Re: But
#327207 - 03/26/08 08:54 AM
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Syl
Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA
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I know of only three probiotics that have been proven through clinical trials to be effective for IBS: VSL#3, lactobacillus plantarum and Bifidobacterium infantis 35624 (Align). A recent review of probiotics in clinical practice (see first reference below) indicates that only certain species of lactobacillus and bifidobacterium have any efficacy for IBS.
VSL#3 and lactobacillus plantarum were small trials showing limited efficacy compared to placebo. There have been three Bifidobacterium infantis 35624 trial that were much larger and the efficacy was high for all IBS symptoms in IBS-C and IBS-D. The mechanism by which the later probiotic works in IBD to reduce localized bowel inflammation is better understood (see second reference below) and hypothesized to be similar in IBS. VSL#3 contains a variety of organisms including lactobacillus plantarum and Bifidobacterium infantis (perhaps different strain than 35624) and this may be part of the reason for its partial efficacy in IBS.
It is not the number of organisms in a probiotic that determines it's effectiveness. It is the type, species and amount of individual organisms that determine the efficacy. While there may be other probiotics that are effective for IBS they have not been clinically proven. I won't rely on self-reports from one or even few individuals to judge the efficacy of any probiotic on IBS.
I hope this helps 
Reference
Zuccotti, G. V., et. al., 2008: Probiotics in clinical practice: An overview. Journal of International Medical Research, 36, 1A-53A.
Shiba, T., et. al., 2003: The Suppressive Effect of Bifidobacteria on Bacteroides vulgatus, a Putative Pathogenic Microbe in Inflammatory Bowel Disease. Microbiology and Immunology, 47, 371-378
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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
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Re: But
#327209 - 03/26/08 09:49 AM
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Jordy
Reged: 08/12/06
Posts: 2095
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So, in your opinion, Align has more proven results for all types of IBS than the other two probiotics even though it doesn't contain the plantarum? I was really stuck on getting that one for the bloat.
Thanks for your patience, Syl. Let me know if you ever decide to try the align or the Benefiber with wheat dextrin, okay?
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IBS-C with pain and bloat
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Re: But
#327223 - 03/26/08 10:22 AM
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Syl
Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA
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I don't recommend Align - I only report the findings in the research literature. Bifidobacterium infantis has been reported to reduce all symptoms including bloating.
I am actually going to try the Natren Life Start which contains Bifidobacterium infantis but the strain is NLS not 35624. This strain of Bifidobacterium infantis has not undergone clinical investigation yet but I understand there is one in progress. I would have preferred to try the Life Start 2 but this product is not available in Canada yet.
Some people might have concerns about the Life Start products because the probiotic Bifidobacterium infantis is grown on either cow (Life Start) or goat's (Life Start 2) milk and therefore contains a small amount of dairy. I have no concerns because a 1/2 teaspoon contains 1 billion CFUs and it likely contains very little dairy.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
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Re: But
#327228 - 03/26/08 10:35 AM
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Syl, just to clarify - this stuff is for infants? But because of that certain strain it contains, the bifidobacterium infantis, it may be beneficial to us?? Thanks 
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Re: But
#327236 - 03/26/08 11:40 AM
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Jordy
Reged: 08/12/06
Posts: 2095
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Just curious, why did you choose the life start over the align since it doesn't have the research behind it. I know you must have a reason....you are too researched minded not too!
Thanks for letting me know that Align is suppose to help bloating. I'm sorry, I really thought you had recommended that product and that you were onna try it. Sorry about the confusion
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IBS-C with pain and bloat
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Re: But
#327245 - 03/26/08 01:12 PM
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Syl
Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA
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Bifidobacterium infantis is a bacteria that an infant acquires from its mother when it passes through the birth canal. However, when an infant is born by Cesarean section or was given antibiotics there is a chance that there is not enough of this bacteria to colonize the colon properly. The Life Start probiotic is used for children for this reason.
The original research on bifidobacterium infantis and IBD was done in Japan and published in 2003. They used the strain 1222 in that research. It is quite likely that different strains of bifidobacterium infantis are effective for treating IBS. However, the amount required to have a theraputic effect may be different that the amount used in the clinical trials done on the strain 35624. The cost of Align is high - about $1.10 per dose - probably a result of the clinical trials. And it is not available in Canada. The cost of Life Start is much lower. A 4.5 oz jar cost about $38. A 1/4 teaspoon contains 1 billion CFUs. There are about 260 doses in a jar for a cost of about $0.15 per dose. It is a cheap experiment to try:)
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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
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Re: But
#327251 - 03/26/08 01:43 PM
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Erilyn
Reged: 11/14/07
Posts: 743
Loc: Beautiful British Columbia, Canada
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Syl, can you buy this Life Start in Canada?
Sounds like I had a double whammy - I was born through a C-section, AND had surgery at 20 months so certainly had tons of antibiotics at a very young age.
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IBS-A since age 12, and fructose sensitive; with the exception of my pregnancy, have been following Heather's diet since Nov. 19, 2007.
Taking 12g of Acacia per day. Relatively stable since March 2008!
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Re: But
#327257 - 03/26/08 02:28 PM
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Syl
Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA
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Yes. It is available in Canada. Life Start 2 is grown on goat's milk but it is not available yet. Some regulatory issues regarding labelling to deal with.
I called the head office. They referred me to the Canadian rep in Calgary (natrencanada@shaw.ca). He gave me the name of a local HFS that carries it. I hope to get some later this week. It is also available on-line from CureSelf.
Life Start has to be kept cool so it is shipped in a cold pack from on-line vendors which adds a bit to the cost. However, I expect any Canadian HFS can order it from Natren Canada
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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
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trials
#327286 - 03/26/08 05:31 PM
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Like Syl says it is the number of bacteria and the diversity of strains that determines efficacy. I personally don't feel ones that aren't tested aren't good. I feel the couple that have been tested may have been chosen because of many different reasons including money changing hands. If GI doctors always recommend VSL#3 it could be that company paid for it to be tested. I'm sure it is good but other brands may have been unable to get in trials, if you follow me.
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IBS-A for 20 years with terrible bloating and gas. On the diet since April 2004. Remember this from Heather's information pages:
"You absolutely must eat insoluble fiber foods, and as much as safely possible, but within the IBS dietary guidelines. Treat insoluble fiber foods with suitable caution, and you'll be able to enjoy a wide variety of them, in very healthy quantities, without problem." Please eat IF foods!
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Re: trials
#327292 - 03/26/08 07:15 PM
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Syl
Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA
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I don't think anyone has shown that diversity plays a role in the efficacy of a probiotic. In fact if you read the abstract of the last paper in this message you will see they warn that "Combining potentially anti-inflammatory and proinflammatory bacteria in the same preparation would be particularly counterproductive and presents the alarming situation where an ill-chosen probiotic species might exacerbate disease." I suspect specific strains of individual species may be more important.
Generally speaking it always the company's responsibility to pay for clinical investigation.
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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
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The Role of Food & Dietary Intervention in IBS
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