A Randomized Clinical Trial of Synbiotics in Irritable Bowel Syndrome: Dose-Dependent Effects on Gastrointestinal Symptoms and Fatigue
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Background: This double-blind, randomized controlled design study aimed to assess the dose-dependent effects of synbiotics on gastrointestinal symptoms of and fatigue in irritable bowel syndrome (IBS). Methods: Thirty subjects with IBS were randomly assigned into the following three groups and received 2 capsules a day for 8 weeks: (1) high-dose (2 capsules of synbiotics); (2) low-dose (1 capsule of synbiotics and 1 capsule of placebo); and (3) placebo (2 capsules of placebo). At baseline and 8 weeks, they completed the study questionnaires. Results: Two subjects in the high-dose group were lost to follow-up, leaving a total of 28 patients for the analysis. After 8 weeks, abdominal discomfort, abdominal bloating, frequency of formed stool, fatigue Visual Analog Scale (VAS), and Multidimensional Fatigue Inventory were significantly different among the groups (P=0.002, 0.006, 0.007, 0.028, and 0.041, respectively, by Kruskal-Wallis test). However, only abdominal discomfort, abdominal bloating, frequency of formed stool, and fatigue VAS were significantly improved in the high-dose group compared with those in the placebo group (P=0.002, 0.003, 0.002, and 0.013, respectively) by Mann-Whitney test with Bonferroni correction. No adverse drug reactions were reported. Conclusion: High-dose synbiotics were superior to placebo in improving bowel symptoms and fatigue of IBS patients, suggesting that synbiotic dosage plays an important role in the treatment of IBS.
Abstract
Background: This double-blind, randomized controlled design study aimed to assess the dose-dependent effects of synbiotics on gastrointestinal symptoms of and fatigue in irritable bowel syndrome (IBS). Methods: Thirty subjects with IBS were randomly assigned into the following three groups and received 2 capsules a day for 8 weeks: (1) high-dose (2 capsules of synbiotics); (2) low-dose (1 capsule of synbiotics and 1 capsule of placebo); and (3) placebo (2 capsules of placebo). At baseline and 8 weeks, they completed the study questionnaires. Results: Two subjects in the high-dose group were lost to follow-up, leaving a total of 28 patients for the analysis. After 8 weeks, abdominal discomfort, abdominal bloating, frequency of formed stool, fatigue Visual Analog Scale (VAS), and Multidimensional Fatigue Inventory were significantly different among the groups (P=0.002, 0.006, 0.007, 0.028, and 0.041, respectively, by Kruskal-Wallis test). However, only abdominal discomfort, abdominal bloating, frequency of formed stool, and fatigue VAS were significantly improved in the high-dose group compared with those in the placebo group (P=0.002, 0.003, 0.002, and 0.013, respectively) by Mann-Whitney test with Bonferroni correction. No adverse drug reactions were reported. Conclusion: High-dose synbiotics were superior to placebo in improving bowel symptoms and fatigue of IBS patients, suggesting that synbiotic dosage plays an important role in the treatment of IBS.
