Randomized clinical trial: Effect of Lactobacillus plantarum 299 v on symptoms of irritable bowel syndrome

Stevenson, C; Blaauw, R.; Fredericks, Ernst; Visser, Janicke; Roux, Saartjie

doi:10.1016/j.nut.2014.02.010

Cited by 65 publications

(95 citation statements)

References 34 publications

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“…Similarly, the range of included IBS patients ranged from 12 to 362. Two trials included IBS-C 99,101 and 3 trials only IBS-D patients, 84,96,97 while 2 studies stratified the patients into IBS-C and IBS-D 85 or into IBS-D and IBS-M. 95 Only one study addressed another subgroup of patients who may benefit from probiotics: patients with post-infectious IBS. 110 Unfortunately, the researchers did this post-hoc rather than prospectively (see below).…”

Section: Study Characteristicsmentioning

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%

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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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Section: Study Characteristicsmentioning

confidence: 99%

Section: Bacterial Strainsmentioning

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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“…But the most impressive differences could be seen when the different species used to modify IBS symptoms were analysed separately: 6 studies used Lactobacillus plantagus [50-55], however, of different origin and subspecies. This is of particular importance, since recent studies suggest that probiotic effects are strain-specific and the strains belonging to the same species may have no or different probiotic effect [56].…”

Section: Probiotic Therapy In Ibsmentioning

confidence: 99%

Dysbiosis in Functional Bowel Disorders

Enck¹,

Mazurak²

2018

Ann Nutr Metab

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Functional bowel disorders (FBD) resemble a group of diseases of the gastrointestinal (GI) tract that are without a clear pathogenesis; the best known is probably the “irritable bowel syndrome” (IBS). Only recently we have been able to explore the role of the gut microbiota in FBD due to progress in microbiological analytic techniques. There are different ways to explore the role of the gut microbiota and its dysbiosis in FBD. Comparison of the microbial composition in a group of patients with FBD, for example, with IBS to a group of healthy volunteers is one way. Studies have shown that the microbiota in FBD is different from that of healthy controls, but the recorded differences are not necessarily specific for FBD, they may also occur in other diseases. Another approach to explore the role of the gut microbiota in FBD is to challenge the existing “flora” with novel bacteria (probiotics) or with nutritional substrates that stimulate bacterial growth (prebiotics). More than 60 such trials including several thousand patients have been performed in IBS. These studies have produced mixed outcome: some probiotics appear to be better than others, and some appear to work only for a part of the IBS symptoms and not for all. An extreme form of this approach is the transfer of an entire microbiota from 1 healthy person to another, called fecal microbiota transplantation. This has rarely been tested in FBD but is not without risk in benign disorders.

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“…De manera contraria, el estudio de Stevenson y colaboradores en Sudáfrica es poco concluyente y no encuentra diferencias estadísticamente significativas entre el uso de probióticos (Lactobacillus plantarum 299 en dosis 5 x 10 9 UFC/día) y placebo, al igual que el estudio de Ludidi y colaboradores en Holanda con 35 pacientes, Søndergaard y colaboradores en Dinamarca con 52 pacientes y Abbas y colaboradores en Pakistán, que suministraron 750 mg de Saccharomyces boulardii o placebo a 72 pacientes; sin embargo, en este caso se reportó la disminución de citoquinas proinflamatorias (interleuquina 8 y factor de necrosis tumoral [TNF]) en los pacientes suplementados, lo cual traería un beneficio de esta conducta (p=0,001) (23)(24)(25)(26).…”

Section: Síndrome De Intestino Irritableunclassified

Uso de probióticos en síndrome de intestino irritable y enfermedad inflamatoria intestinal: una revisión de la literatura

Gil-Tamayo

et al. 2017

Rev. Colomb. Gastroenterol.

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Introducción: El síndrome de intestino irritable (SII) y la enfermedad inflamatoria intestinal (EII), son motivos de consulta frecuente. Usualmente su tratamiento se hace en primer nivel de atención, con ajuste de estilo de vida y cambios dietarios. Los tratamientos farmacológicos tienen eficacia limitada e importantes efectos secundarios, por lo que existe un interés creciente en terapias diferentes como el uso de probióticos.Métodos: Se realizó una revisión de la literatura en las bases de datos Medline y Embase buscando estudios que asociaran suplementos nutricionales, con SII o EII, haciendo énfasis en probióticos.Resultados: De un total de 1598 referencias, 43 cumplieron criterios finales de inclusión. El uso de probióticos en SII y EII sugiere ser una terapia que ayuda a mantener los periodos de remisión de enfermedad, mejorar la calidad de vida y atenuar el proceso fisiopatológico.Conclusiones: El uso de probióticos y prebióticos podría ser una alternativa de soporte nutricional en pacientes seleccionados.

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Randomized clinical trial: Effect of Lactobacillus plantarum 299 v on symptoms of irritable bowel syndrome

Cited by 65 publications

References 34 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?

Dysbiosis in Functional Bowel Disorders

Uso de probióticos en síndrome de intestino irritable y enfermedad inflamatoria intestinal: una revisión de la literatura

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