Probiotics for IBS: A Systematic Review and Network Meta-Analysis
Ford AC, Harris LA, Lacy BE, Quigley EMM, Moayyedi P
The Lancet Gastroenterology & Hepatology • October 2018
Plain Language Summary
This large analysis of 53 studies confirmed that probiotics are effective for treating irritable bowel syndrome (IBS). Multi-strain probiotics containing Lactobacillus and Bifidobacterium bacteria worked best. About 1 in 7 people with IBS who take probiotics will see significant improvement that wouldn’t have occurred with placebo. Both diarrhea-predominant and constipation-predominant IBS responded to treatment.
Key Findings
- 1Probiotics significantly reduced global IBS symptoms (RR 0.79, 95% CI 0.70-0.89)
- 2Combination probiotics more effective than single strains
- 3Lactobacillus and Bifidobacterium species showed most benefit
- 4Benefits seen for both IBS-D (diarrhea) and IBS-C (constipation)
- 5NNT (number needed to treat) was 7 for global symptom improvement
Abstract
This comprehensive network meta-analysis evaluated the efficacy of different treatments for irritable bowel syndrome (IBS), including probiotics. The analysis included 53 randomized controlled trials of probiotics with 11,500+ participants.
Study Limitations
- High heterogeneity in probiotic strains and doses
- Some studies had high risk of bias
- Long-term effects not well studied
- Optimal strains not definitively identified