Medically reviewed by Onikepe Adegbola, MD, PhD
Lactobacillus is the primary probiotic used to treat irritable bowel syndrome (IBS). However, a new study found another type of good bacterium, B. coagulans, which may be more effective.
Treatments for IBS are limited. Among them, probiotics have been a useful option to reduce symptoms and bring patients relief.
However, there is a shortage of comparisons between the different probiotics used for IBS. As a result, the need for a comprehensive comparison occurred a long time back.
Now, a new study has been published to fill in the knowledge gap – “Efficacy of Probiotics for Irritable Bowel Syndrome: A Systematic Review and Network Meta-Analysis,” published in the PubMed Central Journal.
In this study, researchers compared 43 randomized controlled trials (RCT) with over five thousand patients. RCTs are performed as a scientific experiment to establish control on factors that researchers cannot control directly.
Additionally, the researchers eliminated some trials as they did not meet the eligibility criteria.
What did the researchers find in their comprehensive analysis of studies?
Scientists have analyzed the results of these studies based on the different symptoms of IBS. They found that B. coagulans was the most effective in reducing the overall symptoms of IBS.
Additionally, L. plantarum and L. acidophilus were second and third in ranking to relieve overall IBS symptoms.
Next, the researchers assessed the effects of different probiotics on the IBS global symptom scores. It is a method to establish the severity of a disease using a scale of, say, one to seven.
Here too, B. coagulans stood out from the rest of the probiotics in terms of effectiveness in reducing symptoms. Additionally, patients who received the probiotics C. butyricum and Bifidobacterium longum also experienced the best outcomes.
Moreover, the researchers analyzed the best probiotics to relieve abdominal pain in IBS. Unsurprisingly, patients who received B. coagulans and S. cerevisiae got the most relief.
Additionally, the researchers evaluated the suitable duration of treatments with the said probiotics for optimum outcomes. They found patients who fared the best received B. coagulans for 8 to 13 weeks and S. cerevisiae for 10 weeks.
Next, the researchers attempted to find the best probiotics to reduce abdominal bloating. According to their analyses, B. coagulans came first to relieve bloating. B. infantis, L. acidophilus, and L. plantarum followed.
Coagulans also ranked first for other IBS symptoms. Therefore, the Lactobacillus species may not be the best probiotics to relieve IBS symptoms, as scientists thought earlier.
Scientists then wanted to investigate the effectiveness of B. coagulans with different IBS treatment options. Generally, patients receive a mix of probiotics that work to improve the biodiversity of gut bacteria.
The researchers saw that B. coagulans stood out from the rest of the probiotic combinations to treat IBS and its symptoms. Additionally, the combination of Bifidobacterium (one strain), Lactobacillus (two strains), and Streptococcus (one strain) came second in the IBS treatment.
Moreover, the researchers wanted to identify the best strains of B. coagulans to treat IBS. They found B. coagulans Unique IS2 as the best strain to relieve the overall symptoms of IBS.
Additionally, the strain B. coagulans MTCC5856 ranked on top in relieving abdominal pain and bloating. B.coagulans Unique IS2 ranked second.
Different health organizations around the world have recommended probiotics for IBS treatment. The list includes the British Society of Gastroenterology, the Japanese Society of Gastroenterology, and the Canadian Association of Gastroenterology.
However, some organizations like the American College of Gastroenterology don’t recommend probiotics for IBS.
Additionally, the study authors think the guidelines of the organizations that recommend probiotics are controversial. There is disparity among the guidelines, which makes treatment challenging.
The new findings may bring a standard approach to using probiotics for IBS treatment.
Moreover, the study makes a much-needed comparison of the different probiotics. The findings throw light on new bacteria that we might not have prioritized before. Thus, we may be able to use probiotics with greater effectiveness for patients with IBS.
Additionally, the findings can act as the foundation to create a standard guideline for using probiotics for IBS globally. They can bring an end to the controversy and allow patients with IBS to lead better and healthier lives.
Zhang, T., Zhang, C., Zhang, J., Sun, F., & Duan, L. (2022). Efficacy of Probiotics for Irritable Bowel Syndrome: A Systematic Review and Network Meta-Analysis. Frontiers in Cellular and Infection Microbiology, 12.