Effect of probiotic species on irritable bowel syndrome symptoms: A bring up to date meta-analysis.

BACKGROUND AND OBJECTIVES: immune system alteration in irritable 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 randomized controlled trials comparing probiotics with placebo in treating IBS symptoms was performed with continuous data summarized 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), Bifidobacterium infantis, Lactobacillus casei, or Lactobacillus plantarum (SMD, -0.53; 95% CI, -1.00; -0.06) species. All probiotic species tested improved 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.

Efecto de los probióticos en los síntomas del síndrome del intestino irritable: un meta-análisis actualizado / Effect of probiotic species on irritable bowel syndrome symptoms: a bring up to date meta-analysis

Antecedentes y objetivos: la alteración del sistema inmune en los pacientes con síndrome del intestino irritable (SII) podría modularse por el efecto de los probióticos. Se evaluó la eficacia de algunas especies de probióticos en el alivio de síntomas característicos del SII. Material y métodos: se realizó un meta-análisis de todos los ensayos clínicos aleatorios identificados donde se comparaba los probióticos con el placebo en el tratamiento de síntomas del SII. El meta-análisis se realizó empleando datos continuos empleando diferencias de medias estandarizadas (DME) con intervalos de confianza del 95% (IC 95%). Se empleó el modelo de efectos aleatorios en casos de heterogeneidad, si no, el modelo de efectos fijos. Resultados: el meta-análisis se realizó con 10 de los 24 estudios que cumplían los criterios de inclusión. Los probióticos mejoraron el dolor si contenían las especies Bifidobacterium breve (DME, 0,34; IC 95%, -0,66; -0,02), Bifidobacterium longum(DME, -0,48; IC 95%, -0,91; -0,06), o Lactobacillus acidophilus (DME, -0,31; IC 95%, -0,61; -0,01). La distensión mejoró si los probióticos contenían las especies B. breve (DME, -0,45; IC 95%, -0,77; -0,13), Bifidobacterium infantis, Lactobacillus casei, o Lactobacillus plantarum(DME, -0,53; IC 95%, -1,00; -0,06). Todas las especies de probióticos evaluadas mejoraron la flatulencia: B. breve (DME, -0,42; IC 95%, -0,75; -0,10), B. infantis, L. casei, L. plantarum(DME, -0,60; IC 95%, -1,07; -0,13), B. longum, L. acidophilus, Lactobacillus bulgaricus, y Streptococcus salivarius ssp. thermophilus (DME, -0,61; IC 95%, -1,01; -0,21). No hubo un efecto positivo claro de los probióticos en relación a la calidad de vida. Conclusiones: algunos probióticos son una opción terapéutica eficaz para los pacientes con SII, y sus efectos en cada síntoma del SII parecen ser específicos de la especie. Los futuros estudios deberían focalizarse en el papel de los probióticos en la modulación de la microbiota intestinal y del sistema inmune considerando el perfil de síntomas individual para cada paciente(AU)

Background and objectives: immune system alteration in irritable 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 randomized controlled trials comparing probiotics with placebo in treating IBS symptoms was performed with continuous data summarized using standardized mean differences (SMDs) with 95% confidence intervals (95% CIs), where appropriate. The randomeffects 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), Bifidobacterium infantis, Lactobacillus casei, or Lactobacillus plantarum(SMD, -0.53; 95% CI, -1.00; -0.06) species. All probiotic species tested improved 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(AU)