참고문헌 (30)
- Longstreth GF, "Functional bowel disorders", Gastroenterology, 130, pp.1480~1491 (2006)
- Han SH, "Prevalence of irritable bowel syndrome in Korea : population-based survey using the Rome II criteria", J Gastroenterol Hepatol, 21, pp.1687~1692 (2006)
- Spiegel BM, "Burden of illness in irritable bowel syndrome : looking beyond the patient", Clin Gastroenterol Hepatol, 11, pp.156~157 (2013)
- Parkes GC, "Gastrointestinal microbiota in irritable bowel syndrome : their role in its pathogenesis and treatment", Am J Gastroenterol, 103, pp.1557~1567 (2008)
- Uday C Ghoshal, "Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy", Gut and Liver, 11(2), pp.196~208 (2017), 거트앤리버 소화기연관학회협의회
- Brenner DM, "The utility of probiotics in the treatment of irritable bowel syndrome : a systematic review", Am J Gastroenterol, 104, pp.1033~1049 (2009)
- McFarland LV, "Meta-analysis of probiotics for the treatment of irritable bowel syndrome", World J Gastroenterol, 14, pp.2650~2661 (2008)
- Kim HJ, "A randomized controlled trial of a probiotic, VSL#3, on gut transit and symptoms in diarrhoea-predominant irritable bowel syndrome", Aliment Pharmacol Ther, 17, pp.895~904 (2003)
- Zeng J, "Clinical trial : effect of active lactic acid bacteria on mucosal barrier function in patients with diarrhoea-predominant irritable bowel syndrome", Aliment Pharmacol Ther, 28, pp.994~1002 (2008)
- Michail S, "Gut microbiota is not modified by randomized, double-blind, placebo-controlled trial of VSL#3 in diarrhea-predominant irritable bowel syndrome", Probiotics Antimicrob Proteins, 3, pp.1~7 (2011)
- Riegler G, "Bristol scale stool form: a still valid help in medical practice and clinical research", Tech Coloproctol, 5, pp.163~164 (2001)
- Krupp LB, "The fatigue severity scale : application to patients with multiple sclerosis and systemic lupus erythematosus", Arch Neurol, 46, pp.1121~1123 (1989)
- Smets EM, "The Multidimensional Fatigue Inventory(MFI)psychometric qualities of an instrument to assess fatigue", J Psychosom Res, 39, pp.315~325 (1995)
- Tsuchiya J, "Singleblind follow-up study on the effectiveness of a symbiotic preparation in irritable bowel syndrome", Chin J Dig Dis, 5, pp.169~174 (2004)
- Min YW, "Effect of composite yogurt enriched with acacia fiber and Bifidobacterium lactis", World J Gastroenterol, 18, pp.4563~4569 (2012)
- Mayer EA, "Gut feelings : the emerging biology of gut-brain communication", Nat Rev Neurosci, 12, pp.453~466 (2011)
- Singh PK, "Role of Lactobacillus acidophilus loaded floating beads in chronic fatigue syndrome: behavioral and biochemical evidences", Neurogastroenterol Motil, 24, pp.366-e170~ (2012)
- Forsythe P, "Immunomodulation by commensal and probiotic bacteria", Immunol Invest, 39, pp.429~448 (2010)
- Zhuang X, "Alterations of gut microbiota in patients with irritable bowel syndrome : a systematic review and meta-analysis", J Gastroenterol Hepatol, 32, pp.28~38 (2017)
- Guarner F, "Gut flora in health and disease", Lancet, 361, pp.512~519 (2003)
- Grimoud J, "In vitro screening of probiotics and synbiotics according to antiinflammatory and anti-proliferative effects", Int J Food Microbiol, 144, pp.42~50 (2010)
- De Giorgio R, "Is irritable bowel syndrome an inflammatory disorder", Curr Gastroenterol Rep, 10, pp.385~390 (2008)
- Muzes G, "Changes of the cytokine profile in inflammatory bowel diseases", World J Gastroenterol, 18, pp.5848~5861 (2012)
- Giovanni Barbara, "The Immune System in Irritable Bowel Syndrome", Journal of Neurogastroenterology and Motility (JNM), 17(4), pp.349~359 (2011), 대한소화기 기능성질환∙운동학회
- Benton D, "Impact of consuming a milk drink containing a probiotic on mood and cognition", Eur J Clin Nutr, 61, pp.355~361 (2007)
- Rogha M, "The efficacy of a synbiotic containing Bacillus Coagulans in treatment of irritable bowel syndrome : a randomized placebo-controlled trial", Gastroenterol Hepatol Bed Bench, 7, pp.156~163 (2014)
- Abbas Z, "Cytokine and clinical response to Saccharomyces boulardii therapy in diarrhea-dominant irritable bowel syndrome : a randomized trial", Eur J Gastroenterol Hepatol, 26, pp.630~639 (2014)
- Ford AC, "Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation : systematic review and meta-analysis", Am J Gastroenterol, 109, pp.1547~1561 (2014)
- Elli M, "Survival of yogurt bacteria in the human gut", Appl Environ Microbiol, 72, pp.5113~5117 (2006)
- Elli M, "Evaluation of prebiotic potential of refined psyllium (Plantago ovata) fiber in healthy women", J Clin Gastroenterol, 42(Suppl 3 Pt 2), pp.S174~S176 (2008)