Re: Probiotics....oh, and calcium?
06/25/12 05:37 AM
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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."
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IBS A. Managing my symptoms with the EFI/FODMAP diet and probiotics.
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