Applied Evidence

What you must know before you recommend a probiotic

Author and Disclosure Information

 

References

Most evidence suggests probiotics are useful for IBS

In RCTs, probiotic supplements—but not yogurt containing probiotics—reduced IBS symptoms. Research suggests that imbalances in GI flora, along with subsequent dysfunction in intestinal barriers and translocation of intestinal flora, may play a role in symptoms associated with IBS, such as abdominal pain, bloating, and diarrhea/constipation.20 There are few effective therapeutic options for patients suffering with IBS.

In a systematic review of 19 RCTs (N=1650), probiotics were significantly more effective than placebo for patients with IBS, with an NNT of 4 (95% CI, 3-12.5).21 This review did not evaluate the difference between various probiotic species and strains.

In an RCT (N=122), the probiotic strain Bifidobacterium bifidum MIMBb75 was found to be safe and beneficial for treating IBS symptoms and improving patients’ quality of life.20 On a 7-point scale of global assessment of IBS symptoms, the score was reduced by 0.88 points (95% CI, 0.69-1.07) in the group that received B. bifidum MIMBb75 and 0.16 points (95% CI, -0.32-0.00) in the placebo group (P<0.0001). Almost half (47%) of the patients who received B. bifidum MIMBb75 reported adequate relief, compared to 11% in the placebo group (P<.0001).

An RCT (N=179) that compared yogurt that contained probiotics to non-probiotic yogurt found the probiotic yogurt had no benefits for treating IBS symptoms.23 After 4 weeks, 57% of patients who ate the probiotic yogurt reported adequate relief, compared to 53% of those who ate non-probiotic yogurt (P=0.71). After 8 weeks, those numbers were 47% and 68%, respectively.23

CORRESPONDENCE
Erik R. Clauson, DO, Nellis Family Medicine Residency, 99 MDOS/SGOF, 4700 Las Vegas Boulevard North, Nellis Air Force Base, NV 89191; erik.clauson.1@us.af.mil

Pages

Recommended Reading

Smoking linked to many ‘new’ causes of death
MDedge Family Medicine
FDA allows marketing of vaginally inserted device for fecal incontinence
MDedge Family Medicine
HPV-16 E6 seropositivity common before anal cancer develops
MDedge Family Medicine
Remission before conception: goal for IBD patients desiring pregnancy
MDedge Family Medicine
Difficult-to-clean ERCP duodenoscopes linked to serious infections
MDedge Family Medicine
Two regimens achieve high response in HCV/HIV coinfection
MDedge Family Medicine
Death rates rising for liver cancer, falling for colorectal cancer
MDedge Family Medicine
C. difficile responsible for nearly a half million infections in the United States
MDedge Family Medicine
Emulsifiers alter gut bacteria in mice, set the stage for IBD and metabolic syndrome
MDedge Family Medicine
C. difficile burden in U.S. documented in 2011 estimates of infections, deaths
MDedge Family Medicine

Related Articles