Irritable bowel syndrome symptom severity improves equally with probiotic and placebo

• Published in: World journal of gastroenterology : WJG Vol. 22; no. 48; pp. 10631 - 10642
• Main Authors: Lyra, Anna, Hillilä, Markku, Huttunen, Teppo, Männikkö, Sofia, Taalikka, Mikko, Tennilä, Julia, Tarpila, Anneli, Lahtinen, Sampo, Ouwehand, Arthur C, Veijola, Lea
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 28.12.2016
• Subjects: Abdominal Pain - drug therapy; Adult; Clinical Trials Study; Colon - metabolism; Dose-Response Relationship, Drug; Female; Humans; Intestinal Mucosa - metabolism; Irritable Bowel Syndrome - drug therapy; Lactobacillus acidophilus - chemistry; Male; Middle Aged; Pain Measurement; Probiotics - administration & dosage; Probiotics - adverse effects; Probiotics - therapeutic use; Receptors, Opioid - drug effects; Severity of Illness Index; Surveys and Questionnaires; Treatment Outcome; Visceral Pain - drug therapy; Intervention; Probiotic; Visceral pain; Irritable bowel syndrome; Abdominal pain; Functional bowel disorder; Lactobacillus acidophilus; Symptom questionnaire; Quality of life
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v22.i48.10631

AIM To determine the effects of Lactobacillus acidophilus NCFM on irritable bowel syndrome(IBS) symptoms and quality of life(Qo L).METHODS In this randomized triple-blind trial, adult IBS volunteerswho were recruited according to Rome Ⅲ criteria received 109 or 1010 colony-forming units of NCFM or placebo daily for 12 wk. IBS Symptom Severity Score(IBS-SSS), which constituted the primary outcome, and secondary outcomes, including individual IBS symptoms, IBS-related QoL questionnaire, anxiety and depression, defecation frequency, and stool consistency, were assessed at baseline at the end of the 8-wk runin period, after 4 and 12 wk of intervention, and after a 4-wk washout.RESULTS A total of 340 of 391 randomized volunteers completed the trial. IBS-SSS improved over 12 wk of treatment in all treatment groups, decreasing by a mean ± SD of 44.0 ± 80.2, 50.8 ± 82.4, and 48.3 ± 72.2 in the placebo, active low-dose, and active high-dose groups, respectively. Similarly, secondary outcomes did not differ between treatment groups. However, in a post hoc analysis of volunteers with moderate to severe abdominal pain at baseline(VAS > 35/100), the treatment significantly reduced the sensation of abdominal pain. Pain scores fell by 20.8 ± 22.8, 29.4 ± 17.9, and 31.2 ± 21.9 in the placebo, active low-dose, and active high-dose groups, respectively(P value for placebo vs combined active doses = 0.0460).CONCLUSION NCFM alleviates moderate to severe abdominal pain, consistent with earlier observations of this strain mitigating visceral pain through increased analgesic receptor expression.