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Question answered:26/11/07 Warning! this question is over two years old.
CKS have a 2005 guideline on IBS [1] and this reports:
“There are conflicting reports of the efficacy of probiotics in irritable bowel syndrome (IBS) [DTB, 2004].
- Four small placebo-controlled double-blind randomized trials (n = 168), lasting 4–6 weeks, found that probiotics (Lactobacillus acidophilus, L plantarum, and/or Bifidobacterium breve) reduced symptoms of IBS.
- However, two trials (n = 49) lasting 8 weeks found that probiotics (VSL#3 or L casei) did not reduce global or individual symptoms.”
Recently (2007), the British Society of Gastroenterology (BSG) have published “Guidelines on the irritable bowel syndrome: mechanisms and practical management” [2] and this discusses probiotics:
“Probiotics are a more attractive though possibly less effective way of altering bowel flora, and five randomised placebo controlled trials of probiotics have shown benefit for some symptoms, notably bloating and flatulence, using a variety of probiotic agents including Lactobacillus rhamnosus plantarum and VSL#3, a mixture of lactobacilli, bifidobacteria, and a streptococcus. A more recent study using Bifidobacterium infantis suggested benefit and linked this to a downregulation of immune response, but this finding also needs to be replicated. A subsequent larger study has confirmed the benefit of B infantis, though problems with formulation mean that further studies are needed before this can be firmly recommended.”
Finally, a further RCT has been published since the BSG guidance. In this trial [3] the authors studied the effects of fermented milk containing Bifidobacterium animalis DN-173 010 and yoghurt strains on the IBS in a multicentre, double-blind, controlled trial. Overall, they concluded:
“This study suggests a beneficial effect of a probiotic food on discomfort HRQoL score and bloating in constipation-predominant IBS, and on stool frequency in subjects with <3 stools/week.”
References
1) http://cks.library.nhs.uk/irritable_bowel_syndrome/view_whole_guidance
2) http://gut.bmj.com/cgi/content/abstract/56/12/1770
3) http://pmid.us/17635382
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