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

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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  • Authors+Show Affiliations

    ,

    Department of Health Services Research and Development, VA Puget Sound Health Care System, Seattle WA 98101, United States. lynne.mcfarland@va.gov

    Source

    World journal of gastroenterology 14:17 2008 May 07 pg 2650-61

    MeSH

    Gastrointestinal Tract
    Humans
    Irritable Bowel Syndrome
    Probiotics
    Randomized Controlled Trials as Topic
    Research Design
    Treatment Outcome

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, Non-P.H.S.
    Review

    Language

    eng

    PubMed ID

    18461650

    Citation

    McFarland, Lynne V., and Sascha Dublin. "Meta-analysis of Probiotics for the Treatment of Irritable Bowel Syndrome." World Journal of Gastroenterology, vol. 14, no. 17, 2008, pp. 2650-61.
    McFarland LV, Dublin S. Meta-analysis of probiotics for the treatment of irritable bowel syndrome. World J Gastroenterol. 2008;14(17):2650-61.
    McFarland, L. V., & Dublin, S. (2008). Meta-analysis of probiotics for the treatment of irritable bowel syndrome. World Journal of Gastroenterology, 14(17), pp. 2650-61.
    McFarland LV, Dublin S. Meta-analysis of Probiotics for the Treatment of Irritable Bowel Syndrome. World J Gastroenterol. 2008 May 7;14(17):2650-61. PubMed PMID: 18461650.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Meta-analysis of probiotics for the treatment of irritable bowel syndrome. AU - McFarland,Lynne V, AU - Dublin,Sascha, PY - 2008/5/8/pubmed PY - 2008/8/21/medline PY - 2008/5/8/entrez SP - 2650 EP - 61 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 14 IS - 17 N2 - 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. SN - 1007-9327 UR - https://www.unboundmedicine.com/medline/citation/18461650/Meta_analysis_of_probiotics_for_the_treatment_of_irritable_bowel_syndrome_ L2 - http://www.wjgnet.com/1007-9327/full/v14/i17/2650.htm DB - PRIME DP - Unbound Medicine ER -