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Effects of probiotic type, dose and treatment duration on irritable bowel syndrome diagnosed by Rome III criteria: a meta-analysis.

Abstract

BACKGROUND

Irritable bowel syndrome (IBS) is one of the most common functional gastroenterological diseases, affecting 11.2 % of people worldwide. Previous studies have shown that probiotic treatment may benefit IBS patients. However, the effect of probiotics and the appropriate type, dose, and treatment duration for IBS are still unclear. The aim of the current study was to assess the efficacy of different probiotic types, doses and treatment durations in IBS patients diagnosed by Rome III criteria via a meta-analysis of randomized controlled trials (RCTs).

METHODS

Medline, EMBASE, and the Cochrane Central Register of Controlled Trials up to October 2015 were searched. RCTs including comparisons between the effects of probiotics and placebo on IBS patients diagnosed by Rome III criteria were eligible. Dichotomous data were pooled to obtain the relative risk (RR) with a 95 % confidence interval (CI), whereas continuous data were pooled using a standardized mean difference (SMD) with a 95 % CI.

RESULTS

Twenty-one RCTs were included in this meta-analysis. Probiotic therapy was associated with more improvement than placebo administration in overall symptom response (RR: 1.82, 95 % CI 1.27 to 2.60) and quality of life (QoL) (SMD: 0.29, 95 % CI 0.08 to 0.50), but not in individual IBS symptoms. Single probiotics, a low dose, and a short treatment duration were more effective with respect to overall symptom response and QoL. No differences were detected in individual IBS symptoms in the subgroup analyses.

CONCLUSION

Probiotics are an effective pharmacological therapy in IBS patients. Single probiotics at a low dose and with a short treatment duration appear to be more effective in improving overall symptom response and QoL, but more evidence for these effects is still needed.

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  • Authors+Show Affiliations

    ,

    Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong Province, China.

    ,

    Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong Province, China.

    ,

    Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong Province, China.

    ,

    Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong Province, China.

    ,

    Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong Province, China.

    ,

    Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong Province, China.

    Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong Province, China. liyanqing@sdu.edu.cn.

    Source

    BMC gastroenterology 16:1 2016 Jun 13 pg 62

    MeSH

    Abdominal Pain
    Drug Administration Schedule
    Gases
    Humans
    Intestines
    Irritable Bowel Syndrome
    Probiotics
    Quality of Life
    Randomized Controlled Trials as Topic

    Pub Type(s)

    Journal Article
    Meta-Analysis

    Language

    eng

    PubMed ID

    27296254

    Citation

    Zhang, Yan, et al. "Effects of Probiotic Type, Dose and Treatment Duration On Irritable Bowel Syndrome Diagnosed By Rome III Criteria: a Meta-analysis." BMC Gastroenterology, vol. 16, no. 1, 2016, p. 62.
    Zhang Y, Li L, Guo C, et al. Effects of probiotic type, dose and treatment duration on irritable bowel syndrome diagnosed by Rome III criteria: a meta-analysis. BMC Gastroenterol. 2016;16(1):62.
    Zhang, Y., Li, L., Guo, C., Mu, D., Feng, B., Zuo, X., & Li, Y. (2016). Effects of probiotic type, dose and treatment duration on irritable bowel syndrome diagnosed by Rome III criteria: a meta-analysis. BMC Gastroenterology, 16(1), p. 62. doi:10.1186/s12876-016-0470-z.
    Zhang Y, et al. Effects of Probiotic Type, Dose and Treatment Duration On Irritable Bowel Syndrome Diagnosed By Rome III Criteria: a Meta-analysis. BMC Gastroenterol. 2016 Jun 13;16(1):62. PubMed PMID: 27296254.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effects of probiotic type, dose and treatment duration on irritable bowel syndrome diagnosed by Rome III criteria: a meta-analysis. AU - Zhang,Yan, AU - Li,Lixiang, AU - Guo,Chuanguo, AU - Mu,Dan, AU - Feng,Bingcheng, AU - Zuo,Xiuli, AU - Li,Yanqing, Y1 - 2016/06/13/ PY - 2016/05/04/received PY - 2016/05/27/accepted PY - 2016/6/15/entrez PY - 2016/6/15/pubmed PY - 2017/1/19/medline KW - Irritable bowel syndrome KW - Meta-analysis KW - Probiotics SP - 62 EP - 62 JF - BMC gastroenterology JO - BMC Gastroenterol VL - 16 IS - 1 N2 - BACKGROUND: Irritable bowel syndrome (IBS) is one of the most common functional gastroenterological diseases, affecting 11.2 % of people worldwide. Previous studies have shown that probiotic treatment may benefit IBS patients. However, the effect of probiotics and the appropriate type, dose, and treatment duration for IBS are still unclear. The aim of the current study was to assess the efficacy of different probiotic types, doses and treatment durations in IBS patients diagnosed by Rome III criteria via a meta-analysis of randomized controlled trials (RCTs). METHODS: Medline, EMBASE, and the Cochrane Central Register of Controlled Trials up to October 2015 were searched. RCTs including comparisons between the effects of probiotics and placebo on IBS patients diagnosed by Rome III criteria were eligible. Dichotomous data were pooled to obtain the relative risk (RR) with a 95 % confidence interval (CI), whereas continuous data were pooled using a standardized mean difference (SMD) with a 95 % CI. RESULTS: Twenty-one RCTs were included in this meta-analysis. Probiotic therapy was associated with more improvement than placebo administration in overall symptom response (RR: 1.82, 95 % CI 1.27 to 2.60) and quality of life (QoL) (SMD: 0.29, 95 % CI 0.08 to 0.50), but not in individual IBS symptoms. Single probiotics, a low dose, and a short treatment duration were more effective with respect to overall symptom response and QoL. No differences were detected in individual IBS symptoms in the subgroup analyses. CONCLUSION: Probiotics are an effective pharmacological therapy in IBS patients. Single probiotics at a low dose and with a short treatment duration appear to be more effective in improving overall symptom response and QoL, but more evidence for these effects is still needed. SN - 1471-230X UR - https://www.unboundmedicine.com/medline/citation/27296254/full_citation L2 - https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-016-0470-z DB - PRIME DP - Unbound Medicine ER -