A study from the University of College Cork, Cork, Ireland, aimed to compare the response of symptoms and cytokine ratios in IBS with ingestion of probiotic preparations containing either Lactobacillus salivarius UCC4331 or B. infantis 35624.30 For eight weeks, 77 subjects with IBS drank a malted drink with a dose of 1 X 1010 live bacterial culture cells or a placebo drink. For all IBS symptoms, with the exception of bowel movement frequency and consistency, those randomized to B. infantis 35624 experienced a greater reduction in symptom scores, composite and individual scores with abdominal pain/discomfort, bloating, and bowel movement difficulty were lower than for placebo. A study from the University of Manchester, England, also focused on B. infantis 35624 as a nutrient to relieve certain IBS symptoms in women at a dosage level of 1 X 108 colony forming units (cfu) and delivered in a capsule.31 The researchers concluded that the specific probiotic dosage delivered in a capsule could relieve many IBS symptoms.
Stress plays an important role in the initiation and exacerbation of bowel and discomfort symptoms contributing to IBS. A study out of the University of Washington showed a link and correlation between stress and IBS symptoms in women.32 The researchers found psychological distress moderated the effect of stress on GI symptoms, suggesting treatment protocols that incorporate strategies to decrease stress and psychological distress are likely to reduce GI symptoms.
A double blind, placebo-controlled, randomized study investigated the effects of a probiotic preparation (Probio-Stick®, from Institut Rosell Lallemand SAS) containing Lactobacillus acidophilus Rosell-52 and Bifidobacterium longum Rosell-175 on stress-induced symptoms in volunteers.33 After three weeks, the consumption of probiotics significantly reduced two stress-induced gastrointestinal symptoms (abdominal pain and nausea/vomiting) but did not significantly modify other physical and psychological symptoms and sleep problems associated with stress. The researchers concluded Probio-Stick could provide a beneficial effect on GI symptoms by individuals affected by chronic stress.
Chronic psychological stress, including water avoidance stress (WAS), induces intestinal mucosal barrier dysfunction and impairs mucosal defenses against luminal bacteria. Lactobacillus helveticus and L. rhamnosus in drinking water was given to rats before they were exposed to WAS or sham stress for 10 days.34 The findings from the study indicated probiotics could prevent chronic stress-induced intestinal abnormalities and thereby exert beneficial effects in the intestinal tract.
Multi-species probiotics are also being considered for easing IBS symptoms. A study from the University of Helsinki, Finland investigated the effects of multi-species probiotic supplementation (L. rhamnosus GG, L. rhamnosus Lc705, Propionibacteriumfreudenreichii ssp.Shermanii JS and Bifidobacterium animaliss ssp. Lactis Bb12) on abdominal symptoms, quality of life, intestinal microbiota and inflammatory markers in IBS.35 For five months, 86 IBS patients (Rome II criteria) were randomized to receive either the multi-species probiotic or placebo daily; the results indicated the IBS score decreased 14 points from baseline with the probiotic vs. three points from the placebo.
“Probiotics can provide substantial protection against traveler’s diarrhea, most often related to ingestion of pathogens to which our bodies are unaccustomed,” wrote S.K. Dash, Ph.D., in “A Consumer’s Guide to Probiotics.” In a study published in his book, DDS® probiotics from UAS Laboratories were given to subjects one week before the travel, which markedly reduced incidence of traveler’s diarrhea (TD), with only three of eight individuals coming down with TD.36
Another set of researchers looked at the effect of different probiotic formulations on the travelers’ diarrhea model in rats: five groups of six rats were given either a placebo saline, a suspension of probiotics (Lactobacillus-Rosell 11, Lactobacillus-Rosell 52 and Bifodobacterium-Rosell 175), a yeast probiotic (Saccharomyces boulardii), or a combination of both (Protecflor®, from Institut Rosell-Lallemand).37 All the probiotic groups had improvements in symptoms; but, the combination product appeared to be most efficient.
Several studies have suggested certain probiotics such as L. acidophilus do not prevent TD.38 A meta-analysis from the Veterans Affairs Puget Sound Health Care System looked into the controversy and attempted to compare the efficacy of probiotics for the prevention of TD in published randomized, controlled clinical trials.39 Twelve of the 940 studies (from 1977 to 2005) met the criteria; from these, researchers concluded several probiotics, including Saccaromyces boulardii and a mixture of L. acidophilus and Bifidobacterium bifidum, had significant efficacy.
AAD also plagues adults and is a common complication of antibiotics and Clostridium difficile disease (CDD). The use of probiotics for the prevention of AAD and the treatment of CDD was evaluated in a meta-analysis.40 Of the 180 screened studies, 31 fit the criteria and demonstrated that a variety of probiotics (Saccaromyces boulardii, L. rhamnosus GG and probiotic mixtures) can significantly reduce the risk of AAD and posses significant efficacy for CDD.
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