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Review
. 2009 Feb 16:9:15.
doi: 10.1186/1471-230X-9-15.

A systematic review and meta-analysis: probiotics in the treatment of irritable bowel syndrome

Nourieh Hoveyda  1 , Carl Heneghan, Kamal R Mahtani, Rafael Perera, Nia Roberts, Paul Glasziou
Affiliations
Review

A systematic review and meta-analysis: probiotics in the treatment of irritable bowel syndrome

Nourieh Hoveyda et al. BMC Gastroenterol. .

Abstract

Background: Irritable Bowel Syndrome (IBS) is a common chronic gastrointestinal disorder and the evidence for efficacy of most drug therapies in the treatment of IBS is weak. A popular alternative is probiotics, which have been used in several conditions. including IBS. Probiotics are live microbial food supplements.The aim of this systematic review and meta-analysis of randomized trials study was to evaluate the efficacy of probiotics in alleviating symptoms in patients with irritable bowel syndrome. We searched Ovid versions of MEDLINE (1950-2007), EMBASE (1980-2007), CINAHL (1982-2007), AMED (1985-2007), the Cochrane library and hand searched retrieved papers.

Results: We identified 14 randomized placebo controlled trials. Combined data suggested a modest improvement in overall symptoms after several weeks of treatment: for dichotomous data from seven trials the overall Odds Ratio (OR) was 1.6 (95% CI, 1.2 to 2.2); for continuous data from six trials the standardised mean difference (SMD) was 0.23 (95% CI, 0.07 to 0.38).For individual symptoms the results differed between the pooled dichotomous and pooled continuous data. Trials varied in relation to the length of treatment (4-26 weeks), dose, organisms and strengths of probiotics used.

Conclusion: Probiotics may have a role in alleviating some of the symptoms of IBS, a condition for which currently evidence of efficacy of drug therapies is weak. However, as IBS is a condition that is chronic and usually intermittent longer term trials are recommended. Such research should focus on the type, optimal dose of probiotics and the subgroups of patients who are likely to benefit the most.

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Figures

Figure 1
Figure 1
Flow chart for search results.
Figure 2
Figure 2
Forest plot of improvement in overall symptoms (dichotomous data) in patients with IBS treated with probiotics compared to placebo.
Figure 3
Figure 3
Forest plot of improvement in overall symptoms (continuous data) in patients with IBS treated with probiotics compared to placebo.
Figure 4
Figure 4
Forest plot of improvement of abdominal pain (dichotomous data) in patients with IBS treated with probiotics compared to placebo.
Figure 5
Figure 5
Forest plot of improvement of flatulence (dichotomous data) in patients with IBS treated with probiotics compared to placebo.
Figure 6
Figure 6
Forest plot of improvement of bloating (dichotomous data) in patients with IBS treated with probiotics compared to placebo.
See this image and copyright information in PMC

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References

    1. Agrawal A, Whorwell PJ. Irritable bowel syndrome: diagnosis and management. BMJ. 2006;332(7536):280–3. doi: 10.1136/bmj.332.7536.280. - DOI - PMC - PubMed
    1. Drossman DA, Whitehead WE, Camilleri M. Irritable bowel syndrome: a technical review for practice guideline development. Gastroenterology. 1997;112(6):2120–37. doi: 10.1053/gast.1997.v112.agast972120. - DOI - PubMed
    1. Maxwell PR, Mendall MA, Kumar D. Irritable bowel syndrome. Lancet. 1997;350(9092):1691–5. doi: 10.1016/S0140-6736(97)05276-8. - DOI - PubMed
    1. Akehurst RL. Burden of illness of irritable bowel syndrome. An interim report on behalf of Novartis Pharma AG, Basel, Switzerland. Sheffield: ScHARR, University of Sheffield; 1999.
    1. Akehurst RL, Brazier JE, Mathers N, O'Keefe C, Kaltenthaler E, Morgan A. Health-related quality of life and cost impact of irritable bowel syndrome in a UK primary care setting. Pharmacoeconomics. 2002;20(7):455–62. doi: 10.2165/00019053-200220070-00003. - DOI - PubMed

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