Probiotic Trials for Irritable Bowel Syndrome

Please note that each IBS probiotic trial is not described in detail. In some trials, drugs, prebiotics and/or additional nutrients were provided that may help the beneficial bacteria be more effective. Also the setting, procedure, and dose for each trial are rarely similar. For more details, search for the reference in Google to find the original publication. The simplest way is to copy and paste the title.

Without a doubt, studies of IBS probiotics paint a positive picture. Of the approximately 30 trials found that investigated IBS probiotics, only three showed no improvements. In general, the patients in these trials are administered probiotics daily over a time period from several weeks to several months. After which, the symptoms are measured. Comparisons are made to control groups with a placebo or to baseline measures in the same patient collected before supplementation.

Probiotic SupplementsImprovements Seen in TrialReferences
LacteolBetter general IBS symptoms and quality of life1, 2
Prescript-AssistBetter general IBS symptoms3, 4
Symbioflor-2Better general IBS symptoms5, 6
UB03Better general IBS symptoms7
VSL#3Reduced flatulence and transit8
Probiotic fermented milkImproved metabolism9
Four strains of lactic acid bacteriaReduced pain and constipation10
B. breve
B. lactis
B. longum
L. acidophilus
L. plantarum
L. rhamnosus
S. thermophiles
Better general IBS symptoms11
B. bifidum CUL20 (NCIMB 30153)
B. lactis CUL34 (NCIMB 30172)
L. acidophilus CUL21 (NCIMB 30156)
L. acidophilus CUL60 (NCIMB 30157
Better general IBS symptoms12
B. Longum
L. acidophilus
L. bulgaricus
S. thermophilus
Better general IBS symptoms and gut barrier13
B. breve BB-99
L. rhamnosus GG
L. rhamnosus LC-705
P. freudenreichii shermanii JS
Better general IBS symptoms14
Yoghurt bacteria
B. lactis BB-12
L. acidophilus LA-5
L. paracasei paracasei F19
Better general IBS symptoms15
B. lactis BB-12
L. acidophilus LA-5
L. paracasei paracasei F19
No improvement16
Yoghurt bacteria
B. animalis DN-173 010
Improved quality of life and reduced bloating and constipation17
B. breve BR-03
L. plantarum LP-01
Reduced pain and severity18
L. acidophilus LA-02
L. plantarum LP-01
Reduced pain and severity18
B. subtilis
S. faecium
Reduced pain19
B. infantis 35624Better general IBS symptoms20, 21
B. coagulans GBI-30, 6086Reduced diarrhea, pain and bloating22, 23
B. lactis DN-173 010Better general IBS symptoms24
B. longum W11Better constipation, pain and bloating25
E. coli Nissle 1917Better patient satisfaction26
L. acidophilus SDC 2012Reduced pain27
L. casei Shirota (Yakult)Better general IBS symptoms28
L. plantarum (DSM 9843)Reduced pain and flatulence29
L. plantarum 299VNo improvement30
L. plantarum MF1298More general IBS symptoms31
L. reuteriNo improvement32
L. rhamnosus GGLowered abdominal distention33
L. salivarius UCC4331No improvement20

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment.

References

1.         Tarrerias, A. L. C., V.; Vicari, F.; Letard, J. C.; Adenis-Lamarre, P.; Aisene, A.; Batistelli, D.; Bonnaud, G.; Carpentier, S.; Dalbies, P.; Ecuer, S.; Etienne, J.; Fantoli, M.; Grunberg, B.; Lannoy, P.; Lapuelle, J.; Margulies, A.; Neumeier, M.; Rouillon, J. M.; Schmets, L.; Pingannaud, M. P.; Coulom, P.; Kholer, F.; Canard, J. M. 2011. The effect of inactivated Lactobacillus LB fermented culture medium on symptom severity: observational investigation in 297 patients with diarrhea-predominant irritable bowel syndrome. Dig Dis 29:588-591.

2.         Andresen, V. L., P.; Menge, D.; Keller, J. 2012. [Efficacy of freeze-dried Lactobacilli in functional diarrhoe: a pilot study]. Dtsch Med Wochenschr 137:1792-1796.

3.         Bittner, A. C. C., R. M.; Stranahan, M. C. 2005. Prescript-Assist probiotic-prebiotic treatment for irritable bowel syndrome: a methodologically oriented, 2-week, randomized, placebo-controlled, double-blind clinical study. Clin Ther 27:755-761.

