Probiotics in irritable bowel syndrome (IBS)

Probiotics in Irritable Bowel Syndrome (IBS)

Probiotics

• are living microorganisms that are nonpathogenic
  
  
• are defined as "live microorganisms that, when administered in adequate amounts, confer a health benefit on the host" (2)
  
  
• are known to produce several beneficial effects, such as altering the host's immune response in the gastrointestinal tract and lowering the growth of pathogenic organisms by enhancing the microbial balance (1)
  
  
• can be consumed in the form of food and even dietary supplements
  • familiar sources of probiotics include kefir, yogurt, and some other fermented foods
  • all of these contain different microorganisms that potentially offer better gut health (1)
    • most commonly used organisms in these sources include Streptococcus thermophilus, Lactobacillus strains, Lactobacillus delbrueckii subsp. bulgaricus,and Bifidobacterium strains

Probiotics in IBS

• probiotics are safe and effective in IBS patients, especially those used for a shorter duration such as for less than eight weeks; a higher dosage of a single probiotic strain seem to show greater benefits (1)
  • probiotics have been shown to improve overall stool frequency, gut transit time, and stool consistency
• a systematic review and meta-analysis concluded that:
  • some combinations of probiotics or strains may be beneficial in IBS (2)
    • however, certainty in the evidence for efficacy by GRADE criteria was low to very low across almost all of our analyses
    • for global symptoms, there was moderate certainty for benefit of Escherichia strains, low certainty for Lactobacillus strains and Lactobacillis plantarum 299V, and very low certainty for combination probiotics and Bacillus strains
    • for abdominal pain, there was low certainty for benefit of Saccharomyces cerevisiae I-3856 and Bifidobacterium strains, and very low certainty for combination probiotics, Lactobacillus, Saccharomyces, and Bacillus strains

Reference:

• Satish Kumar L, Pugalenthi LS, Ahmad M, Reddy S, Barkhane Z, Elmadi J. Probiotics in Irritable Bowel Syndrome: A Review of Their Therapeutic Role. Cureus. 2022 Apr 18;14(4):e24240.
• Goodoory VC et al. Efficacy of Probiotics in Irritable Bowel Syndrome: Systematic Review and Meta-analysis. Gastroenterology August 3rd 2023.