A randomized controlled trial of a probiotic combination VSL# 3 and placebo in irritable bowel syndrome with bloating

Kim, H. J.; Roque, Maria I. Vazquez; Camilleri, Michael; Stephens, Debra; Burton, Duane D.; Baxter, Kari; Thomforde, George M.; Zinsmeister, Alan R.

doi:10.1111/j.1365-2982.2005.00695.x

Cited by 334 publications

(340 citation statements)

References 51 publications

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“…Several trials have been excluded from this list because of failure to compare with placebo (49) , re-analysis of old data (50) , unclear end points (51) or the use of multiple interventions (52) . Many early studies were small singlecentre trials (53)(54)(55)(56)(57) , although more recently a number of much larger multi-centre trials have been undertaken, reflecting the growing interest in the area (58)(59)(60)(61) .…”

Section: Probiotics In Irritable Bowel Syndrome: Clinical Trialsmentioning

confidence: 99%

“…No significant reduction in GI transit was found for the study group, although there was a symptom score reduction in abdominal bloating. Thus, a second, larger, trial was designed using forty-eight patients with a reduction in abdominal bloating as the primary end point and colonic transit and other symptoms as secondary end points (54) . Although only a non-significant reduction in abdominal bloating scores was found in the study group v. placebo (31 .…”

Section: Vsl#3mentioning

confidence: 99%

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Treating irritable bowel syndrome with probiotics: the evidence

2010

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Irritable bowel syndrome (IBS) is a disorder of chronic abdominal pain, altered bowel habit and abdominal distension. It is the commonest cause of referral to gastroenterologists in the developed world and yet current therapeutic strategies are often unsatisfactory. There is now increasing evidence linking alterations in the gastrointestinal (GI) microbiota and IBS. Changes in faecal and mucosa-associated microbiota, post-infectious IBS, a link with small intestinal bacterial overgrowth and an up-regulation of the GI mucosal immune system all suggest a role for the GI microbiota in the pathogenesis of IBS. Given this evidence, therapeutic alteration of the GI microbiota by probiotic bacteria could be beneficial. The present paper establishes an aetiological framework for the use of probiotics in IBS and comprehensively reviews randomised placebo-controlled trials of probiotics in IBS using multiple electronic databases. It highlights safety concerns over the use of probiotics and attempts to establish guidelines for their use in IBS in both primary and secondary care.Probiotics: Irritable bowel syndrome: Small bowel intestinal overgrowth: Gastrointestinal microbiota

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Section: Probiotics In Irritable Bowel Syndrome: Clinical Trialsmentioning

confidence: 99%

Section: Vsl#3mentioning

confidence: 99%

Treating irritable bowel syndrome with probiotics: the evidence

2010

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“…The same preparation (VSL#3) was used in only 3 studies. 69,77,80 Up to 8 different bacterial strains are used in some preparations and the combinations are numerous, since in many cases subspecies of specific strains were used that are only available to (and eventually patented by) individual companies. Two studies were performed by the same research group with the same preparation.…”

Section: Bacterial Strain Combinationsmentioning

confidence: 99%

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

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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

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“…17 Kim et al in another study suggested that effect of fiber and probiotics was different among the given organisms and IBS subtypes. 18 The present study patients rated the efficacy of global symptom assessment as grade 4 or above, suggesting a significant improvement in overall relief ( Figure 6). …”

Section: -14mentioning

confidence: 99%

Combination of bulk laxative along with probiotics and prebiotics in the management of irritable bowel syndrome with constipation: A safe & effective option

Faruqui¹,

Jamaiwar²,

Sharma³

2017

Asian J Med Sci

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Background: Irritable bowel syndrome (IBS) is a common and relapsing functional bowel disorder. This disease has a substantial global burden and is associated with significant disability and high costs that adversely affects the health related quality of life of large population worldwide. Aims and Objective: We studied the efficacy and tolerability of bulk laxative plus probiotic and prebiotic in the treatment of constipation associated IBS (IBS-C) in Indian patients. Materials and Methods: Eighty patients with symptoms of IBS-C were enrolled in a post-marketing surveillance, multicentre, open label, non-randomized, noncomparative study where EVAQ-P -combination of fiber (psylliun husk/Ispaghula, probiotic and prebiotic) was given BID for 6 weeks. The symptoms were assessed at baseline, and after completion of 2, 4 and 6 weeks of therapy. Results: Results showed a significant trend (p < 0.0001) of improvement from week 2 for abdominal pain, abdominal fullness, defecation frequency, straining during defecation, constipation and subject global assessment of relief (SGA). Approximately 6% patients showed flatulence (mild) as a treatment emergent side effect. Conclusion: Combination of ispaghula along with a blend of probiotics and prebiotic twice daily for 6 weeks is efficacious, safe, and well-tolerated in IBS-C patients.

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A randomized controlled trial of a probiotic combination VSL# 3 and placebo in irritable bowel syndrome with bloating

Abstract: VSL# 3 reduces flatulence scores and retards colonic transit without altering bowel function in patients with IBS and bloating.

Cited by 334 publications

References 51 publications

Treating irritable bowel syndrome with probiotics: the evidence

Treating irritable bowel syndrome with probiotics: the evidence

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

Combination of bulk laxative along with probiotics and prebiotics in the management of irritable bowel syndrome with constipation: A safe & effective option

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