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Clinical and Microbiological Effect of a Multispecies Probiotic Supplementation in Celiac Patients With Persistent IBS-type Symptoms: A Randomized, Double-Blind, Placebo-controlled, Multicenter Trial.
Francavilla, Ruggiero; Piccolo, Maria; Francavilla, Antonio; Polimeno, Lorenzo; Semeraro, Francesco; Cristofori, Fernanda; Castellaneta, Stefania; Barone, Michele; Indrio, Flavia; Gobbetti, Marco; De Angelis, Maria.
Afiliação
  • Francavilla R; Department of Interdisciplinary Medicine.
  • Piccolo M; Department of Soil, Plant and Food Science.
  • Francavilla A; IRCCS "Saverio De Bellis," Castellana Grotte.
  • Polimeno L; Department of Interdisciplinary Medicine.
  • Semeraro F; Gastroenterology Unit, PO Centrale Taranto, Taranto.
  • Cristofori F; Department of Interdisciplinary Medicine.
  • Castellaneta S; Department of Pediatrics, PO San Paolo, Bari.
  • Barone M; Department of Emergency and Organ Transplantation, University of Bari Aldo Moro.
  • Indrio F; Department of Interdisciplinary Medicine.
  • Gobbetti M; Faculty of Science and Technology, Piazza Università, Free University of Bozen, Bolzano, Italy.
  • De Angelis M; Department of Soil, Plant and Food Science.
J Clin Gastroenterol ; 53(3): e117-e125, 2019 03.
Article em En | MEDLINE | ID: mdl-29688915
GOALS: The goals of this study were to evaluate the efficacy and safety of a probiotic mixture in patients with celiac disease (CD) with irritable bowel syndrome (IBS)-type symptoms despite a strict gluten-free diet (GFD). BACKGROUND: About 30% of patients with CD adherent to a GFD suffer from IBS-type symptoms; a possible cause resides in the imbalances of the intestinal microbiota in CD. Probiotics may represent a potential treatment. STUDY: CD patients with IBS-type symptoms entered a prospective, double-blind, randomized placebo-controlled study. A 6-week treatment period was preceded by a 2-week run-in and followed by a 6-week follow-up phase. Clinical data were monitored throughout the study by validated questionnaires: IBS Severity Scoring System (IBS-SSS); Gastrointestinal Symptom Rating Scale (GSRS); Bristol Stool Form Scale (BSFS); and IBS Quality of Life Questionnaire (IBS-QOL). The fecal microbiota were assayed using plate counts and 16S rRNA gene-based analysis. RESULTS: In total, 109 patients were randomized to probiotics (n=54) or placebo (n=55). IBS-SSS and GSRS decreased significantly in probiotics, as compared with placebo [(-15.9%±14.8% vs. 8.2%±25.9%; P<0.001) and (-19.8%±16.6% vs. 12.9%±31.6%; P<0.001)], respectively. Treatment success was significantly higher in patients receiving probiotics, as compared with placebo (15.3% vs. 3.8%; P<0.04). Presumptive lactic acid bacteria, Staphylococcus and Bifidobacterium, increased in patients receiving probiotic treatment. No adverse events were reported. CONCLUSIONS: A 6-week probiotic treatment is effective in improving the severity of IBS-type symptoms, in CD patients on strict GFD, and is associated with a modification of gut microbiota, characterized by an increase of bifidobacteria.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doença Celíaca / Probióticos / Síndrome do Intestino Irritável / Dieta Livre de Glúten Tipo de estudo: Clinical_trials / Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doença Celíaca / Probióticos / Síndrome do Intestino Irritável / Dieta Livre de Glúten Tipo de estudo: Clinical_trials / Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2019 Tipo de documento: Article