A candidate probiotic with unfavourable effects in subjects with irritable bowel syndrome: a randomised controlled trial

Ligaarden, Solveig Catharina; Axelsson, Lars; Naterstad, Kristine; Lydersen, Stian; Farup, Per G.

doi:10.1186/1471-230x-10-16

Cited by 85 publications

(73 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Two frequently included papers reported studies in children. 49,50 Two were placebo controlled but single-blinded studies, 33,51 one combined acupuncture with probiotic treatment, 46 and one 32 reported microbiota changes from a probiotic trial published before 52 which was already included in our list.…”

Section: Resultsmentioning

confidence: 99%

“…With respect to the bacterial strains studied, the heterogeneity continued: 6 studies used Lactobacillus plantagus, 52,85,89,105,106,108 however of different origin and subspecies; some were nutritional supplements and some were developed as drugs. Other lactobacilli strains were used only in single trials, such as Lactobacillus brevi, 90 L. acidophilus, 56,100 Lactobacillus reuteri, 103 Lactobacillus rhamnosus GG, 107 and Lactobacillus casei (CLR35).…”

Section: Bacterial Strainsmentioning

confidence: 99%

“…37,52,56, Four studies employed a cross-over design, 52,56,90,105 which is frequently used for motivational purposes (patients are easier to recruit when they are offered an effective treatment, at least for a part of the trial). However, they are difficult to evaluate since the assumption that the data in both periods is equal and can be merged may be distorted by unblinding and conditioning effects.…”

Section: Study Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

Probiotic Therapy of the Irritable Bowel Syndrome: Why Is the Evidence Still Poor and What Can Be Done About It?

Mazurak

Broelz²,

Storr

et al. 2015

J Neurogastroenterol Motil

View full text Add to dashboard Cite

Background/AimsDespite numerous randomized clinical trials and meta-analyses, there is no increased evidence for the efficacy of probiotics in the treatment of irritable bowel syndrome (IBS). We review this evidence, identify and analyse the reasons for this lack of evidence and propose methodological improvements for future studies. MethodsBased on a literature search, we identified 56 papers that matched the purpose of our analyses. Twenty-seven studies used multi-species bacterial preparations and 29 used single-strain probiotics. They were analysed regarding patients included, treatment duration, probiotic dosage, and outcome measures. ResultsTrials in both groups suffered from heterogeneity with respect to probiotic concentration, duration of treatment, and other methodological issues (crossover design and underpowered studies). This heterogeneity did not allow the application of a meta-analytic approach and a systematic review was therefore performed instead. Multi-strain preparations combined 2 to 8 different bacterial subspecies, mostly lactobacilli or bifidobacteria, and used variable lengths of treatments. Overall, more than 50% of trials presented negative outcomes. The majority of the single-strain probiotic trials employing lactobacilli or Saccharomyces were negative, whereas trials employing bifidobacteria showed positive results. ConclusionsThe heterogeneity of the studies of probiotics in IBS questions the value of meta-analyses. The use of different bacterial strains and different mixtures of these strains, as well as different dosages, are the main contributors to this heterogeneity. Current data provides limited evidence for the efficacy of a small number of single-strain probiotics in IBS (mostly bifidobacteria) and

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Bacterial Strainsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

Probiotic Therapy of the Irritable Bowel Syndrome: Why Is the Evidence Still Poor and What Can Be Done About It?

Mazurak

Broelz²,

Storr

et al. 2015

J Neurogastroenterol Motil

View full text Add to dashboard Cite

show abstract

“…7,8 However, in other study Lactobacillus plantarum MF1298 species had aggravated IBS symptom score, and this means not all strains with in vitro demonstrated probiotics actually showed therapeutic effects on the in vivo condition. 9 To date, clinical research with probiotics in IBS patients suffered from methodological limitations such as differences in study design, type of probiotics administered, and outcome parameters. Furthermore, previous studies frequently used subject endpoints and included heterogeneous patient populations.…”

Section: Commentsmentioning

confidence: 99%

What Is the Therapeutic Mechanism of the Probiotics in Irritable Bowel Syndrome Patients With Visceral Hypersensitivity?

