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Probiotics....oh, and calcium?
      #367660 - 06/22/12 04:54 AM
TwinsPlusOne

Reged: 05/08/12
Posts: 10
Loc: Western MA

So I had a nutritionist recommend that I add probiotics into my daily routine. I tried acidophilus and it made my gut just ache. I took it for 3 days to see if it changed and the ache was there until I eliminated the probiotics. Is this common -- did I perhaps take them incorrectly? Or is acidophilus not recommended for IBS sufferers and I just got bad advice?

Is there a good way to supplement my calcium intake? I have IBS-A and am severely underweight. I know that I am lacking in a variety of key nutrients but don't even know where to begin.....everything says it can be constipating or cause diarrhea.....sheesh :/

Thanks for the help!

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IBS C + D for 14 years. I am finally becoming open-minded enough to get out of my own way. Happily married and proud mother to 3 wonderful boys

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Re: Probiotics....oh, and calcium? new
      #367661 - 06/22/12 05:09 AM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

Very few probiotics have been clinically tested for efficacy in treating IBS symptoms. Acidophilus has been shown to have marginal effect on IBS symptoms. Check this post for more information. And do a search of the board using the search function at the top of the page.

Also, check the ingredients to make sure the probiotic does not contain any IBS unfriendly ingredients like inulin and lactose.



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STABLE: ♂, IBS-D 50+ years - Science of IBS

The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS

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Re: Probiotics....oh, and calcium? new
      #367662 - 06/22/12 06:41 AM
mradams1

Reged: 07/12/10
Posts: 206


This news has been in the UK media recently with regards to VSL#3 and symprove probiotics and clinical trials.

http://www.nutraingredients.com/Research/Probiotic-fibre-blend-delivers-IBS-benefits-King-s-College

http://www.healthnewsdigest.com/news/consumer%20issues0/Probiotic_VSL_3_Clinically_Proven_to_Improve_Remission_Rates_in_Ulcerative_Colitis_Patients.shtml

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IBS A. Managing my symptoms with the EFI/FODMAP diet and probiotics.

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Re: Probiotics....oh, and calcium? new
      #367663 - 06/22/12 07:09 AM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

Do you have any links to published research on this product ( Symprove )? I cannot find a peer-reviewed publication that discusses the results of the 12 week study done by the company that makes it.

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STABLE: ♂, IBS-D 50+ years - Science of IBS

The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS

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Re: Probiotics....oh, and calcium? new
      #367664 - 06/22/12 07:19 AM
mradams1

Reged: 07/12/10
Posts: 206


Hi Syl,

Yes, the paper was published in the journal Gastroenterology, Volume 142, Issue 5, Supplement 1, May 2012. The authors: Guy Sisson, Salma Ayis, Ingvar T. Bjarnason



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IBS A. Managing my symptoms with the EFI/FODMAP diet and probiotics.

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Re: Probiotics....oh, and calcium? new
      #367665 - 06/22/12 08:28 AM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

Thanks. Unfortunately, the supplements aren't published on-line. I believe they are abstracts of the Digestive Disease Week presentations not the actual paper.

I did find an abstract for a poster not a paper in GUT titled "Assessment of the probiotic Symprove in patients with IBS: A randomised double blind placebo controlled trial" (Gut 2012;61:Suppl 2 A104 doi:10.1136/gutjnl-2012-302514b.76 ) but it contains relatively little information.

