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Clinical and Microbiological Effect of a Multispecies Probiotic Supplementation in Celiac Patients With Persistent IBS-type Symptoms: A Randomized, Double-Blind, Placebo-controlled, Multicenter Trial.
- Source :
-
Journal of clinical gastroenterology [J Clin Gastroenterol] 2019 Mar; Vol. 53 (3), pp. e117-e125. - Publication Year :
- 2019
-
Abstract
- Goals: The goals of this study were to evaluate the efficacy and safety of a probiotic mixture in patients with celiac disease (CD) with irritable bowel syndrome (IBS)-type symptoms despite a strict gluten-free diet (GFD).<br />Background: About 30% of patients with CD adherent to a GFD suffer from IBS-type symptoms; a possible cause resides in the imbalances of the intestinal microbiota in CD. Probiotics may represent a potential treatment.<br />Study: CD patients with IBS-type symptoms entered a prospective, double-blind, randomized placebo-controlled study. A 6-week treatment period was preceded by a 2-week run-in and followed by a 6-week follow-up phase. Clinical data were monitored throughout the study by validated questionnaires: IBS Severity Scoring System (IBS-SSS); Gastrointestinal Symptom Rating Scale (GSRS); Bristol Stool Form Scale (BSFS); and IBS Quality of Life Questionnaire (IBS-QOL). The fecal microbiota were assayed using plate counts and 16S rRNA gene-based analysis.<br />Results: In total, 109 patients were randomized to probiotics (n=54) or placebo (n=55). IBS-SSS and GSRS decreased significantly in probiotics, as compared with placebo [(-15.9%±14.8% vs. 8.2%±25.9%; P<0.001) and (-19.8%±16.6% vs. 12.9%±31.6%; P<0.001)], respectively. Treatment success was significantly higher in patients receiving probiotics, as compared with placebo (15.3% vs. 3.8%; P<0.04). Presumptive lactic acid bacteria, Staphylococcus and Bifidobacterium, increased in patients receiving probiotic treatment. No adverse events were reported.<br />Conclusions: A 6-week probiotic treatment is effective in improving the severity of IBS-type symptoms, in CD patients on strict GFD, and is associated with a modification of gut microbiota, characterized by an increase of bifidobacteria.
- Subjects :
- Adolescent
Adult
Double-Blind Method
Feces microbiology
Female
Follow-Up Studies
Gastrointestinal Microbiome
Humans
Irritable Bowel Syndrome physiopathology
Male
Middle Aged
Prospective Studies
Quality of Life
Surveys and Questionnaires
Treatment Outcome
Young Adult
Celiac Disease diet therapy
Diet, Gluten-Free
Irritable Bowel Syndrome diet therapy
Probiotics administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1539-2031
- Volume :
- 53
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of clinical gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 29688915
- Full Text :
- https://doi.org/10.1097/MCG.0000000000001023