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Copyright ©2014 Baishideng Publishing Group Co.
World J Gastroenterol. Mar 14, 2014; 20(10): 2470-2481
Published online Mar 14, 2014. doi: 10.3748/wjg.v20.i10.2470
Table 3 Systemic reviews for randomized controlled trials of probiotics in irritable bowel syndrome
Ref.Selection criterian of identified studiesResults
McFarland et al[73] 2008RCTs in humans published as full articles or meeting abstracts in peer-reviewed journals20 RCTsGlobal IBS symptoms: RR = 0.77 (95%CI: 0.62-0.94)/ abdominal pain: RR = 0.78 (95%CI: 0.69-0.88)
Brenner et al[76] 2009RCTs; adults with IBS defined by Manning or Rome II criteria; single or combination probiotic vs placebo; improvement in IBS symptoms and/or decrease in frequency of adverse events reported16 RCTs → 11 studies showed suboptimal study designBifidobacterium infantis 35624 has shown efficacy for improvement of IBS symptoms. Most RCTs about the utility of probiotics in IBS have not used an appropriate study design
Hoveyda et al[74] 2009RCTs compared the effects of any probiotic therapy with placebo in patients with IBS14 RCTs → 7 RCTs providing outcomes as dichotomous variable and 6 RCTs providing outcomes as continuous variableOverall symptoms: dichtomous data - OR = 0.63 (95%CI: 0.45-0.83)/continuous data - mean ± SD, 0.23 (95%CI: 0.07-0.38) Trials varied in relation to the length of treatment (4-26 wk), dose, organisms and strengths of probiotics used
Moayyedi et al[75] 2010RCTs comparing the effect of probiotics with placebo or no treatment in adult patients with IBS (over the age of 16 yr)19 RCTs → 10 RCTs providing outcomes as a dichotomous variableProbiotics appear to be efficacious in IBS (Probiotics were statistically significantly better than placebo, but there was statistically significant heterogeneity). The magnitude of benefit and the most effective species and strain are uncertain
Ortiz-Lucas et al[77] 2013RCTs comparing probiotics with placebo in treating IBS symptoms24 RCTs → 10 RCTs providing continuous data performed with continuous data summarized using mean ± SD and 95%CIsPain scores: improved by probiotics containing Bifidobacterium breve, Bifidobacterium longum, or Lactobacillus acidophilus species Distension scores: improved by probiotics containing B. breve, B. infantis, Lactobacillus casei, or Lactobacillus plantarum species Flatulence: improved by probiotics containing B. breve, B. infantis, L. casei, L. plantarum, B. longum, L. acidophilus, Lactobacillus bulgaricus, and Streptococcus salivarius ssp. thermophilus