--------------------
STABLE: ♂, IBS-D 50+ years - Science of IBS

The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS

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Re: Probiotics....oh, and calcium? new
      #367678 - 06/25/12 05:37 AM
mradams1

Reged: 07/12/10
Posts: 206



The article I mentioned:

"Assessment of the Probiotic Symprove in Patients With IBS: A Randomised
Double Blind Placebo Controlled Trial
Guy Sisson, Salma Ayis, Ingvar T. Bjarnason
Background and Aim: Treatment of patients with Irritable Bowel Syndrome (IBS) is often
difficult, empiric and not evidence based. Recent insights into the pathogenesis of IBS have
suggested that intestinal bacterial dysbiosis may result in symptomatic IBS. Accordingly,
there is considerable interest in new treatments centred on modifying the intestinal bacterial
flora with antibiotics or administration of appropriately designed probiotics. Therapeutic
efficacy of probiotics appears to be strain specific. Symprove is a liquid probiotic formulation
containing 4 bacterial strains (Lactobacillus casei, acidophilus and plantarum as well as
Enterococcus faecium) with a shell life in excess of 3 months. We assessed its efficacy in
patients with IBS. Material and Methods: This was a single centre, double blind, randomised,
placebo controlled trial involving treatment with Symprove (1 ml/kg body weight) versus
placebo for 3 months. Patients were recruited from two large GP practices in London and
from GP referrals to the Department of Gastroenterology at King's College Hospital. All
patients had failed conventional first and second line treatment by GP's. An initial 391
patients were screened for the trial and 186 were eligible and consented to the trial (fulfilled
ROME III criteria, exclusion of organic disease by extensive investigation including intestinal
permeability, faecal calprotectin, endoscopy, wireless capsule endoscopy, colonoscopy and
radiology when indicated). Using a simple non-stratified two-stage computer randomisation
protocol (the Mersenne twister pseudo-random number generator) 124 received the active
treatment and 62 placebo. The main outcome measure was the reduction in IBS symptom
severity scores (IBS-SSS) at 3 months. All patients were symptomatic with IBS-SSS > 150.
Results: There were no significant differences between the two treatment groups with respect
to demographic details (male/female ratio, mean age, duration of disease or previous treatment).
There were no significant differences (p > 0.1) at pre treatment IBS-SSS scores
between active (303 ± 68, mean ±SD) and placebo (306 ±80) (p=0.841) treated patients.
During the last week of treatment (week 12) there was a statistically significant (p < 0.027)
greater improvement in the mean IBS-SSS (230,± 109) in the Symprove treated patients as
compared with placebo (270±103 ). The number of dropouts during the study did not
differ significantly between the 2 groups and no severe adverse events were evident. Conclusion:
Three months treatment with the probiotic Symprove was associated with significantly
greater reduction in symptom severity in patients with moderate to severe IBS as compared
with placebo. Symprove was well tolerated and without significant side effects."

--------------------
IBS A. Managing my symptoms with the EFI/FODMAP diet and probiotics.

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Re: Probiotics....oh, and calcium? new
      #367679 - 06/25/12 06:48 AM
Syl

Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA

That you. That abstract is essentially the same as the abstract in GUT. However, the abstract in GUT was for a poster session at a conference not a peer-reviewed paper to be published in a journal. Poster session are usually for conference submissions that are interesting but don't meet the more stringent requirement to be accepted as a paper to be presented. I was hoping to see the full paper if there was one to read about the full details and methodology used in the study not just the brief overview given in the abstract. Hopefully someday they will publish a full paper.

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STABLE: ♂, IBS-D 50+ years - Science of IBS

The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS

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VSL 3 new
      #367695 - 06/27/12 09:48 AM
Susie1985

Reged: 05/04/11
Posts: 211


I tried VSL3 and it works great, although does not eliminate the symptoms wholly. I can totally tolerate non-grain sources of IF if I take it and the pain I get from too much fat is also less.

It is quite expensive however so I cannot keep taking it long-term so financially it's more worth taking just the SF supplement, which VSL3 basically substitutes for me.

I reckon all people are different so my experience may not be that much help.

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now: stable through EFI+FODMAP dieting (no lactose/no fructose/some fructans and some polyols)

before: IBS-D(pseudo-diarrhoea), bloating, often unbearable pain esp from too much fat: Apr 2007- Dec 2010


FODMAPs: http://www.todaysdietitian.com/newarchives/072710p30.shtml


[I've tried VSL#3 -> I could tolerate v good amounts of IF (even with less SF), it worked great (but overall I find it too expensive)]

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