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Probiotics to treat Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) is a gastrointestinal disorder, not associated to structural or biochemical alteration, chronic, with abdominal pain, recurrent uneasiness, altered intestinal motility, with diarrhea, constipation and bloating as recurrent symptoms.

IBS cases diarrhea if the intestinal motility is increased, causing a lower water absorption from the gut; meanwhile it causes constipation if the intestinal motility is decreased, causing a higher water absorption from the gut. All the IBS forms are characterized by alteration in the gut microbiota, with lower abundance of beneficial commensal species and increased abundance of pathogenic species, which further contribute to diarrhea and constipation. Also bloating and pain can be linked to the altered gut microbiota.

Probiotics supplementation can be an adjuvant in the treatment of IBS: here are reported the evidences found in literature about the use of probiotics in the treatment of IBS.

Bifidobacterium longum subsp. longum BB536

B. longum subsp. longum BB536 is able to normalize the bowel movements in subjects with diarrhea or constipation, the most common IBS symptoms. Kondo and colleagues (2016) recruited 206 elderlies and, as shown in the figure, during the 16 weeks of probiotics consumption, the intestinal movements increases in those affected by constipation and significantly decreases in those affected by diarrhea.

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Lactobacillus acidophilus NCFM

L. acidophilus NCFM was tested by Sandrin and colleagues (2020) on 80 people affected by IBS to evaluate the ability to manage the most common symptoms: blowing, flatus, rumbling and abdominal pain. As shown in the figure, even if there is a placebo effect, all the considered symptoms significantly decrease compared to placebo.

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The most interesting aspect is related to the possibility of reducing the abdominal pain and further studies demonstrated that L. acidophilus NCFM is able to increase the expression of µ-opioid and cannabinoid receptors on intestinal cells, with an effect comparable to pain-killers (Rousseaux et al., 2007).

Lactobacillus rhamnosus HN001

L. rhamnosus HN001 was tested for its ability to colonize and remain in the gut of the people who received it. As shown in the figure from the research of Toscano et al. (2017), the fecal levels of lactobacilli increase in 5 out of 8 subject and, interestingly, these levels remain high even after one month from the last intake, demonstrating the ability to colonize the gut and exert the probiotic functions. 

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In conclusion, probiotics administration as an adjuvant in the treatment of IBS is supported by many researches and faces the disease from different point of view.

References

Kondo, J., Xiao, J. Z., Shirahata, A., Baba, M., Abe, A., Ogawa, K., & Shimoda, T. (2013). Modulatory effects of Bifidobacterium longum BB536 on defecation in elderly patients receiving enteral feeding. World Journal of Gastroenterology: WJG, 19(14), 2162.

Rousseaux, C., Thuru, X., Gelot, A., Barnich, N., Neut, C., Dubuquoy, L., … & Desreumaux, P. (2007). Lactobacillus acidophilus modulates intestinal pain and induces opioid and cannabinoid receptors. Nature medicine, 13(1), 35-37.

Sadrin, S., Sennoune, S., Gout, B., Marque, S., Moreau, J., Zinoune, K., … & Maixent, J. M. (2020). A 2-strain mixture of Lactobacillus acidophilus in the treatment of irritable bowel syndrome: A placebo-controlled randomized clinical trial. Digestive and Liver Disease, 52(5), 534-540.

Toscano, M., De Grandi, R., Stronati, L., De Vecchi, E., & Drago, L. (2017). Effect of Lactobacillus rhamnosus HN001 and Bifidobacterium longum BB536 on the healthy gut microbiota composition at phyla and species level: A preliminary study. World journal of gastroenterology, 23(15), 2696.

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