The Effectiveness of Synbiotic Preparation Containing Lactobacillus and Bifidobacterium Probiotic Strains and Short Chain Fructooligosaccharides in Patients with Diarrhea Predominant Irritable Bowel Syndrome-A Randomized Double-Blind, Placebo-Controlled Study

• Published in: Nutrients Vol. 12; no. 7; p. 1999
• Main Authors: Skrzydło-Radomańska, Barbara, Prozorow-Król, Beata, Cichoż-Lach, Halina, Majsiak, Emilia, Bierła, Joanna B, Kosikowski, Wojciech, Szczerbiński, Mariusz, Gantzel, Jesper, Cukrowska, Bożena
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 05-07-2020; MDPI
• Subjects: Abdomen; Adolescent; Adult; Antibiotics; Bacteria; Bifidobacterium animalis; Bifidobacterium bifidum; Bifidobacterium longum; Bioethics; Clinical trials; Defecation; Diarrhea; Diarrhea - etiology; Diarrhea - microbiology; Diarrhea - therapy; Dietary supplements; Disease; Double-Blind Method; Double-blind studies; Drug dosages; Feces - microbiology; Female; Flatulence; Fructooligosaccharides; Humans; Infantile colic; Intestine; Irritable bowel syndrome; Irritable Bowel Syndrome - complications; Irritable Bowel Syndrome - microbiology; Irritable Bowel Syndrome - therapy; Lactobacilli; Lactobacillus; Lactobacillus acidophilus; Lactobacillus rhamnosus; Male; Meta-analysis; Microbiota; Microorganisms; Middle Aged; Motility; Oligosaccharides; Pain; Pathogenesis; prebiotics; Probiotics; Randomization; Severity of Illness Index; short chain fructooligosaccharides; Substance abuse treatment; synbiotics; Synbiotics - administration & dosage; Treatment Outcome; Young Adult; Denmark; Bifidobacterium; irritable bowel syndrome; short chain fructooligosaccharides; prebiotics; synbiotics; Lactobacillus; probiotics
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu12071999

The purpose of the randomized double-blind placebo-controlled trial was to assess the effectiveness of synbiotic preparation containing probiotic
FloraActive™ 19070-2,
DSMZ 32418,
DSMZ 32269,
DSMZ 32946,
DSMZ 32403 and fructooligosaccharides in adult patients with diarrhea-dominant IBS (IBS-D). The study included eighty patients with moderate and severe IBS-D who were randomized to receive synbiotics or placebo for eight weeks. Finally, a total of sixty-eight patients finished the study. The primary endpoints included the assessment of the symptoms' severity with IBS symptom severity scale (IBS-SSS), an improvement of IBS global symptoms with Global Improvement Scale (IBS-GIS) and adequate relief of symptoms after four and eight weeks of therapy. Secondary endpoints, which were collected by telephone interviewers three times a week included the assessment of individual IBS symptoms and adverse events. Synbiotic treatment in comparison to placebo significantly improved IBS-GIS (
= 0.043), and IBS-SSS score inducing a decrease in the total IBS-SSS (
= 0.042) and in domain-specific scores related to flatulence (
= 0.028) and bowel habit (
= 0.028) after four and eight weeks. Patients treated with synbiotics reported in weekly observations a significant amelioration in a feeling of incomplete bowel movements, flatulence, pain, stool pressure and diarrheal stools compared to those receiving placebo. There were no differences in adverse events between both groups. Concluding, the multi-strain synbiotic preparation was associated with a significant improvement in symptoms in IBS-D patients and was well-tolerated. These results suggest that the use of synbiotics offers a benefit for IBS-D patients. [Clinicaltrials.gov NCT04206410 registered 20 December 2019].