4.         Bittner, A. C. C., R. M.; Stranahan, M. C.; Yokelson, T. N. 2007. Prescript-assist probiotic-prebiotic treatment for irritable bowel syndrome: an open-label, partially controlled, 1-year extension of a previously published controlled clinical trial. Clin Ther 29:1153-1160.

5.         Enck, P. Z., K.; Menke, G.; Klosterhalfen, S. 2009. Randomized controlled treatment trial of irritable bowel syndrome with a probiotic E.-coli preparation (DSM17252) compared to placebo. Z Gastroenterol 47:209-214.

6.         Martens, U. E., P.; Zieseniss, E. 2010. Probiotic treatment of irritable bowel syndrome in children. Ger Med Sci 8:Doc07.

7.         Sudha, M. R. S., P. 2011. Effect of capsule ‘UB03’ containing potential probiotic strains for the treatment of patients with irritable bowel syndrome. Benef Microbes 2:229-233.

8.         Kim, H. J. V. R., M. I.; Camilleri, M.; Stephens, D.; Burton, D. D.; Baxter, K.; Thomforde, G.; Zinsmeister, A. R. 2005. A randomized controlled trial of a probiotic combination VSL# 3 and placebo in irritable bowel syndrome with bloating. Neurogastroenterol Motil 17:687-696.

9.         Hong, Y. S. H., K. S.; Park, M. H.; Ahn, Y. T.; Lee, J. H.; Huh, C. S.; Lee, J.; Kim, I. K.; Hwang, G. S.; Kim, J. S. 2011. Metabonomic understanding of probiotic effects in humans with irritable bowel syndrome. J Clin Gastroenterol 45:415-425.

10.       Drouault-Holowacz, S. B., S.; Burckel, A.; Cazaubiel, M.; Dray, X.; Marteau, P. 2008. A double blind randomized controlled trial of a probiotic combination in 100 patients with irritable bowel syndrome. Gastroenterol Clin Biol 32:147-152.

11.       Ki Cha, B. M. J., S.; Hwan Choi, C.; Song, I. D.; Woong Lee, H.; Joon Kim, H.; Hyuk, J.; Kyung Chang, S.; Kim, K.; Chung, W. S.; Seo, J. G. 2012. The effect of a multispecies probiotic mixture on the symptoms and fecal microbiota in diarrhea-dominant irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial. J Clin Gastroenterol 46:220-227.

12.       Williams, E. A. S., J.; Wang, D.; Plummer, S.; Garaiova, I.; Barker, M. E.; Corfe, B. M. 2009. Clinical trial: a multistrain probiotic preparation significantly reduces symptoms of irritable bowel syndrome in a double-blind placebo-controlled study. Aliment Pharmacol Ther 29:97-103.

13.       Zeng, J. L., Y. Q.; Zuo, X. L.; Zhen, Y. B.; Yang, J.; Liu, C. H. 2008. Clinical trial: effect of active lactic acid bacteria on mucosal barrier function in patients with diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther 28:994-1002.

14.       Kajander, K. K., R. 2006. Clinical studies on alleviating the symptoms of irritable bowel syndrome. Asia Pac J Clin Nutr 15:576-580.

15.       Simren, M. O., L.; Olsson, J.; Svensson, U.; Ohlson, K.; Posserud, I.; Strid, H. 2010. Clinical trial: the effects of a fermented milk containing three probiotic bacteria in patients with irritable bowel syndrome – a randomized, double-blind, controlled study. Aliment Pharmacol Ther 31:218-227.

16.       Sondergaard, B. O., J.; Ohlson, K.; Svensson, U.; Bytzer, P.; Ekesbo, R. 2011. Effects of probiotic fermented milk on symptoms and intestinal flora in patients with irritable bowel syndrome: a randomized, placebo-controlled trial. Scand J Gastroenterol 46:663-672.

17.       Guyonnet, D. C., O.; Ducrotte, P.; Picard, C.; Mouret, M.; Mercier, C. H.; Matuchansky, C. 2007. Effect of a fermented milk containing Bifidobacterium animalis DN-173 010 on the health-related quality of life and symptoms in irritable bowel syndrome in adults in primary care: a multicentre, randomized, double-blind, controlled trial. Aliment Pharmacol Ther 26:475-486.

