PROBIOTICS IN THE IRRITABLE COLON SYNDROME: SCIENCE AND TESTS

Quigley EM1.



Information on the author: j. clinic gastroenterol 2015 Nov-Dec; 49 Suppl 1: S60-4. doi: 10.1097 / MCG.0000000000000348.



Abstract:



Although probiotics have been used for many years by those who suffer from what is termed irritable bowel syndrome (IBS), a scientific rationale for their use in this indication and clinical trials to support their benefits have emerged very recently. Evidence to support evaluation strategies, such as probiotics, which modulate the intestinal microbiome, in IBS, have been provided by laboratory studies that have implicated the microbiota and the host response to the enteric microenvironment in IBS, as well as studies in vitro and in vivo that demonstrate the ability of various commensal bacteria to influence such relevant functions as motility, visceral sensation, intestinal barrier integrity and brain-intestinal interactions. Clinical studies supporting a role of probiotics in the management of IBS preceded these experimental data and continue to be reported in randomized controlled trials of probiotics in IBS. Their interpretation is hampered by the non-optimal quality of many studies; however, it is evident that probiotics, as a category, have significant effects in IBS. Defining the optimal strain, dose, formulation and duration of therapy is more difficult given the limitations of the available data. There is also an urgent need for appropriately motorized and rigorously designed clinical trials of appropriate probiotic duration in IBS; such studies should also help to define those most likely to respond to probiotics. The future laboratory and translational research should attempt to define the mechanism (s) of probiotic action in IBS and explore the response to components or bacterial products in this common and often bothersome disorder.

Source: Pubmed