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Meta-Analysis Provides Roadmap for More Studies of Probiotics to Treat IBS
Meta-Analysis Provides Roadmap for More Studies of Probiotics to Treat IBS
By Denise B. Hensley
A recently published meta-analysis of 82 trials, containing data from more than 10,000 patients, shows probiotics use is beneficial for irritable bowel syndrome (IBS). Studies continue to evolve, and more head-to-head research of specific probiotics is needed in the future.
“If you take all the probiotic evidence that’s out there, you will find that probiotics are effective as a group,” said Eamonn Quigley, MD, David M. Underwood Chair of Medicine in Digestive Disorders, Co-Director Lynda K. and David M. Underwood Center for Digestive Disorders
Chief, Chief of Gastroenterology and Hepatology.
The study showed evidence of benefit for Escherichia strains, low certainty for Lactobacillusstrains and L. plantarum 299V, and very low certainty for combination probiotics, LacClean Gold S, Duolac 7s, and Bacillus strains.
“The number of trials has increased, and the size of individual trials has increased. So, the quality of studies has gotten better and what has evolved essentially is that we’ve moved from general statements to slightly more specific ones and now to even more specific ones.”
“Making specific recommendations concerning which probiotics, or combinations of probiotics, are beneficial according to IBS subtype or individual symptom remains difficult to resolve,” he added.
Eamonn Quigley, MD
The study showed evidence of benefit for Escherichia strains, low certainty for Lactobacillusstrains and L. plantarum 299V, and very low certainty for combination probiotics, LacClean Gold S, Duolac 7s, and Bacillus strains. “Efficacy of Probiotics in Irritable Bowel Syndrome: Systematic Review and Meta-Analysis” was published last summer in Gastroenterology.
“What we have here, with this meta-analysis, is a roadmap for future studies,” Quigley noted. “There’s a whole range of quality (in probiotics). Does the product contain what it says it does? Are they alive; are they dead? All those factors are very important.”
Contact with original investigators allowed investigators to pool dichotomous data from more studies than previously, leading to more meaningful conclusions.
“We’re still not there in terms of being able to give people very concrete advice. The evidence for the role of the microbiome in IBS continues to accumulate and, of course, there are multiple ways you can manipulate the microbiome, and probiotics are one of those but there are others.
“That’s the power of meta-analysis,” Quigley said. “You’re going from studies that may only have 100 patients to more than 10,000 patients, so that gives it a lot of power.”