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Efficacy and Safety of Probiotics, Prebiotics and Synbiotics in the Treatment of Irritable Bowel Syndrome: A systematic review and meta-analysis.
Sultan Qaboos Univ Med J. 2020 Feb; 20(1):e13-e24.SQ

Abstract

Treatments that target alterations in gut microbiota may be beneficial for patients with irritable bowel syndrome (IBS). A systematic review and meta-analysis was conducted of randomised clinical trials (RCTs) evaluating the efficacy and safety of probiotics, prebiotics and synbiotics. Factors considered in the analysis included global IBS symptoms and/or abdominal pain, secondary symptoms and the frequency of adverse events. A total of 33 RCTs involving 4,321 patients were identified. Overall, probiotics significantly improved global IBS symptoms compared to placebos (standardised mean difference = -0.32, 95% confidence interval: -0.48 to -0.15; P <0.001), with significant heterogeneity between studies (I 2 = 72%; P <0.001). This remained apparent in both single- and multi-strain probiotic interventions as well as synbiotic formulations. However, evidence regarding prebiotics was scarce. There were no significant inter-group differences in terms of the frequency of adverse events. Future RCTs should address methodological limitations, including short follow-up periods and patient adherence.

Authors+Show Affiliations

Department of Internal Medicine, Dr Mohamad Amine Zbeib Polyclinic, Doha, Qatar.Department of Pharmacology, University of Jordan, Amman, Jordan.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

32190365

Citation

Asha, Mohammad Z., and Sundos F H. Khalil. "Efficacy and Safety of Probiotics, Prebiotics and Synbiotics in the Treatment of Irritable Bowel Syndrome: a Systematic Review and Meta-analysis." Sultan Qaboos University Medical Journal, vol. 20, no. 1, 2020, pp. e13-e24.
Asha MZ, Khalil SFH. Efficacy and Safety of Probiotics, Prebiotics and Synbiotics in the Treatment of Irritable Bowel Syndrome: A systematic review and meta-analysis. Sultan Qaboos Univ Med J. 2020;20(1):e13-e24.
Asha, M. Z., & Khalil, S. F. H. (2020). Efficacy and Safety of Probiotics, Prebiotics and Synbiotics in the Treatment of Irritable Bowel Syndrome: A systematic review and meta-analysis. Sultan Qaboos University Medical Journal, 20(1), e13-e24. https://doi.org/10.18295/squmj.2020.20.01.003
Asha MZ, Khalil SFH. Efficacy and Safety of Probiotics, Prebiotics and Synbiotics in the Treatment of Irritable Bowel Syndrome: a Systematic Review and Meta-analysis. Sultan Qaboos Univ Med J. 2020;20(1):e13-e24. PubMed PMID: 32190365.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and Safety of Probiotics, Prebiotics and Synbiotics in the Treatment of Irritable Bowel Syndrome: A systematic review and meta-analysis. AU - Asha,Mohammad Z, AU - Khalil,Sundos F H, Y1 - 2020/03/09/ PY - 2019/06/25/received PY - 2019/08/11/revised PY - 2019/09/12/accepted PY - 2020/3/20/entrez PY - 2020/3/20/pubmed PY - 2020/11/13/medline KW - Dietary Supplements KW - Gastrointestinal Microbiome KW - Irritable Bowel Syndrome KW - Meta-Analysis KW - Prebiotics KW - Probiotics KW - Synbiotics KW - Systematic Review SP - e13 EP - e24 JF - Sultan Qaboos University medical journal JO - Sultan Qaboos Univ Med J VL - 20 IS - 1 N2 - Treatments that target alterations in gut microbiota may be beneficial for patients with irritable bowel syndrome (IBS). A systematic review and meta-analysis was conducted of randomised clinical trials (RCTs) evaluating the efficacy and safety of probiotics, prebiotics and synbiotics. Factors considered in the analysis included global IBS symptoms and/or abdominal pain, secondary symptoms and the frequency of adverse events. A total of 33 RCTs involving 4,321 patients were identified. Overall, probiotics significantly improved global IBS symptoms compared to placebos (standardised mean difference = -0.32, 95% confidence interval: -0.48 to -0.15; P <0.001), with significant heterogeneity between studies (I 2 = 72%; P <0.001). This remained apparent in both single- and multi-strain probiotic interventions as well as synbiotic formulations. However, evidence regarding prebiotics was scarce. There were no significant inter-group differences in terms of the frequency of adverse events. Future RCTs should address methodological limitations, including short follow-up periods and patient adherence. SN - 2075-0528 UR - https://www.unboundmedicine.com/medline/citation/32190365/Efficacy_and_Safety_of_Probiotics_Prebiotics_and_Synbiotics_in_the_Treatment_of_Irritable_Bowel_Syndrome:_A_systematic_review_and_meta_analysis_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/32190365/ DB - PRIME DP - Unbound Medicine ER -