A systematic review and meta-analysis: Probiotics in the treatment of irritable bowel syndrome

Nourieh Hoveyda, Carl Heneghan, Kamal R. Mahtani, Rafael Perera, Nia Roberts, Paul Glasziou

Research output: Contribution to journalReview articleResearchpeer-review

223 Citations (Scopus)

Abstract

Background: Irritable Bowel Syndrome (IBS) is a common chronic gastrointestinal disorder and the evidence for efficacy of most drug therapies in the treatment of IBS is weak. A popular alternative is probiotics, which have been used in several conditions. including IBS. Probiotics are live microbial food supplements.

The aim of this systematic review and meta-analysis of randomized trials study was to evaluate the efficacy of probiotics in alleviating symptoms in patients with irritable bowel syndrome. We searched Ovid versions of MEDLINE (1950-2007), EMBASE (1980-2007), CINAHL (1982-2007), AMED (1985-2007), the Cochrane library and hand searched retrieved papers.

Results: We identified 14 randomized placebo controlled trials. Combined data suggested a modest improvement in overall symptoms after several weeks of treatment: for dichotomous data from seven trials the overall Odds Ratio (OR) was 1.6 (95% CI, 1.2 to 2.2); for continuous data from six trials the standardised mean difference (SMD) was 0.23 (95% CI, 0.07 to 0.38).

For individual symptoms the results differed between the pooled dichotomous and pooled continuous data. Trials varied in relation to the length of treatment (4-26 weeks), dose, organisms and strengths of probiotics used.

Conclusion: Probiotics may have a role in alleviating some of the symptoms of IBS, a condition for which currently evidence of efficacy of drug therapies is weak. However, as IBS is a condition that is chronic and usually intermittent longer term trials are recommended. Such research should focus on the type, optimal dose of probiotics and the subgroups of patients who are likely to benefit the most.

Original languageEnglish
Article number15
Number of pages11
JournalBMC Gastroenterology
Volume9
DOIs
Publication statusPublished - 16 Feb 2009
Externally publishedYes

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Irritable Bowel Syndrome
Probiotics
Meta-Analysis
Therapeutics
Drug Therapy
Dietary Supplements
MEDLINE
Libraries
Randomized Controlled Trials
Odds Ratio
Placebos
Research

Cite this

Hoveyda, Nourieh ; Heneghan, Carl ; Mahtani, Kamal R. ; Perera, Rafael ; Roberts, Nia ; Glasziou, Paul. / A systematic review and meta-analysis : Probiotics in the treatment of irritable bowel syndrome. In: BMC Gastroenterology. 2009 ; Vol. 9.
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abstract = "Background: Irritable Bowel Syndrome (IBS) is a common chronic gastrointestinal disorder and the evidence for efficacy of most drug therapies in the treatment of IBS is weak. A popular alternative is probiotics, which have been used in several conditions. including IBS. Probiotics are live microbial food supplements.The aim of this systematic review and meta-analysis of randomized trials study was to evaluate the efficacy of probiotics in alleviating symptoms in patients with irritable bowel syndrome. We searched Ovid versions of MEDLINE (1950-2007), EMBASE (1980-2007), CINAHL (1982-2007), AMED (1985-2007), the Cochrane library and hand searched retrieved papers.Results: We identified 14 randomized placebo controlled trials. Combined data suggested a modest improvement in overall symptoms after several weeks of treatment: for dichotomous data from seven trials the overall Odds Ratio (OR) was 1.6 (95{\%} CI, 1.2 to 2.2); for continuous data from six trials the standardised mean difference (SMD) was 0.23 (95{\%} CI, 0.07 to 0.38).For individual symptoms the results differed between the pooled dichotomous and pooled continuous data. Trials varied in relation to the length of treatment (4-26 weeks), dose, organisms and strengths of probiotics used.Conclusion: Probiotics may have a role in alleviating some of the symptoms of IBS, a condition for which currently evidence of efficacy of drug therapies is weak. However, as IBS is a condition that is chronic and usually intermittent longer term trials are recommended. Such research should focus on the type, optimal dose of probiotics and the subgroups of patients who are likely to benefit the most.",
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A systematic review and meta-analysis : Probiotics in the treatment of irritable bowel syndrome. / Hoveyda, Nourieh; Heneghan, Carl; Mahtani, Kamal R.; Perera, Rafael; Roberts, Nia; Glasziou, Paul.

In: BMC Gastroenterology, Vol. 9, 15, 16.02.2009.

Research output: Contribution to journalReview articleResearchpeer-review

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