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Prebiotics and probiotics in irritable bowel syndrome and inflammatory bowel disease in children.
Benef Microbes. 2015; 6(2):209-17.BM

Abstract

Underlying pathophysiological mechanisms of irritable bowel syndrome (IBS), a common disorder characterized by abdominal pain associated to a change in stool consistency or frequency, include low-grade inflammation and intestinal microbiota changes. Few and disappointing data are available for prebiotics. A few controlled trials (RCTs) of probiotics are instead available with favourable effects, although most are limited by suboptimal design and small sample size. A recent report from the Rome foundation group included 32 RCTs of probiotics, most of which showed an overall modest improvement in symptoms, with the patients most benefitting from probiotics being those with predominant diarrhoea and those having a post-infectious IBS. A review focusing only on children with functional gastrointestinal disorders concluded that probiotics are more effective than placebo in the treatment of patients with abdominal pain-related functional gastrointestinal disorders, although no effect on constipation was evident. The role for probiotics in inflammatory bowel disease (IBD) appears logical: the endogenous intestinal microbiota plays a central role in their development, and various probiotics have been found effective in animal models of IBD. However, research in humans has been overall quite limited, and it would seem that after a phase of intense research in the first decade of this century, the pace has slowed down, with fewer clinical trials been published in the past 2-3 years. To summarize current evidence: no probiotic has proven successful in Crohn's disease. In ulcerative colitis, on the other hand, data are more promising, and a very recent meta-analysis, that included 23 randomized controlled trials, concluded that there is evidence of efficacy for the probiotic mixture VSL#3 in helping inducing and maintaining remission, as well as in maintaining remission in patients with pouchitis. It is fair to state that for both IBD and IBS, more well-designed, rigorous, randomized clinical trials must be performed.

Authors+Show Affiliations

Section of Gastroenterology, Hepatology and Nutrition Department of Pediatrics, University of Chicago, 5841 S. Maryland Ave., MC 4065, Chicago, IL 60637, USA.Section of Gastroenterology, Hepatology and Nutrition Department of Pediatrics, University of Chicago, 5841 S. Maryland Ave., MC 4065, Chicago, IL 60637, USA.Section of Gastroenterology, Hepatology and Nutrition Department of Pediatrics, University of Chicago, 5841 S. Maryland Ave., MC 4065, Chicago, IL 60637, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

25391345

Citation

Guandalini, S, et al. "Prebiotics and Probiotics in Irritable Bowel Syndrome and Inflammatory Bowel Disease in Children." Beneficial Microbes, vol. 6, no. 2, 2015, pp. 209-17.
Guandalini S, Cernat E, Moscoso D. Prebiotics and probiotics in irritable bowel syndrome and inflammatory bowel disease in children. Benef Microbes. 2015;6(2):209-17.
Guandalini, S., Cernat, E., & Moscoso, D. (2015). Prebiotics and probiotics in irritable bowel syndrome and inflammatory bowel disease in children. Beneficial Microbes, 6(2), 209-17. https://doi.org/10.3920/BM2014.0067
Guandalini S, Cernat E, Moscoso D. Prebiotics and Probiotics in Irritable Bowel Syndrome and Inflammatory Bowel Disease in Children. Benef Microbes. 2015;6(2):209-17. PubMed PMID: 25391345.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prebiotics and probiotics in irritable bowel syndrome and inflammatory bowel disease in children. AU - Guandalini,S, AU - Cernat,E, AU - Moscoso,D, PY - 2014/11/14/entrez PY - 2014/11/14/pubmed PY - 2016/3/10/medline KW - Crohn's disease, ulcerative colitis KW - functional gastrointestinal disorders KW - inflammatory bowel disease KW - irritable bowel syndrome SP - 209 EP - 17 JF - Beneficial microbes JO - Benef Microbes VL - 6 IS - 2 N2 - Underlying pathophysiological mechanisms of irritable bowel syndrome (IBS), a common disorder characterized by abdominal pain associated to a change in stool consistency or frequency, include low-grade inflammation and intestinal microbiota changes. Few and disappointing data are available for prebiotics. A few controlled trials (RCTs) of probiotics are instead available with favourable effects, although most are limited by suboptimal design and small sample size. A recent report from the Rome foundation group included 32 RCTs of probiotics, most of which showed an overall modest improvement in symptoms, with the patients most benefitting from probiotics being those with predominant diarrhoea and those having a post-infectious IBS. A review focusing only on children with functional gastrointestinal disorders concluded that probiotics are more effective than placebo in the treatment of patients with abdominal pain-related functional gastrointestinal disorders, although no effect on constipation was evident. The role for probiotics in inflammatory bowel disease (IBD) appears logical: the endogenous intestinal microbiota plays a central role in their development, and various probiotics have been found effective in animal models of IBD. However, research in humans has been overall quite limited, and it would seem that after a phase of intense research in the first decade of this century, the pace has slowed down, with fewer clinical trials been published in the past 2-3 years. To summarize current evidence: no probiotic has proven successful in Crohn's disease. In ulcerative colitis, on the other hand, data are more promising, and a very recent meta-analysis, that included 23 randomized controlled trials, concluded that there is evidence of efficacy for the probiotic mixture VSL#3 in helping inducing and maintaining remission, as well as in maintaining remission in patients with pouchitis. It is fair to state that for both IBD and IBS, more well-designed, rigorous, randomized clinical trials must be performed. SN - 1876-2891 UR - https://www.unboundmedicine.com/medline/citation/25391345/Prebiotics_and_probiotics_in_irritable_bowel_syndrome_and_inflammatory_bowel_disease_in_children_ L2 - http://www.wageningenacademic.com/doi/full/10.3920/BM2014.0067?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -