Year 2013 / Volume 105 / Number 1
Original
Effect of probiotic species on irritable bowel syndrome symptoms: A bring up to date meta-analysis

pp. 19-36

María Ortiz-Lucas, Aurelio Tobias, Pablo Saz y Juan José Sebastián

Abstract
Background and objectives: immune system alteration in irri- table bowel syndrome (IBS) patients may be modulated by probiotics. We assessed the efficacy of some probiotic species in alleviating characteristic IBS symptoms.

Material and methods: a meta-analysis of all identified ran- domized controlled trials comparing probiotics with placebo in tre- ating IBS symptoms was performed with continuous data summa- rized using standardized mean differences (SMDs) with 95% confidence intervals (95% CIs), where appropriate. The random- effects model was employed in cases of heterogeneity; otherwise, fixed-effects models were used.

Results: meta-analysis was performed with 10 of 24 studies identified as suitable for inclusion. Probiotics improved pain scores if they contained Bifidobacterium breve (SMD, -0.34; 95% CI, -0.66; -0.02), Bifidobacterium longum (SMD, -0.48; 95% CI, -0.91; -0.06), or Lactobacillus acidophilus (SMD, -0.31; 95% CI, -0.61; -0.01) species. Distension scores were improved by probiotics containing B. breve (SMD, -0.45; 95% CI, -0.77; -0.13), Bifidobacte- rium infantis, Lactobacillus casei, or Lactobacillus plantarum (SMD, -0.53; 95% CI, -1.00; -0.06) species. All probiotic species tested impro- ved flatulence: B. breve (SMD, -0.42; 95% CI, -0.75; -0.10), B. infantis, L. casei, L. plantarum (SMD, -0.60; 95% CI, -1.07; -0.13), B. longum, L. acidophilus, Lactobacillus bulgaricus, and Streptococcus salivarius ssp. thermophilus (SMD, -0.61; 95% CI, -1.01; -0.21). There was not a clear positive effect of probiotics concerning the quality of life.

Conclusions: some probiotics are an effective therapeutic option for IBS patients, and the effects on each IBS symptom are likely species-specific. Future studies must focus on the role of probiotics in modulating intestinal microbiota and the immune system while considering individual patient symptom profiles.
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María Ortiz-Lucas, Aurelio Tobias, Pablo Saz y Juan José Sebastián. Effect of probiotic species on irritable bowel syndrome symptoms: A bring up to date meta-analysis. 19-36


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