Selvaganapathi G.¹, Jinat Ahmed J.A.^2,, Mathialagan AG², Dinesh M.³, Azra N.², Harikrishnan T.⁴, Kohila J.R.¹, Fathy I.⁵, Ramalinggam R.¹, Tee HY², Vanita S.⁶

Objective: To examine the relationship between Probiotics and its efficacy in reducing the symptoms of Irritable Bowel Syndrome (IBS). Methods: A meta-analysis was conducted to evaluate the quality of the clinical trials and evidence with respect to the efficacy of probiotics for the treatment of IBS. Medline, PubMed, Google Scholar, NIH registry of clinical trials, and Cochrane Central Register of Controlled Trials were reviewed from the year 1990-2017 to identify studies that fulfilled inclusion criteria and exclusion criteria. Findings: 1650 studies were found on probiotics use in IBS. From that, only 70 studies fulfilled inclusion and exclusion criteria that were defined for this study. After assessment with Linde Internal Validity Scale, around 18 clinical trials were identified for data extraction. From those studies, it was seen that probiotic use was associated with improvement in global IBS symptoms compared to placebo [pooled relative risk (RRpooled) 0.77, 95% confidence interval (95% CI) 0.62-0.94]. Probiotics were also associated with less abdominal pain compared to placebo [RRpooled = 0.78 (0.69-0.88)]. Of the 11 species and species mixtures, Lactobacillus rhamnosus GG was the most frequent tested probiotics. None of the 18 trials reported any serious adverse events with probiotic use. Conclusion: For management of IBS, probiotics were significantly more protective and effective than placebo.

irritable bowel syndrome, probiotics, placebo-controlled, randomized controlled trials, Manning criteria, Rome criteria, double blinding