Lactiplantibacillus plantarum P9 alleviates chronic diarrhea via modulation of gut microbiota and its intestinal metabolites: a double-blind, randomized, placebo-controlled study

Abstract

This study evaluated the beneficial effects of administering Lactiplantibacillus plantarum P9 (P9) on chronic diarrhea. A randomized, double-blind, placebo-controlled trial was performed. Patients were assigned to the probiotic or placebo group randomly. The primary endpoint was the diarrhea symptom severity score; the secondary endpoints were the stool consistency, the number of bowel movements, fecal urgency score, the Depression Anxiety Stress Scales-21 score, fecal metagenome and metabolome. Administering P9 for 4-week significantly improved diarrhea symptoms and the stool consistency, accompanied by a multitude of patients’ gut microbiota and metabolome changes: increases in several gut short-chain fatty acid (SCFA)-producers and a bile acid metabolizing species; elevation in fecal metabolites of bile acids, amino acids, and short-chain fatty acids; increases in cumulative gene abundances of 15 carbohydrate-active enzyme subfamilies; increases in fecal acetate and butyrate concentrations. P9 administration had a remarkable therapeutic effect on chronic diarrhea, supporting using probiotics to alleviate chronic diarrhea.