Are Certain Probiotics More Effective for IBS and Depression?

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Efficacy of Probiotics for Irritable Bowel Syndrome: A Systematic Review and Network Meta-Analysis

• 43 RCTs, 5,531 IBS patients treated w/ probiotics
• Different probiotic strains were evaluated for efficacy 
• This meta-analysis found that:
  • Bacillus coagulans (soil based probiotic) led to the greatest improvements in IBS symptom scores
  • Length of probiotic therapy (NOT dose) was more influential on clinical outcome in IBS
• Commentary: This study supports the use of multi-strain/species probiotics in patients with IBS.
• 3 different B. Coag strains used…
  • As for the symptom relief rate and global symptom scores, only B. coagulans Unique IS2 was involved, thus it is not difficult to conclude that B. coagulans Unique IS2 ranked first in improving the symptom relief rate and global symptoms of IBS relatively among all interventions. 
  • In terms of the ability to alleviate abdominal pain of IBS patients, the league table (Table S26) showed that B.coagulans MTCC5856 ranked first and B.coagulans Unique IS2 ranked second, which was consistent with the result of abdominal bloating scores (Table S27). 

 

Probiotics Evaluation in Oncological Surgery: A Systematic Review of 36 Randomized Controlled Trials Assessing 21 Diverse Formulations

• 36 RCTs, 3,305 participants undergoing oncological surgery, randomized to control or various combinations of probiotics
• Probiotics were effective in preventing post-surgical infections in 70% of the studies
• The most effective combination of probiotics included BOTH lacto/bifido + saccharomyces boulardii
• Commentary: Probiotics were effective in preventing post-surgical infections, especially those containing multiple categories of probiotics.

 

Prevention of Recurrent Childhood Caries with Probiotic Supplements: A Randomized Controlled Trial with a 12-Month Follow-Up

• 24 preschool children with history of cavities, randomized to: 
  • Placebo
  • Probiotic 
• After 1 year, there was NO significant difference in recurrence of cavities between groups 
• Commentary: This small study failed to show a benefit of probiotics on cavity recurrence.

 

Impact of synbiotic supplementation on cardiometabolic and anthropometric indices in patients with metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials

• 5 studies, 1,049 participants w/ metabolic syndrome
• Synbiotics led to improvements in:
  • Insulin (-6.3 μU/mL)
  • Triglycerides (-20.3 mg/dl) 
  • LDL-C (-9.0 mg/dl)
  • Total cholesterol (-7.8 mg/dl)
  • Weight (-9.4 lbs)
  • Waist circumference (-4.0 cm)
  • Systolic blood pressure (-1.8 mmHg)
  • HDL-C (+2.3 mg/dl)
• NO improvements in fasting glucose or insulin resistance (HOMA-IR)
• Commentary: Synbiotics can improve metabolic markers associated with metabolic syndrome.
  

 

Saccharomyces boulardii CNCM I-745 supplementation modifies the fecal resistome during Helicobacter pylori eradication therapy

• Compared composition of antibiotic resistance after H pylori therapy between:
  • Triple therapy + S. boulardii
  • Triple therapy alone 
• In the triple therapy + S boulardii group, the number of antibiotic resistance expression was lower
• Commentary: S boulardii may improve H pylori eradication rate by lowering antibiotic resistance.

 

Role of Lactobacillus plantarum 299v versus Placebo in symptomatic improvement of irritable bowel syndrome patients

• 108 IBS patients, randomized to placebo or probiotics
• After 6 months, NO significant difference in IBS symptoms were observed between groups
• Commentary: While this study showed no benefit for probiotics on IBS symptoms, there are many other studies that do show benefit.

 

Probiotics supplementation in patients with colorectal cancer: a systematic review of randomized controlled trials

• 23 RCTs of patients w/ colorectal cancer (CRC), randomized to placebo or probiotics
• Compared to placebo, probiotics led to improvements in: 
  • Quality of life
  • Reduced postoperative infections 
  • Chemotherapy side effects 
  • Surgical outcomes
  • Reduced hospital stays
  • Reduced risk of death
• Commentary: Probiotics led to improved clinical outcomes and quality of life in patients with CRC.

