The Role of Probiotics in Functional Bowel Disorders

What are Functional Bowel Disorders?

Functional bowel disorders (FBD) are some of the most common gastrointestinal problems causing major disability, impaired quality of life, and a serious burden on society economically. FBD are characterized by changes in intestinal motility or hypersensitivity to sensations in the gut. However, despite intensive research over the past 15 years, we still do not know what causes these disorders. Additionally, limited treatments provide only partial relief from symptoms and often have considerable side effects.

The Different Benefits of Probiotic Strains

Clinical data over the past few years suggests that the intestinal microbiota play a role in maintaining normal gastrointestinal (GI) function. When this function is disrupted, symptoms such as diarrhea and constipation can develop. Recent clinical data suggest that probiotics and antibiotics may effectively alleviate these symptoms. Studies examining the effect of probiotics in functional GI disorders have shown mixed results because of methodological limitations, the use of different probiotic bacteria, and the use of a heterogeneous study population. However, with more recent data from studies using more sound methodologies, we know that some probiotics have positive clinical and physiological effects. However, we cannot say that all probiotics have the same effect because each probiotic strain has different benefits. These studies also show that we need to test the beneficial effect of each probiotic product separately for specific clinical conditions.

Our investigator-initiated study aimed to investigate if a blend of two probiotic bacteria, Lactobacillus acidophilus NCFM (L-NCFM) and Bifidobacterium animalis subsp. lactis Bi-07 (B-LBi07) has a clinical effect, is safe, and is tolerated well by a group of patients with non-constipation FBD.

The Study Method on Two Probiotic Bacteria for Functional Bowel Disorders

In this prospective, double-blind, placebo-controlled clinical trial, the participants are those who met the Rome III criteria for non-constipation-IBS, had diarrhea, or bloating for at least two weeks before participation in the study despite therapy. Subjects were randomized into two parallel intervention arms — active probiotic and a placebo. The study included a two-week run-in period to evaluate baseline symptoms and severity and an eight-week intervention period. Participants received either the probiotic or a placebo. Both products were in pill form, taken twice daily for eight weeks. They contain equivalent amounts of two probiotic bacteria (L-NCFM and B-LBi07) or a placebo of microcrystalline cellulose. A four-week follow-up period followed the intervention to evaluate post-intervention effects.

The Results

Of the 52 patients who completed the study, 28 had the probiotic, and 24 had the placebo. Compared with the placebo, probiotics resulted in significant improvements in abdominal bloating, bloating severity, and irritable bowel syndrome.

The Conclusion

Twice a day administration of probiotics L-NCFM and B-LBi07 improves symptoms of bloating in patients with FBD. These data support the hypothesis that manipulation of intestinal bacteria may be beneficial in those with FBD and the important and useful role of probiotic bacteria in the management of these disorders.

Reference

Probiotic Bacteria Lactobacillus Acidophilus NCFM and Bifidobacterium Lactis Bi-07 Versus Placebo for the Symptoms of Bloating in Patients with Functional Bowel Disorders: A Double-Blind Study

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