Treating irritable bowel syndrome with probiotics: the evidence

Abstract

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

Gastrointestinal microbiota in irritable bowel syndrome: present state and perspectives

“…(3) IBS symptoms can be improved by treatments that target the microbiota (antibiotics, probiotics, prebiotics). This aspect has also been recently reviewed (Moayyedi et al, 2010;Parkes et al, 2010;Pimentel & Lezcano, 2007) and will not be further discussed in this review.…”

“…(3) IBS symptoms can be improved by treatments that target the microbiota (antibiotics, probiotics, prebiotics). This aspect has also been recently reviewed (Moayyedi et al, 2010;Parkes et al, 2010;Pimentel & Lezcano, 2007) and will not be further discussed in this review.The differences in the intestinal microbiota between IBS patients and healthy controls (HCs) have mostly been studied using faecal material, as this is the most accessible source of the GI microbiota. For clarity and easier comparability of the results, we first discuss the results in which IBS patients were not subdivided according to Rome II criteria but were compared as a single group with the HCs.…”

Pathophysiologic Findings of Irritable Bowel Syndrome in China

“…The therapeutic effect of probiotics varied in different studies for different strains chosen and trial designs. But a meta-analysis of these studies confirmed the benefit of probiotics in the treatment of IBS 114. However, probiotics cannot be effective for all IBS patients, so further work is deserved to identify the patient groups which can get most benefit from it and to choose the most appropriate and effective strains.…”

Caracterización y potencial probiótico de bacterias lácticas aisladas de leche de oveja guirra

“…Mantenimiento de la microbiota intestinal normal: La microbiota intestinal está influenciada por la edad, dieta, condición socio-económica, uso de antibióticos y estado de salud (Parkes et al, 2009). Los probióticos interactúan con la microbiota intestinal y con los receptores de la pared intestinal produciendo variedad de efectos en el hospedador (S. Salminen et al, 2010).…”

“…Los probióticos interactúan con la microbiota intestinal y con los receptores de la pared intestinal produciendo variedad de efectos en el hospedador (S. Salminen et al, 2010). Sin embargo, se desconoce el papel metabólico e inmunológico de la microbiota del tracto gastrointestinal y si estos cambios son primarios o secundarios (Parkes et al, 2009).…”