Multi-strain probiotic shows potential to help manage IBS: RCT
The severity of abdominal pain was reduced by almost 70% in people receiving the probiotic, compared with 505 in the placebo group, reported scientists from Bangabandhu Sheikh Mujib Medical University (Bangladesh) in BMC Gastroenterology.
In addition, the proportion of people in the probiotic group who rated their symptoms as moderate-to-severe fell from 100% at the start of the study to 14% after five months, compared with a decrease to 48% for the placebo group.
“In this large controlled clinical trial, well-validated instruments to assess symptom severity (IBS-SSS) and [Quality of life] (IBS-QoL) were used in patients with IBS-D. We found that the multi-strain probiotic Bio-Kult (14 different bacterial strains; 8 billion colony-forming units per day) was safe and superior to placebo in improving [gastro-intestinal] symptoms over a period of 4 months in patients with IBS-D,” wrote the researchers.
“Furthermore, symptom improvement was paralleled by statistically significant benefits in all measures of QoL […] it is important to note that the findings only apply to the multi-strain probiotic administered and should not be generalised to other probiotics or IBS patient subtypes.”
Study details
The Bangladesh-based scientists randomly assigned 400 people with moderate-to-severe symptomatic diarrhea-predominant IBS (IBS-D) to receive either Bio-Kult supplements or placebo for four months.
The data showed that participants in the probiotic group experienced significant improvements in the severity of abdominal pain the prevalence of moderate-to-severe symptoms, compared with placebo.
Improvements were also seen for the number of bowel movements after two months of probiotic supplementation, compared with placebo.
Furthermore, the researchers found that the probiotic was associated with improvements in all dimensions of quality of life in the 34-item IBS-Quality of Life (IBS-QoL) questionnaire.
“The multi-strain probiotic was associated with significant improvement in symptoms in patients with IBS-D and was well-tolerated,” wrote the researchers.
“Limited understanding”
Commenting on the potential mechanism, the authors wrote: “It is undeniable that the gut microbiota has both direct and indirect effects on the immune system and inflammation, Current evidence suggests that IBS patients have greater mucosal cellularity and other signs of increased inflammatory activity which might contribute to the development of IBS.
“In this study markers of inflammation were not measured, however future studies would benefit from monitoring inflammation to explore the impact of probiotics on systemic and local inflammatory markers. Overall, and despite the growing interest in this field, our understanding of the role of the gut microbiota in functional GIs such as IBS remains limited.
“The results of the current trial provide an insight into the benefits that may be obtained using a multi-strain probiotic, but the study was not designed to help elucidate the physiological mechanisms underpinning the observed clinical improvements.”
Source: BMC Gastroenterology
2018 18:71 doi: 10.1186/s12876-018-0788-9
“A randomized placebo-controlled clinical trial of a multi-strain probiotic formulation (Bio-Kult) in the management of diarrhea-predominant irritable bowel syndrome”
Authors: S.M. Ishaque et al.
