Multispecies Probiotics May Provide Symptom Relief in Irritable Bowel Syndrome

The authors of “Effect of Multi-species Probiotics on Irritable Bowel Syndrome: A Randomized, Double-blind, Placebo-controlled Trial,” published in the Journal of Gastroenterology and Hepatology, looked at the ways in which multispecies probiotics altered the gut microbiota and promoted symptom relief in cohort of patients who met the Rome III criteria for irritable bowel syndrome (IBS).

In the study, 25 patients received twice-daily multispecies probiotic (consisting of Bifidobacterium longum, Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus, Lactobacillus rhamnosus, and Streptococcus thermophilus) for four weeks. Twenty-four patients received twice-daily placebo for four weeks.

The primary endpoint of the study was “the proportion of participants whose IBS symptoms were substantially relieved at week 4.” Secondary endpoints included “intensity of abdominal pain/discomfort, bloating, stool frequency/consistency, alterations in fecal microflora over the four weeks.”

Researchers also analyze fecal microflora in 17 patients from each group.

They reported that “the proportion of patients whose IBS symptoms were substantially relieved at week 4 was significantly higher in the probiotics group than in the placebo group: 68.0% (17/25) vs. 37.5% (9/24) (p<0.05). Secondary endpoints such as improvement in abdominal pain/discomfort and bloating occurred in the probiotics group but not in the placebo group.”

Analysis of fecal microflora revealed that revealed that Bifidobacterium lactis, Lactobacillus rhamnosus and Streptococcus thermophilus had “increased significantly” in the probiotics group after four weeks, and that Bifidobacterium lactis had increased in the placebo group.

Based on these results, the authors concluded that multispecies probiotics effective relieve symptoms in IBS patients, and induce alterations in the composition of intestinal microbiota.

These findings track with similar results seen in prior studies of multispecies probiotics in IBS, such as “Multispecies Probiotic Supplementation Alleviates the Symptoms of Irritable Bowel Syndrome and Stabilizes Intestinal Microbiota,” published in Alimentary Pharmacology & Therapeutics.

In that study, researchers looked at the effects of treatment with a multispecies probiotic (consisting of Lactobacillus rhamnosus GG, L. rhamnosus Lc705, Propionibacterium freudenreichii ssp. shermanii JS and Bifidobacterium animalis ssp. lactis Bb12) on “abdominal symptoms, quality of life, intestinal microbiota and inflammatory markers” in IBS.

Eighty-six patients who met the Rome II criteria for IBS were randomized to receive either daily multispecies probiotic or placebo. Researchers monitored IBS symptoms, quality of life, microarray-based intestinal microbiota stability, serum cytokines, and sensitive C-reactive protein.

They reported that composite IBS score had decreased 14 points at five months from baseline for patients treated with multispecies probiotic, compared with a decrease of three points for patients who received placebo. They also reported stabilization of the gut microbiota, with the microbiota similarity index increasing with probiotic supplementation and decreasing with placebo.

The authors concluded that “this multispecies probiotic seems to be an effective and safe option to alleviate symptoms of irritable bowel syndrome, and to stabilize the intestinal microbiota.”