Irritable bowel syndrome symptom severity improves equally with probiotic and placebo.
AIM
To determine the effects of Lactobacillus acidophilus NCFM on irritable bowel syndrome (IBS) symptoms and quality of life (QoL).


METHODS
In this randomized triple-blind trial, adult IBS volunteers who were recruited according to Rome III criteria received 109 or 1010 colony-forming units of NCFM or placebo daily for 12 wk. IBS Symptom Severity Score (IBS-SSS), which constituted the primary outcome, and secondary outcomes, including individual IBS symptoms, IBS-related QoL questionnaire, anxiety and depression, defecation frequency, and stool consistency, were assessed at baseline at the end of the 8-wk run-in period, after 4 and 12 wk of intervention, and after a 4-wk washout.


RESULTS
A total of 340 of 391 randomized volunteers completed the trial. IBS-SSS improved over 12 wk of treatment in all treatment groups, decreasing by a mean ± SD of 44.0 ± 80.2, 50.8 ± 82.4, and 48.3 ± 72.2 in the placebo, active low-dose, and active high-dose groups, respectively. Similarly, secondary outcomes did not differ between treatment groups. However, in a post hoc analysis of volunteers with moderate to severe abdominal pain at baseline (VAS > 35/100), the treatment significantly reduced the sensation of abdominal pain. Pain scores fell by 20.8 ± 22.8, 29.4 ± 17.9, and 31.2 ± 21.9 in the placebo, active low-dose, and active high-dose groups, respectively (P value for placebo vs combined active doses = 0.0460).


CONCLUSION
NCFM alleviates moderate to severe abdominal pain, consistent with earlier observations of this strain mitigating visceral pain through increased analgesic receptor expression.
['Lyra|Anna|A|', 'Hillilä|Markku|M|', 'Huttunen|Teppo|T|', 'Männikkö|Sofia|S|', 'Taalikka|Mikko|M|', 'Tennilä|Julia|J|', 'Tarpila|Anneli|A|', 'Lahtinen|Sampo|S|', 'Ouwehand|Arthur C|AC|', 'Veijola|Lea|L|']
D015746:Abdominal Pain D000328:Adult D003106:Colon D004305:Dose-Response Relationship, Drug D005260:Female D006801:Humans D007413:Intestinal Mucosa D043183:Irritable Bowel Syndrome D007779:Lactobacillus acidophilus D008297:Male D008875:Middle Aged D010147:Pain Measurement D019936:Probiotics D011957:Receptors, Opioid D012720:Severity of Illness Index D011795:Surveys and Questionnaires D016896:Treatment Outcome D059265:Visceral Pain
Irritable bowel syndrome Probiotic Lactobacillus acidophilus Quality of life Intervention Abdominal pain Visceral pain Functional bowel disorder Symptom questionnaire