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Review article: probiotics and prebiotics in irritable bowel syndrome.
Aliment Pharmacol Ther. 2008 Aug 15; 28(4):385-96.AP

Abstract

BACKGROUND

The human gut harbours a complex community of bacteria whose relationship with their host is normally mutually beneficial. Recent studies suggest a disturbance of this relationship in irritable bowel syndrome (IBS) and the potential to correct this using prebiotics and probiotics.

AIM

To review the mechanisms of action of probiotics and prebiotics in IBS and to assess their performance in clinical trials.

METHODS

Articles relating to modes of action and randomized control trials of treatment were reviewed by searching PubMed using terms 'probiotic', 'prebiotic' and 'irritable bowel'. Small uncontrolled studies in IBS were excluded.

RESULTS

Probiotics can enhance gut barrier function, inhibit pathogen binding and modulate gut inflammatory response. They can also reduce visceral hypersensitivity associated with both inflammation and psychological stress. Probiotics can alter colonic fermentation and stabilize the colonic microbiota. Several large randomized, placebo-controlled trials of adequate design have shown an improvement in flatulence and abdominal distension with a reduction in composite IBS symptoms scores.

CONCLUSIONS

Each probiotic has unique features and IBS patients are heterogeneous. Future efforts should be directed to identifying biomarkers of responsiveness to facilitate better targeting of treatment and hence improved efficacy.

Authors+Show Affiliations

Wolfson Digestive Diseases Centre, University Hospital, University of Nottingham, Nottinghamshire, UK. robin.spiller@nottingham.ac.uk

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18532993

Citation

Spiller, R. "Review Article: Probiotics and Prebiotics in Irritable Bowel Syndrome." Alimentary Pharmacology & Therapeutics, vol. 28, no. 4, 2008, pp. 385-96.
Spiller R. Review article: probiotics and prebiotics in irritable bowel syndrome. Aliment Pharmacol Ther. 2008;28(4):385-96.
Spiller, R. (2008). Review article: probiotics and prebiotics in irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 28(4), 385-96. https://doi.org/10.1111/j.1365-2036.2008.03750.x
Spiller R. Review Article: Probiotics and Prebiotics in Irritable Bowel Syndrome. Aliment Pharmacol Ther. 2008 Aug 15;28(4):385-96. PubMed PMID: 18532993.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Review article: probiotics and prebiotics in irritable bowel syndrome. A1 - Spiller,R, Y1 - 2008/06/04/ PY - 2008/6/6/pubmed PY - 2008/12/17/medline PY - 2008/6/6/entrez SP - 385 EP - 96 JF - Alimentary pharmacology & therapeutics JO - Aliment Pharmacol Ther VL - 28 IS - 4 N2 - BACKGROUND: The human gut harbours a complex community of bacteria whose relationship with their host is normally mutually beneficial. Recent studies suggest a disturbance of this relationship in irritable bowel syndrome (IBS) and the potential to correct this using prebiotics and probiotics. AIM: To review the mechanisms of action of probiotics and prebiotics in IBS and to assess their performance in clinical trials. METHODS: Articles relating to modes of action and randomized control trials of treatment were reviewed by searching PubMed using terms 'probiotic', 'prebiotic' and 'irritable bowel'. Small uncontrolled studies in IBS were excluded. RESULTS: Probiotics can enhance gut barrier function, inhibit pathogen binding and modulate gut inflammatory response. They can also reduce visceral hypersensitivity associated with both inflammation and psychological stress. Probiotics can alter colonic fermentation and stabilize the colonic microbiota. Several large randomized, placebo-controlled trials of adequate design have shown an improvement in flatulence and abdominal distension with a reduction in composite IBS symptoms scores. CONCLUSIONS: Each probiotic has unique features and IBS patients are heterogeneous. Future efforts should be directed to identifying biomarkers of responsiveness to facilitate better targeting of treatment and hence improved efficacy. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/18532993/Review_article:_probiotics_and_prebiotics_in_irritable_bowel_syndrome_ L2 - https://doi.org/10.1111/j.1365-2036.2008.03750.x DB - PRIME DP - Unbound Medicine ER -