Probiotics, Prebiotics, and Synbiotics for Irritable Bowel Syndrome.

[Argirios Argiriou]

November 25, 2014
Probiotics, Prebiotics, and Synbiotics for Irritable Bowel Syndrome
Allan S. Brett, MD reviewing Ford AC et al. Am J Gastroenterol 2014 Oct.

In a meta-analysis, probiotics conferred some benefit, but the number needed to treat was 7.

Some patients with irritable bowel syndrome (IBS) use probiotic therapy — ingestion of live or attenuated microorganisms — either on their own or as recommended by clinicians. Alternatives to probiotics include prebiotics (nondigestible food ingredients that stimulate growth or activity of intestinal bacteria) and synbiotics (combinations of prebiotics and probiotics). In this meta-analysis, researchers examined the efficacy of these substances in patients with IBS or chronic idiopathic constipation.

For IBS, the proportion of patients with overall improvement in symptoms was significantly higher with probiotics than with placebo (44% vs. 27%) in 23 trials; seven patients had to be treated to benefit one patient. Synbiotics (2 trials) were of no clear benefit, and no trials of prebiotics were eligible for inclusion. For chronic idiopathic constipation, stool frequency increased from baseline with probiotics (3 trials) and with synbiotics (2 trials) but not with prebiotics (1 trial).

Comment

Probiotic therapy appears to be worthwhile for a minority of IBS patients. However, we don't know whether responses persist long term, because most studies lasted only a few weeks or months. Moreover, the bacterial strains used in these studies were quite heterogeneous. For patients with chronic idiopathic constipation, probiotics and synbiotics might be beneficial, but they require further study. Although probiotics generally are considered to be safe, data are sparse on long-term use and use by immunocompromised patients.

Citation(s):

    Ford AC et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: Systematic review and meta-analysis. Am J Gastroenterol 2014 Oct; 109:1547. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)

Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος