the Irritable Bowel Syndrome-Quality of Life Questionnaire for Iranian patients. Acta Med Iran 2011;49:390-5.  Back to cited text no. 18
    
19. Kim HJ, Camilleri M, McKinzie S, Lempke MB, Burton DD, Thomforde GM, et al. A randomized controlled trial of a probiotic, VSL#3, on gut transit and symptoms in diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther 2003;17:895-904.  Back to cited text no. 19
    
20. Kim HJ, Vazquez Roque MI, Camilleri M, Stephens D, Burton DD, Baxter K, et al. A randomized controlled trial of a probiotic combination VSL# 3 and placebo in irritable bowel syndrome with bloating. Neurogastroenterol Motil 2005;17:687-96.  Back to cited text no. 20
    
21. Ki Cha B, Mun Jung S, Hwan Choi C, Song ID, Woong Lee H, Joon Kim H, et al. The effect of a multispecies probiotic mixture on the symptoms and fecal microbiota in diarrhea-dominant irritable bowel syndrome: A randomized, double-blind, placebo-controlled trial. J Clin Gastroenterol 2012;46:220-7.  Back to cited text no. 21
    
22. Williams EA, Stimpson J, Wang D, Plummer S, Garaiova I, Barker ME, et al. Clinical trial: A multistrain probiotic preparation significantly reduces symptoms of irritable bowel syndrome in a double-blind placebo-controlled study. Aliment Pharmacol Ther 2009;29:97-103.  Back to cited text no. 22
    
23. Kajander K, Hatakka K, Poussa T, Färkkilä M, Korpela R. A probiotic mixture alleviates symptoms in irritable bowel syndrome patients: A controlled 6-month intervention. Aliment Pharmacol Ther 2005;22:387-94.  Back to cited text no. 23
    
24. Kajander K, Myllyluoma E, Rajiliæ-Stojanoviæ 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.  Back to cited text no. 24
    
25. Søndergaard B, Olsson J, Ohlson K, Svensson U, Bytzer P, Ekesbo R. Effects of probiotic fermented milk on symptoms and intestinal flora in patients with irritable bowel syndrome: A randomized, placebo-controlled trial. Scand J Gastroenterol 2011;46:663-72.  Back to cited text no. 25
    
26. 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.  Back to cited text no. 26
    
27. Design of Treatment Trials Committee, Irvine EJ, Whitehead WE, Chey WD, Matsueda K, Shaw M, et al. Design of treatment trials for functional gastrointestinal disorders. Gastroenterology 2006;130:1538-51.  Back to cited text no. 27
    
28. Gholamrezaei A, Nemati K, Emami MH. Which end point is more comprehensive in reflecting changes in irritable bowel syndrome treatment trials? Am J Gastroenterol 2009;104:2859.  Back to cited text no. 28
Advanced Biomedical Research
Volume 2014, june
June 2014
Pages 1-5