Anthony Lembo, MD: Exploring Probiotics for IBS Treatment

Treatment for irritable bowel syndrome (IBS) currently includes an individualized treatment plan incorporating various dietary and lifestyle interventions as well as medication. Although the use of probiotics in this patient population is still being explored, findings from a recent study suggest they may be a safe and effective intervention for IBS.

The research was presented at Digestive Disease Week (DDW) 2024 in Washington, DC, and highlights the potential of DS-01, a multi-species synbiotic composed of 24- Bifidobacterium- and lactobacilli- strains, for effectively alleviating IBS symptoms and altering the gastrointestinal microbiome community composition.

“It’s an interesting study that dives into the mechanism. It's not a definitive study, this is an exploratory initial study, but the results are really intriguing and warrant much further study with this combination of probiotics,” Anthony Lembo, MD, director of research for Cleveland Clinic’s Digestive Disease Institute, said to HCPLive.

The double-blind, placebo-controlled study included adults diagnosed with IBS-M or IBS-C not consuming probiotics, prebiotics, or synbiotics. In both IBS-M and IBS-C patients, DS-01 supplementation was safe and maintained overall alpha- and beta-diversity and significantly enriched for synbiotic species (30x, P = .014), Bifidobacterium spp. (4.6x, P = .01092), and lactobacilli (4.2x, P = .00249), for up to 84 days.

DS-01 relieved constipation (reduction avg -7.9%, P = .029) by end-of-study in IBS-M patients compared to placebo. IBS-M patients with higher abdominal pain at baseline showed a greater decrease in pain with treatment compared to placebo (reduction avg -3.96%, P = .036). Further analysis revealed that an increase in DS-01 consortium species (D0 to D84) in the stool was associated with decreased systemic immune activation (CD40, P = .0007; IL-12B, P = .0045; IL-18R, P = .0034; IL-18, P <.0001; CASP8, P =.0002) and neutrophil extracellular trap formation (CitH3, P = .0013).

“As the study gives some credence to the fact that probiotics have activity within the gut, most of which we think are in a positive way, it should be explored in a prospective multicenter trial, maybe including all subtypes of IBS,” Lembo concluded.

Reference:

Napier BA, Van Den Elzen C, Al-Ghalith GA, et al. A MULTI-SPECIES SYNBIOTIC (DS-01) ALLEVIATES CONSTIPATION AND ABDOMINAL PAIN IN IRRITABLE BOWEL SYNDROME SUBTYPE MIXED (IBS-M) SUBJECTS WHILE BOOSTING SYNBIOTIC SPECIES ASSOCIATED WITH DECREASED SYSTEMIC INFLAMMATION AND NET FORMATION. Abstract presented at Digestive Disease Week (DDW) 2024 Annual Meeting. Washington, DC. May 17-21, 2024.