Efficacy of Lactobacillus casei Shirota for patients with irritable bowel syndrome

Thijssen, Ayla; Clemens, Cees H.; Vankerckhoven, Vanessa; Goossens, Herman; Jonkers, Daisy; Masclee, Ad

doi:10.1097/meg.0000000000000484

Cited by 40 publications

(51 citation statements)

References 51 publications

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“…Agreement between reviewers for assessment of trial eligibility was excellent (kappa statistic = 0.85). Eighteen of the RCTs of probiotics in IBS were identified since our last systematic review …”

Section: Resultsmentioning

confidence: 99%

Systematic review with meta‐analysis: the efficacy of prebiotics, probiotics, synbiotics and antibiotics in irritable bowel syndrome

Ford

Harris

Lacy

et al. 2018

Aliment Pharmacol Ther

477

339

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Summary Background Irritable bowel syndrome (IBS) is a chronic functional bowel disorder. Disturbances in the gastrointestinal microbiome may be involved in its aetiology. Aim To perform a systematic review and meta‐analysis to examine the efficacy of prebiotics, probiotics, synbiotics and antibiotics in IBS. Methods MEDLINE, EMBASE, and the Cochrane Controlled Trials Register were searched (up to July 2017). Randomised controlled trials (RCTs) recruiting adults with IBS, comparing prebiotics, probiotics, synbiotics or antibiotics with placebo or no therapy were eligible. Dichotomous symptom data were pooled to obtain a relative risk (RR) of remaining symptomatic after therapy, with a 95% confidence interval (CI). Continuous data were pooled using a standardised mean difference with a 95% CI. Results The search identified 4017 citations. Data for prebiotics and synbiotics were sparse. Fifty‐three RCTs of probiotics, involving 5545 patients, were eligible. Particular combinations of probiotics, or specific species and strains, appeared to have beneficial effects on global IBS symptoms and abdominal pain, but it was not possible to draw definitive conclusions about their efficacy. There were five trials of similar design that used rifaximin in non‐constipated IBS patients, which was more effective than placebo (RR of symptoms persisting = 0.84; 95% CI 0.79‐0.90). Adverse events were no more common with probiotics or antibiotics. Conclusions Which particular combination, species or strains of probiotics are effective for IBS remains, for the most part, unclear. Rifaximin has modest efficacy in improving symptoms in non‐constipated IBS.

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Section: Resultsmentioning

confidence: 99%

Systematic review with meta‐analysis: the efficacy of prebiotics, probiotics, synbiotics and antibiotics in irritable bowel syndrome

Ford

Harris

Lacy

et al. 2018

Aliment Pharmacol Ther

477

339

View full text Add to dashboard Cite

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“…The majority of the 70 studies (Table S1) focused on IBS (based on Rome I, II or III criteria or physician diagnosis; 34 studies), antibiotic‐associated diarrhoea (13 studies) or diarrhoea‐associated Helicobacter pylori eradication therapy (7 studies). Other conditions were investigated in 16 studies.…”

Section: Resultsmentioning

confidence: 99%

Systematic review: probiotics in the management of lower gastrointestinal symptoms – an updated evidence‐based international consensus

Hungin

Mitchell

Whorwell³

et al. 2018

Aliment Pharmacol Ther

121

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SummaryBackgroundIn 2013, a systematic review and Delphi consensus reported that specific probiotics can benefit adult patients with irritable bowel syndrome (IBS) and other gastrointestinal (GI) problems.AimTo update the consensus with new evidence.MethodsA systematic review identified randomised, placebo‐controlled trials published between January 2012 and June 2017. Evidence was graded, previously developed statements were reassessed by an 8‐expert panel, and agreement was reached via Delphi consensus.ResultsA total of 70 studies were included (IBS, 34; diarrhoea associated with antibiotics, 13; diarrhoea associated with Helicobacter pylori eradication therapy, 7; other conditions, 16). Of 15 studies that examined global IBS symptoms as a primary endpoint, 8 reported significant benefits of probiotics vs placebo. Consensus statements with 100% agreement and “high” evidence level indicated that specific probiotics help reduce overall symptom burden and abdominal pain in some patients with IBS and duration/intensity of diarrhoea in patients prescribed antibiotics or H. pylori eradication therapy, and have favourable safety. Statements with 70%‐100% agreement and “moderate” evidence indicated that, in some patients with IBS, specific probiotics help reduce bloating/distension and improve bowel movement frequency/consistency.ConclusionsThis updated review indicates that specific probiotics are beneficial in certain lower GI problems, although many of the new publications did not report benefits of probiotics, possibly due to inclusion of new, less efficacious preparations. Specific probiotics can relieve lower GI symptoms in IBS, prevent diarrhoea associated with antibiotics and H. pylori eradication therapy, and show favourable safety. This study will help clinicians recommend/prescribe probiotics for specific symptoms.

