Two Lactobacilli strains as adjuvant therapy in the management of irritable bowel syndrome: a randomized control trial

Abstract

Alleviating the symptoms of irritable bowel syndrome (IBS) through the addition of probiotics to the treatment of IBS patients appears to be promising. The present randomized clinical trial seeks to assess the efficacy of a multi-strain probiotic product combining two Lactobacillus (L.) strains: L. acidophilus and L. plantarum, in diarrhea-predominant IBS (IBS-D) patients. A randomized, single-blinded clinical trial design was adopted to randomly assign 100 patients into two groups. Patients in group A received standard IBS treatment, whereas Group B patients were treated with probiotics besides the standard treatment. Both groups were treated for up to 12 weeks. The patients were assessed clinically by using IBS – Symptom Severity Scale (IBS-SSS) before starting the treatment and then at the end of the treatment period to evaluate the actual effect of probiotic intervention in treating IBS-D. Both treatments resulted in significant reductions in the total IBS-SSS score, but the reduction in Group B was significantly higher than in Group A. The reduction was significant in the number of days with pain, the severity of abdominal distension, satisfaction with bowel symptoms, and the effect of IBS on patients’life. The standard treatment showed a reduction of 241 points in the overall IBS-SSS score, while adding the probiotic resulted in 307 points reduction. Before treatment, all patients had severe IBS symptoms, but after treatment, 100% of patients in group B either achieved complete remission or had mild symptoms, while 14.3% of patients in group A still had moderate IBS. The patients on probiotics exhibited higher reductions in IBS-SSS overall scores as well as scores of individual sections. The probiotics also improved the severity of the disease and its symptoms when added to standard treatment. The results of this trial could support the addition of probiotics to the guidelines for managing IBS.