Meta-analysis of probiotics for the treatment of irritable bowel syndrome. World J Gastroenterol

Department of Health Services Research and Development, VA Puget Sound Health Care System, Seattle WA 98101, United States.
World Journal of Gastroenterology (Impact Factor: 2.43). 06/2008; 14(17):2650-61. DOI: 10.3748/wjg.14.2650
Source: PubMed

ABSTRACT Irritable bowel syndrome (IBS) is a chronic condition affecting 3%-25% of the general population. As no curative treatment is available, therapy is aimed at reducing symptoms, often with little success. Because alteration of the normal intestinal microflora has been observed in IBS, probiotics (beneficial microbes taken to improve health) may be useful in reducing symptoms. This paper systematically reviews randomized, controlled, blinded trials of probiotics for the treatment of IBS and synthesizes data on efficacy across trials of adequate quality. PubMed, Medline, Google Scholar, NIH registry of clinical trials, metaRegister, and the Cochrane Central Register of Controlled Trials were searched from 1982-2007. We also conducted secondary searches of reference lists, reviews, commentaries, relevant articles on associated diseases, books and meeting abstracts. Twenty trials with 23 probiotic treatment arms and a total of 1404 subjects met inclusion criteria. Probiotic use was associated with improvement in global IBS symptoms compared to placebo [pooled relative risk (RR pooled) 0.77, 95% confidence interval (95% CI) 0.62-0.94]. Probiotics were also associated with less abdominal pain compared to placebo [RR pooled = 0.78 (0.69-0.88)]. Too few studies reported data on other IBS symptoms or on specific probiotic strains to allow estimation of a pooled RR. While our analyses suggest that probiotic use may be associated with improvement in IBS symptoms compared to placebo, these results should be interpreted with caution, given the methodological limitations of contributing studies. Probiotics warrant further study as a potential therapy for IBS.

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    • "Several bacteria of the LAB family, usually representing species of the genera Lactobacillus, Enterococcus or Bifidobacterium, have been named as probiotic bacteria, which are currently used in several products intended for both human and animal consumption (Fuller 1989). Probiotics have received increasing attention in recent years and have been shown to be useful to treatment of some human diseases (McFarland and Dublin 2008). Probiotics exhibit strainspecific differences in acid and bile resistance, ability to colonize the gastrointestinal tract, clinical efficacy, and health benefit to the host (Dunne et al. 1999; Pham et al. 2008). "
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    ABSTRACT: A total of 38 lactic acid bacteria, belonging to Lactobacillus, isolated from 24 samples of traditional Egyptian dairy products, were screened for antimicrobial activity against different Gram-positive and Gram-negative bacteria. A strain of Lactobacillus brevis showed the best inhibitory activity when tested by well diffusion assay. The antibacterial activity was pronounced between early logarithmic and early stationary phases. The strain produced a heat-stable antimicrobial compound showing no reduction in activity after heat treatment from 60 to 100°C for 15 and 30 min. Since it was inactivated by proteolytic enzymes, it is considered to be proteinaceous in nature and, therefore, referred to as a bacteriocin-like substance. This compound was also active over a wide pH range (pH 2–6). The antimicrobial compound was partially purified by 40% ammonium sulfate precipitation. Lactobacillus brevis was tested for its in vitro antibiotics susceptibility, tolerance to bile salts, resistance to low pH values, acidifying activity, proteolytic activity, and haemolytic activity. The results showed the potential of L. brevis strain as a probiotic culture, and hence it can be utilized in the manufacturing of pharmaceuticals and dietary supplements.
    Annals of Microbiology 03/2012; 63(1). DOI:10.1007/s13213-012-0447-2 · 1.04 Impact Factor
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    • "Interest in probiotics for health promotion is at an all time high in more than 100 years they have been used (De Vecchi and Drago, 2006). The primary use of probiotics has been suggested for the prevention and/or mitigation of specific disorders such as irritable bowel syndrome (IBS), eczema, allergies, Helicobacter pylori infection, as well as for support of intestinal and immunological health (Tappenden and Deutsch, 2007; Quigley, 2007; Rastall et al., 2005; Hyronimus et al., 2000; Spiller, 2008; McFarland and Dublin, 2008; Lesbros-Pantoflickova et al., 2007; Ouwehand, 2007). Since 2009, the results of six clinical trials with GanedenBC 30 ™ have been published (Mandel et al., 2010; Kimmel et al., 2010; Dolin, 2009; Hun, 2009; Kalman et al., 2009; Baron 2009). "
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    ABSTRACT: Some strains of Bacillus coagulans can survive extremes of heat, stomach acid and bile acids, to which commonly consumed probiotics are susceptible. A toxicological safety assessment was published in 2009 on a proprietary preparation of B. coagulans - GanedenBC(30)™ - a novel probiotic. It was concluded that GanedenBC(30)™ is safe for chronic human consumption based upon scientific procedures, supported by a safe history of use (Endres et al., 2009). A one-year chronic oral toxicity study combined with a one-generation reproduction study was conducted to further investigate safety of long-term consumption. The one-year study of GanedenBC(30)™ administered to male and female HsdBrlHan: Wistar rats in their diet showed no signs of toxicity at the highest dose tested. The conclusion from the reproduction toxicity study is that administration of GanedenBC(30)™ in the diet caused no signs of toxicity in the parental generation (male or female) nor the F1 offspring. Using the lowest NOEL of 1948 mg/kg concluded at the end of the 1-year feeding study, a 100-fold safety factor, a test article concentration of 6.88×10(10) CFU (colony forming units) per gram, and an average 70 kg human, it is determined that GanedenBC(30)™ is safe for chronic consumption at up to 9.38×10(10) CFUs per day.
    Food and chemical toxicology: an international journal published for the British Industrial Biological Research Association 02/2011; 49(5):1174-82. DOI:10.1016/j.fct.2011.02.012 · 2.61 Impact Factor
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    • "Both the recent interest in prebiotic and probiotic treatment for functional intestinal [16] [17], other intestinal "
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    ABSTRACT: The composition of colonic mircoflora and its changes with maturation have rarely been investigated in large samples. Methods. We used conventional microbiological testing to analyse the colonic flora (Kyberstatus, Institut forMicroecology, Herborn, Germany) of stool samples from 12 484 children with different intestinal and nonintestinal diagnoses. Stool samples were analysed for total colony forming units (CFU) (per g stool) and the abundance of Bifidobacteria, Bacteroides sp., Escherichia coli, Enterococcus sp., and Lactobacillus sp. with respect to age, gender. A subset of 1089 infants was analysed for monthly changes within the first year of life. Results. Total CFU and individual microbial species were highest during the first year of life, decreased within the first 2 years, and then stabilized for the remaining childhood. In infants, the total CFU rose until month 5, declined with weaning, and peaked at 9-10 months. Significant effects of age, but not of gender, were found in Bacteroides sp. and Lactobacilli. However Bacterioids sp. and Lactobacilli increased with age, while Enterococci and E. coli decreased, and Bifidobacteria remained stable. Conclusion. Colonic microflora show both a bacteria-specific and general pattern of maturation which is most profound within the first year.
    Gastroenterology Research and Practice 09/2009; 2009(1):752401. DOI:10.1155/2009/752401 · 1.75 Impact Factor
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