Efficacy and Safety of Probiotics in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

BackgroundIrritable bowel syndrome is a functional gastrointestinal disease. Evidence has suggested that probiotics may benefit IBS symptoms. However, clinical trials remain conflicting.AimsTo implement a systematic review and meta-analysis of clinical trials regarding the efficacy and safety of pro...

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Main Authors: Bing Li, Li Liang, Huijie Deng, Jinmin Guo, He Shu, Li Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-04-01
Series:Frontiers in Pharmacology
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fphar.2020.00332/full
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author Bing Li
Li Liang
Huijie Deng
Jinmin Guo
He Shu
Li Zhang
author_facet Bing Li
Li Liang
Huijie Deng
Jinmin Guo
He Shu
Li Zhang
author_sort Bing Li
collection DOAJ
description BackgroundIrritable bowel syndrome is a functional gastrointestinal disease. Evidence has suggested that probiotics may benefit IBS symptoms. However, clinical trials remain conflicting.AimsTo implement a systematic review and meta-analysis of clinical trials regarding the efficacy and safety of probiotics for IBS patients.MethodsWe searched for relevant trials in Medline(1966 to Jan 2019), Embase(1974 to Jan 2019), the Cochrane Central Register of Controlled Trials(up to Jan 2019), the ClinicalTrials.gov trials register(up to Jan 2019), and Chinese Biomedical Literature Database(1978 to Jan 2019). Risk ratio (RR) and a 95% confidence interval (CI) were calculated for dichotomous outcomes. Standardized mean difference (SMD) and 95% CI were calculated for continuous outcomes.ResultsA total of 59 studies, including 6,761 patients, were obtained. The RR of the improvement or response with probiotics versus placebo was 1.52 (95% CI 1.32–1.76), with significant heterogeneity (I2 = 71%, P < 0.001). The SMD of Probiotics in improving global IBS symptoms vs. Placebo was -1.8(95% CI -0.30 to -0.06), with significant heterogeneity (I2 = 65%, P < 0.001). It was impossible to draw a determinate conclusion. However, there were differences in subgroup analyses of probiotics type, dose, treatment duration, and geographic position. Probiotics seem to be safe by the analysis of adverse events(RR = 1.07; 95% CI 0.92–1.24; I2 = 0, P = 0.83).ConclusionProbiotics are effective and safe for IBS patients. Single probiotics with a higher dose (daily dose of probiotics ≥1010) and shorter duration (< 8 weeks) seem to be a better choice, but it still needs more trials to prove it.
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spelling doaj.art-d5193ada8fe44399a667601e805194942022-12-22T01:43:20ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122020-04-011110.3389/fphar.2020.00332510369Efficacy and Safety of Probiotics in Irritable Bowel Syndrome: A Systematic Review and Meta-AnalysisBing LiLi LiangHuijie DengJinmin GuoHe ShuLi ZhangBackgroundIrritable bowel syndrome is a functional gastrointestinal disease. Evidence has suggested that probiotics may benefit IBS symptoms. However, clinical trials remain conflicting.AimsTo implement a systematic review and meta-analysis of clinical trials regarding the efficacy and safety of probiotics for IBS patients.MethodsWe searched for relevant trials in Medline(1966 to Jan 2019), Embase(1974 to Jan 2019), the Cochrane Central Register of Controlled Trials(up to Jan 2019), the ClinicalTrials.gov trials register(up to Jan 2019), and Chinese Biomedical Literature Database(1978 to Jan 2019). Risk ratio (RR) and a 95% confidence interval (CI) were calculated for dichotomous outcomes. Standardized mean difference (SMD) and 95% CI were calculated for continuous outcomes.ResultsA total of 59 studies, including 6,761 patients, were obtained. The RR of the improvement or response with probiotics versus placebo was 1.52 (95% CI 1.32–1.76), with significant heterogeneity (I2 = 71%, P < 0.001). The SMD of Probiotics in improving global IBS symptoms vs. Placebo was -1.8(95% CI -0.30 to -0.06), with significant heterogeneity (I2 = 65%, P < 0.001). It was impossible to draw a determinate conclusion. However, there were differences in subgroup analyses of probiotics type, dose, treatment duration, and geographic position. Probiotics seem to be safe by the analysis of adverse events(RR = 1.07; 95% CI 0.92–1.24; I2 = 0, P = 0.83).ConclusionProbiotics are effective and safe for IBS patients. Single probiotics with a higher dose (daily dose of probiotics ≥1010) and shorter duration (< 8 weeks) seem to be a better choice, but it still needs more trials to prove it.https://www.frontiersin.org/article/10.3389/fphar.2020.00332/fullefficacysafetyirratable bowel syndromeprobioticsmeta-analysis
spellingShingle Bing Li
Li Liang
Huijie Deng
Jinmin Guo
He Shu
Li Zhang
Efficacy and Safety of Probiotics in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis
Frontiers in Pharmacology
efficacy
safety
irratable bowel syndrome
probiotics
meta-analysis
title Efficacy and Safety of Probiotics in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis
title_full Efficacy and Safety of Probiotics in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis
title_fullStr Efficacy and Safety of Probiotics in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis
title_full_unstemmed Efficacy and Safety of Probiotics in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis
title_short Efficacy and Safety of Probiotics in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis
title_sort efficacy and safety of probiotics in irritable bowel syndrome a systematic review and meta analysis
topic efficacy
safety
irratable bowel syndrome
probiotics
meta-analysis
url https://www.frontiersin.org/article/10.3389/fphar.2020.00332/full
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