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“…16 weeks) [82]. In a separate study, most (64%) patients with IBS with SIBO (n = 18) who received a solution containing L casei Shirota once daily no longer met the criteria for a SIBO diagnosis after 6 weeks.…”

Section: Lactobacillus Casei Shirotamentioning

confidence: 99%

“…Two studies that examined the efficacy of Lactobacillus casei Shirota (Yakult ® , Yakult USA Inc., Fountain Valley, CA) in patients with IBS reported mixed results, with patients achieving improvement in some, but not all, GI-related symptoms; these studies did not assess alterations in the gut microbiota [82,83]. A randomized, double-blind, placebo-controlled study of adults with IBS (n = 80) who received a solution containing L casei Shirota administered twice daily for 8 weeks did not achieve a significant improvement from baseline of ≥30% in mean symptom score nor did they achieve significant improvements in individual symptom scores for discomfort, pain, bloating, and flatulence, after 8 weeks of treatment [82].…”

Section: Lactobacillus Casei Shirotamentioning

confidence: 99%

“…A randomized, double-blind, placebo-controlled study of adults with IBS (n = 80) who received a solution containing L casei Shirota administered twice daily for 8 weeks did not achieve a significant improvement from baseline of ≥30% in mean symptom score nor did they achieve significant improvements in individual symptom scores for discomfort, pain, bloating, and flatulence, after 8 weeks of treatment [82].…”

Section: Lactobacillus Casei Shirotamentioning

confidence: 99%

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Modulation of the gut microbiota: a focus on treatments for irritable bowel syndrome

Harris

Baffy

2017

Postgraduate Medicine

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Irritable bowel syndrome (IBS), which is characterized by recurrent abdominal pain and disordered bowel habits, is one of the most common functional bowel disorders. IBS is a substantial burden on both patient health-related quality of life and healthcare costs. Several pathophysiologic mechanisms have been postulated for the occurrence of IBS, including altered gastrointestinal motility, visceral hypersensitivity, changes in gut permeability, immune activation, gut-brain dysregulation, central nervous system dysfunction, and changes in the gut microbiota. Of note, both qualitative and quantitative differences have been observed in the gut microbiota of a population with IBS versus a healthy population. Because of the substantial interest in the gut microbiota and its role as a therapeutic target in IBS, this article provides an overview of specific interventions with the potential to modulate the gut microbiota in IBS, including elimination diets, prebiotics, probiotics, synbiotics, and nonsystemic antibiotics. Although probiotics and synbiotics are generally well tolerated, differences in the composition and concentration of different bacterial species and inclusion or exclusion of prebiotic components varies widely across studies and has prevented strong recommendations on their use in IBS. For nonsystemic antibiotics, rifaximin is indicated in the United States for the treatment of IBS with diarrhea in adults and has been shown to be efficacious and well tolerated in well-designed clinical trials. Overall, more consistent evidence is needed regarding the efficacy and safety of elimination diets, prebiotics, probiotics, and synbiotics for the treatment of patients with IBS. Furthermore, additional well-designed studies are needed that examine alterations in the gut microbiota that occur with these interventions and their potential associations with clinical symptoms of IBS. ARTICLE HISTORY

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Efficacy of Lactobacillus casei Shirota for patients with irritable bowel syndrome

Abstract: After probiotic treatment with LcS, no improvement of 30% in MSS was observed after 8 weeks.

Cited by 40 publications

References 51 publications

Systematic review with meta‐analysis: the efficacy of prebiotics, probiotics, synbiotics and antibiotics in irritable bowel syndrome

Systematic review with meta‐analysis: the efficacy of prebiotics, probiotics, synbiotics and antibiotics in irritable bowel syndrome

Systematic review: probiotics in the management of lower gastrointestinal symptoms – an updated evidence‐based international consensus

Modulation of the gut microbiota: a focus on treatments for irritable bowel syndrome

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