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Probiotics Significantly Reduce Symptoms of IBS,
Ulcerative Colitis
Medscape Medical News 2003. 2003 Medscape
Martha Kerr
May 21, 2003 (Orlando) — Probiotic therapy, primarily in the form of
Lactobacillus acidophilus and Bifidobacteria infantis, significantly
improves symptoms and quality of life in patients with irritable bowel
syndrome (IBS) and other bowel disorders, researchers reported in a
number of presentations here at Digestive Disease Week 2003.
In a study designed to assess the efficacy of probiotics alone or in
combination with antibiotics in patients with IBS, Stephen M. Faber,
MD, from Albemarle Gastroenterology Associates, PC, in Elizabeth
City, North Carolina, evaluated treatment in 44 patients with IBS.
Twenty patients received probiotics alone and 24 received ciprofloxacin
500 mg twice daily for one week and two probiotic formulations,
Lactobacillus (NCFM) 10 billion/g and Bifidobacteia infantis (Bifdo), 10
billion/g for four weeks.
Patients completed the IBS-Quality of Life (IBS-QOL) questionnaire
and the Symptom Frequency Index (SFI) before and after treatment.
For the study group as a whole, IBS-QOL scores averaged 66.2 before
treatment and 84.6 after treatment. SFI scores before treatment
averaged 38, decreasing to 18 after treatment.
In patients who received both probiotics and antibiotics, IBS-QOL
scores averaged 67.6 before and 87.8 after treatments. SFI scores
averaged 35 at baseline, decreasing to 18 after treatment.
In the probiotic-only group, baseline IBS-QOL scores were 69.3,
increasing to 86.4 after treatment. SFI scores were 39 at baseline and 17
after treatment.

Differences in IBS-QOL and SFI scores between probiotic plus
antibiotic treatment and probiotic-only treatment were statistically
insignificant, Dr. Faber reported.
A retrospective look at IBS patients treated with probiotics indicates
that there is a deficiency of Lactobacillus in the gut flora in patients
with IBS, Dr. Faber noted, "but we're not ready to call IBS an
infectious disease."
Probiotic therapy also improved symptoms of ulcerative colitis (UC) in
a separate study presented by Richard N. Fedorak, MD, professor of
medicine and director of the division of gastroenterology at the
University of Alberta in Edmonton, Canada.
In a safety and efficacy study of the probiotic formulation VSL3 (VSL
Pharmaceuticals, Inc., Ft. Lauderdale, FL), which contains eight lactic
acid bacterial species, Dr. Fedorak and colleagues evaluated 30 patients
with active mild-to-moderate UC with recent flares. Patients continued
with previous treatment that included mesalamine, corticosteroids,
and/or azathiaprine, as long as the treatment regimen was stable prior
to the study.
Patients took two VSL3 sachets twice a day for six weeks. Ulcerative
Colitis Clinical Scores were measured and sigmoidoscopy performed at
baseline and after the six-week treatment period.
Dr. Fedorak reported that remission occurred in 63% (19 patients) and
there was a clinical response in an additional 23% (seven patients).
There was no response in 13% (four patients). Worsening of symptoms
occurred in one patient.
Dr. Fedorak said that probiotic therapy was not associated with any
adverse clinical or biochemical events.
"I haven't heard of getting into trouble with probiotics," Dr. Faber told
Medscape. "These are organisms that are supposed to be in the gut. The
body knows how to control them, so it doesn't seem that you can
overtreat."

While probiotics have been recognized as beneficial components of food,
Dr. Fedorak pointed out that "we don't use it as a food product
anymore but as a treatment.
"Infantile diarrhea can be shortened by about a day from the usual
three- to four-day course. That is very important in infants. Probiotics
are effective with rotavirus symptoms, with antibiotic-induced diarrhea,
in pseudomembranous colitis, and perhaps in radiation-induced
diarrhea," he said.
But Dr. Fedorak cautioned that "we don't know how they work. They
appear to strengthen the mucosal barrier of the bowel and improve
immune function. And we don't know which probiotics to use or in what
combination."
DDW 2003: Abstract M1582, presented May 19, 20003; Abstract
W1523, presented May 21, 2003.
Reviewed by Gary D. Vogin, MD

Source: http://www.kimiara.com/download/probiotics%20reduce%20IBS.pdf

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