TOPLINE:

A probiotic combination of Lactobacillus acidophilus LA-5 and Bifidobacterium animalis ssp. lactis BB-12 leads to greater symptom improvement than placebo in patients with nonconstipated irritable bowel syndrome (IBS), with benefits apparent as early as day 28.

METHODOLOGY:

• IBS pathogenesis involves gut microbiota dysbiosis, and because current treatments often fall short, several microbiota-targeted approaches are under investigation.
• Between November 2020 and November 2022, researchers at multiple centers across India enrolled adult patients (aged 18-65 years) with nonconstipated IBS, who were randomly assigned to receive a two-strain probiotic (LA-5 and BB-12) or placebo twice daily for 84 days alongside standard care.
• The primary efficacy endpoint was the proportion of participants with moderate or substantial symptom improvement on the IBS Global Improvement Scale.
• Fecal microbiota changes with probiotic treatment were analyzed in a subset of 80 participants.

TAKEAWAY:

• Of 200 patients enrolled (65% male; 101 receiving probiotics and 99 receiving placebo), 173 completed treatment until day 84.
• A significantly higher proportion of patients receiving probiotics showed improvement on the IBS Global Improvement Scale by day 28 than those receiving placebo (19.4% vs 8.9%; P = .048); in the probiotic group, the percentage of patients reporting severe symptoms decreased from 20.8% at baseline to 3.9% at day 84.
• By day 28, probiotic-treated patients experienced significantly greater improvements in abdominal pain duration, abdominal distension, and quality-of-life scores from baseline.
• Rates of mild or moderate adverse events did not significantly differ between groups (P = .167).
• Although overall fecal microbiota profiles were similar between groups, beneficial bacterial genera were more abundant in the probiotic group.

IN PRACTICE:

“The results of this study represent the first evidence for the efficacy and safety of Lactobacillus acidophilus LA-5 and Bifidobacterium animalis ssp. lactis BB-12 as a probiotic blend in the treatment of nonconstipated IBS in adults,” the authors of the study wrote.

SOURCE:

The study was led by Uday C. Ghoshal, Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. It was published online in the Journal of Gastroenterology and Hepatology.

LIMITATIONS:

The study had a relatively short 84-day intervention duration, relied on self-reported symptom scores, and had limited analysis of associations between microbiota alteration and symptom improvement. Microbiota analysis was conducted in only a subset of patients from one center due to pandemic-related restrictions, potentially affecting representativeness.

DISCLOSURES:

The study was funded by Zydus Healthcare Limited and Shanti Public Educational and Development Society, India. One author disclosed holding patents and patent applications and receiving a research grant from a bioscience company via their institution.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.