 

Probiotics and synbiotics for preventing postoperative infectious complications in colorectal cancer patients: a systematic review and meta-analysis

• Assessing the impact of probiotics/synbiotics on infections in those who had surgery for colon cancer
• 14 RCTs, 1,566 patients
• Probiotic/synbiotics significantly reduced the risk of developing postoperative infectious complications by 37% (RR 0.63)
• Commentary: Probiotics may reduce the risk of abdominal surgery related infections.

 

Efficacy and Safety of Lactobacillus plantarum K50 on Lipids in Koreans With Obesity: A Randomized, Double-Blind Controlled Clinical Trial

• 81 obese participants randomized to placebo or probiotic (L plantarum)
• After 12 weeks, the probiotic group had:
  • Reduced total cholesterol (209 to 203 mg/dL)
  • Reduced triglycerides (135 to 114 mg/dL)
• Commentary: Probiotic led to statistically, yet clinically insignificant improvement in the lipid profile.

 

Bifidobacterium breve CCFM1025 attenuates major depression disorder via regulating gut microbiome and tryptophan metabolism: A randomized clinical trial

• 45 patients w/ depression randomized to placebo or probiotic
• After 30 days of supplementation, the probiotic group had improved mood

 

A Systematic Review and Meta-Analysis: Lactobacillus acidophilus for Treating Acute Gastroenteritis in Children

• 15 RCTs, 1,765 pediatric patients w/ acute gastroenteritis
• Lactobacillus acidophilus was associated with a reduced duration of diarrhea 
  • But the effect was not statistically significant when only the L. acidophilus strain was used
• Commentary: This study suggests that a multi-strain probiotic may be more effective than a single-strain.

 

The effect of gastric acid suppression on probiotic colonization in a double blinded randomized clinical trial

• 30 healthy participants randomized to placebo or PPI x 6 weeks
  • At weeks 2-6, all participants started probiotics 
• Probiotics prevented PPI-induced microbial changes 
• Commentary: Probiotics may be a useful treatment in those also taking PPIs to reduce microbiome disruption.

 

Lactobacilli reduce recurrences of vaginal candidiasis in pregnant women: a randomized, double-blind, placebo-controlled study

• 78 pregnant women w/ recurrent vaginal candidiasis, randomized to placebo or probiotic (Lactobacillus)
• After 8 weeks, the probiotic group had:
  • Reduced irritation and discharge
  • Reduced impairment of daily activities
  • Reduced emotional/social stress
  • Less constipation
• Commentary: Remember that probiotics have antimicrobial properties. 

 

An Open-label, Multicenter Study to Assess the Efficacy and Safety of a Novel Probiotic Blend in Patients With Functional Gastrointestinal Symptoms

• 188 patients with functional GI disorders all given 5-strain Bifidobacterium/Lactobacillus probiotic
• After 1 month of supplementation 85% reported overall GI symptom improvement
  • 76% had improved diarrhea
  • 87% had improved bloating
  • 74% had improved constipation frequency, 80% constipation severity
• Commentary: More support for multi-strain/species probiotics.

 

Randomized control trial on the efficacy of Limosilactobacillus reuteri ATCC PTA 4659 in reducing inflammatory markers in acute uncomplicated diverticulitis

• 119 patients w/ acute diverticulitis, randomized to: 
  • Standard therapy (fluids, bowel rest) + placebo
  • Standard therapy + probiotic
• After 3 days of treatment, the probiotic group experienced:
  • Reduced CRP (- 59% probiotic vs – 40% placebo)
  • Reduced calprotectin (- 17% vs – 11%) 
  • Shorter hospital stay (76 hours vs 84 hours) 
• Both groups experienced equal reductions in abdominal pain score (-4 points) 
• Commentary: Probiotics led to improved inflammatory markers and shorter hospital stay in patients with acute diverticulitis.

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