Kim

2014

J Neurogastroenterol Motil

View full text Add to dashboard Cite

SummaryIrritable bowel syndrome (IBS) is characterized by heterogeneous pathogenesis and many IBS patients suffer from visceral hypersensitivity. Visceral hypersensitivity is evaluated under stimulated condition with mechanical distension using barostat to provide sensations of discomfort or visceral pain in most clinical researches. Distensions administered to rectum using the barostat, can induce visceral discomfort or pain, which are like typical symptoms for IBS. In addition, increased rectal sensitivity has found to be related to symptom severity in daily life. It is known that visceral hypersensitivity was associated with increased intestinal permeability and inflammation. Increased intestinal permeability leads to translocation of bacteria and their products, resulting to induce hypersensitivity by targeting the enteric neurons. Increased release of immunologic mediators resulted in visceral hypersensitivity via sensitization of neuronal cells.Previous studies with probiotic therapeutic effects have focus on daily symptoms in IBS patients, and the effects were a small but significant improvement in overall symptom score. However, in previous studies, heterogeneous groups of IBS patients have been included rather than a selection of IBS patients based on pathophysiological characteristics. None of the studies up to now has chosen an approach by evaluating effects of probiotics targeting on one common pathophysiological mechanism. In this study, Ludidi et al 1 investigated that whether implementing probiotics in IBS patients with documented visceral hypersensitivity had potential effect to reduce visceral hypersensitivity (primary end point).This study was performed a randomized, placebo-controlled, double-blind trial in 40 Rome III IBS patients with visceral hypersensitivity. Prior to participation, patients kept a 2-weak symptom diary and underwent barostat measurement. When visceral hypersensitivity was confirmed, patients were enrolled this study and received a multispecies probiotics (6 different probiotic strains 10 9 CFU/g), or a placebo products of one sachet (5 g) per day for 6 weeks. At the end of the intervention period, visceroperception and symptoms were reevaluated. In total, 35 patients were completed the study (19 in pro-

show abstract

“…Similarly, because probiotics potentially modulate a number of the pathophysiological mechanisms involved in IBS, they are usually given to all subtypes of the condition both in the clinical setting as well as in therapeutic trials. There have been twenty-eight controlled trials assessing the efficacy of probiotics in adults suffering from IBS with twenty (71 %) showing a positive effect (43,(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74)(75) , seven showing no effect (43,(76)(77)(78)(79)(80)(81) and one leading to a deterioration of symptoms (82) . In addition, four trials in children all gave positive results (83)(84)(85)(86) .…”

Section: Treating Irritable Bowel Syndrome With Probioticsmentioning

confidence: 99%

Irritable bowel syndrome: the problem and the problem of treating it – is there a role for probiotics?

Santos¹,

Whorwell²

2014

Proc. Nutr. Soc.

View full text Add to dashboard Cite

The aim of this review is to highlight the impact of irritable bowel syndrome (IBS) in those patients who consult the medical profession and examine the therapeutic potential of probiotics in this condition, where there is a strong need for new treatment options. Traditionally, IBS is frequently regarded as a trivial condition which is certainly not life threatening and mainly psychological in origin. However, these preconceptions are misplaced, as in some patients the condition can be devastating with the pain being as severe as that of childbirth coupled with incapacitating bowel dysfunction. In addition, patients suffer from a variety of non-colonic symptoms such as low backache, constant lethargy, nausea and genito-urinary problems, all of which lead to these patients having extremely poor quality of life. Unfortunately, the treatment of IBS is very unsatisfactory with only one new medication being developed for this condition in the last 25 years. It is now recognised that IBS is a multifactorial condition with symptoms being triggered by a variety of factors, some of which appear to be influenced by probiotics, resulting in speculation that they may have therapeutic potential in this condition. There have been over thirty controlled clinical trials of probiotics in IBS with approximately two-thirds of these studies showing evidence of an improvement in symptoms. However, not all probiotics appear to be effective with different symptoms being improved by different strains and some improving symptoms more than others. Consequently, the ideal probiotic for the treatment of IBS has yet to be defined, but the evidence is good enough to encourage further research with the aim of identifying an optimal strain or strains.

show abstract

A candidate probiotic with unfavourable effects in subjects with irritable bowel syndrome: a randomised controlled trial

Cited by 85 publications

References 25 publications

Probiotic Therapy of the Irritable Bowel Syndrome: Why Is the Evidence Still Poor and What Can Be Done About It?

Probiotic Therapy of the Irritable Bowel Syndrome: Why Is the Evidence Still Poor and What Can Be Done About It?

What Is the Therapeutic Mechanism of the Probiotics in Irritable Bowel Syndrome Patients With Visceral Hypersensitivity?

Irritable bowel syndrome: the problem and the problem of treating it – is there a role for probiotics?

Contact Info

Product

Resources

About