Abstract
Micro-inflammation in the gut, assessed by fecal calprotectin (FC), is considered a component of the pathogenesis of functional diarrhea (FD). Since probiotics may suppress micro-inflammation in the intestine by competing with harmful bacteria, we hypothesized that they would reduce the ratio of loose stool symptoms and gut inflammation in patients with FD. We conducted a double-blind, placebo-controlled trial to assess the clinical and laboratory effects of Lactobacillus plantarum CJLP243 in FD patients with elevated FC levels for two months. Twenty-four patients diagnosed with FD with elevated FC levels were randomly assigned to either a probiotic group or a placebo group. After 2 months, 10 patients in the probiotic group and 12 patients in the placebo group completed the study, and FD symptoms, FC values, and intestinal flora were re-evaluated in these subjects. The percentage of subjects who had adequate FD relief (decrease in loose stool frequency) in the probiotic group was significantly increased after two months compared with the baseline. In addition, the probiotic group showed a statistically significant decrease in log-transformed FC values compared with the pre-treatment group, whereas the placebo group showed no difference before and after the intervention. Furthermore, the levels of Leuconostoc genus organisms in the gut microbiota composition in the probiotic group increased significantly after the end of the study compared with the baseline values. In this preliminary exploratory research, we found that two months of Lactiplantibacillus plantarum CJLP243 treatment resulted in FD symptom improvement, reduced FC values, and increased Leuconostoc levels, suggesting that the intake of Lactiplantibacillus plantarum was helpful in those patients. These findings need to be validated via further clinical studies.
Highlights
Functional diarrhea (FD) is characterized by chronic or recurrent diarrhea that is not explained by structural or biochemical abnormalities and is distinguished from diarrheapredominant irritable bowel syndrome (IBS), where abdominal pain is the main symptom [1]
Which was the primary goal of this study—in the probiotic group compared with the placebo group after two months
fecal calprotectin (FC), an indicator of colonic inflammation, was decreased significantly after two months compared with baseline in the probiotic group
Summary
Functional diarrhea (FD) is characterized by chronic or recurrent diarrhea that is not explained by structural or biochemical abnormalities and is distinguished from diarrheapredominant irritable bowel syndrome (IBS), where abdominal pain is the main symptom [1]. Recent results from the Rome Foundation Global Study showed that, according to the Rome IV criteria, FD had a prevalence of about 4.7%, which was higher than the prevalence of IBS (4.1%), in which abdominal pain is the main symptom [2]. Previous studies have reported the presence of inflammation in biopsy samples of the intestinal mucosa of patients with FD compared with controls [5,6]. Taken together, these findings suggest that inflammation of the gut plays a role in FD. FC has been used as a biomarker for colonic inflammation
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