18.       Saggioro, A. 2004. Probiotics in the treatment of irritable bowel syndrome. J Clin Gastroenterol 38:S104-106.

19.       Kim, Y. G. M., J. T.; Lee, K. M.; Chon, N. R.; Park, H. 2006. [The effects of probiotics on symptoms of irritable bowel syndrome]. Korean J Gastroenterol 47:413-419.

20.       O’Mahony, L. M., J.; Kelly, P.; Hurley, G.; Luo, F.; Chen, K.; O’Sullivan, G. C.; Kiely, B.; Collins, J. K.; Shanahan, F.; Quigley, E. M. 2005. Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles. Gastroenterology 128:541-551.

21.       Whorwell, P. J. A., L.; Morel, J.; Bond, Y.; Charbonneau, D.; O’Mahony, L.; Kiely, B.; Shanahan, F.; Quigley, E. M. 2006. Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome. Am J Gastroenterol 101:1581-1590.

22.       Dolin, B. J. 2009. Effects of a proprietary Bacillus coagulans preparation on symptoms of diarrhea-predominant irritable bowel syndrome. Methods Find Exp Clin Pharmacol 31:655-659.

23.       Hun, L. 2009. Bacillus coagulans significantly improved abdominal pain and bloating in patients with IBS. Postgrad Med 121:119-124.

24.       Agrawal, A. H., L. A.; Morris, J.; Reilly, B.; Guyonnet, D.; Goupil Feuillerat, N.; Schlumberger, A.; Jakob, S.; Whorwell, P. J. 2009. Clinical trial: the effects of a fermented milk product containing Bifidobacterium lactis DN-173 010 on abdominal distension and gastrointestinal transit in irritable bowel syndrome with constipation. Aliment Pharmacol Ther 29:104-114.

25.       Colecchia, A. V., A.; La Rocca, A.; Pasqui, F.; Nikiforaki, A.; Festi, D. 2006. Effect of a symbiotic preparation on the clinical manifestations of irritable bowel syndrome, constipation-variant. Results of an open, uncontrolled multicenter study. Minerva Gastroenterol Dietol 52:349-358.

26.       Mercer, M. B., M. A.; Geller, G.; Harrison, K.; Highland, J.; James, K.; Marshall, P.; McCormick, J. B.; Tilburt, J.; Achkar, J. P.; Farrell, R. M.; Sharp, R. R. 2012. How patients view probiotics: findings from a multicenter study of patients with inflammatory bowel disease and irritable bowel syndrome. J Clin Gastroenterol 46:138-144.

27.       Sinn, D. H. S., J. H.; Kim, H. J.; Lee, J. H.; Son, H. J.; Chang, D. K.; Kim, Y. H.; Kim, J. J.; Rhee, J. C.; Rhee, P. L. 2008. Therapeutic effect of Lactobacillus acidophilus-SDC 2012, 2013 in patients with irritable bowel syndrome. Dig Dis Sci 53:2714-2718.

28.       Barrett, J. S. C., K. E.; Gearry, R. B.; Irving, P. M.; Gibson, P. R. 2008. Probiotic effects on intestinal fermentation patterns in patients with irritable bowel syndrome. World J Gastroenterol 14:5020-5024.

29.       Nobaek, S. J., M. L.; Molin, G.; Ahrne, S.; Jeppsson, B. 2000. Alteration of intestinal microflora is associated with reduction in abdominal bloating and pain in patients with irritable bowel syndrome. Am J Gastroenterol 95:1231-1238.

30.       Sen, S. M., M. M.; Parker, T. J.; Woolner, J. T.; Tarry, S. A.; Hunter, J. O. 2002. Effect of Lactobacillus plantarum 299v on colonic fermentation and symptoms of irritable bowel syndrome. Dig Dis Sci 47:2615-2620.

31.       Ligaarden, S. C. A., L.; Naterstad, K.; Lydersen, S.; Farup, P. G. 2010. A candidate probiotic with unfavourable effects in subjects with irritable bowel syndrome: a randomised controlled trial. BMC Gastroenterol 10:16.

32.       Niv, E. N., T.; Hallak, R.; Vaisman, N. 2005. The efficacy of Lactobacillus reuteri ATCC 55730 in the treatment of patients with irritable bowel syndrome–a double blind, placebo-controlled, randomized study. Clin Nutr 24:925-931.

33.       Bausserman, M. M., S. 2005. The use of Lactobacillus GG in irritable bowel syndrome in children: a double-blind randomized control trial. J Pediatr 147:197-201.

<