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- W2076456485 abstract "The probiotic literature is like a boat listing in a fog of vague claims, in need of scientific ballast. It contracts under scrutiny for evidence for a specific claim with a given strain in a specific indication. The greatest impediment is the assumption that all probiotics are equal.1 Then, there is non-uniform quality control of probiotic products and the lack of well-designed controlled trials. However, in irritable bowel syndrome (IBS), amidst a sea of conflicting data on pharmaceutical and nonpharmaceutical remedies, it is only fair to acknowledge evidence in support of some, but not all probiotic products.1-3 Furthermore, there is emerging rationale for manipulation of the microbiota, at least in a subset of sufferers.4 In defiance of the apparent heterogeneity of IBS, Sisson et al. report a statistically significant improvement in symptom severity score, their primary efficacy measure, with a multi-strain probiotic mixture in a single-centre, randomised, double-blind, placebo-controlled trial over 12 weeks in 186 adult patients with IBS.5 The impact was modest, although severe cases also benefited, and the study confirmed that probiotic effects disappear when consumption stops. Importantly, all clinical subtypes of IBS were included. While the mechanism of action remains unclear and obscured by the inclusion of four different bacterial strains with a delivery vehicle containing barley extract, a source of beta-glucans,6 single strains are effective in IBS, as shown by an earlier larger trial by others with a single bifidobacterium strain in similar patients.7 Of course, additional trials are desirable, but in the interim there is encouragement to pursue microbial biomarkers and predictors of therapeutic response in IBS, which could enhance trial design. Meanwhile, for patients the message is clear; they should be recommended probiotic strains supported by clinical science and only from a reputable company. Declaration of personal interests: FS is a foundation shareholder in a university campus company, Alimentary Health, Ltd. Declaration of funding interests: The authors are supported in part by Science Foundation Ireland. FS has consulted and/or received research grants from Procter and Gamble Co., Trino Pharmaceuticals and GlaxoSmithKline." @default.
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- W2076456485 date "2014-07-09" @default.
- W2076456485 modified "2023-09-27" @default.
- W2076456485 title "Editorial: probiotics and IBS - where are we now?" @default.
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- W2076456485 doi "https://doi.org/10.1111/apt.12836" @default.
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