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British Dietetic Association systematic review of systematic reviews and evidence‐based practice guidelines for the use of probiotics in the management of irritable bowel syndrome in adults (2016 update)
Author(s) -
McKenzie Y. A.,
Thompson J.,
Gulia P.,
Lomer M. C. E.
Publication year - 2016
Publication title -
journal of human nutrition and dietetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.951
H-Index - 70
eISSN - 1365-277X
pISSN - 0952-3871
DOI - 10.1111/jhn.12386
Subject(s) - medicine , irritable bowel syndrome , randomized controlled trial , systematic review , probiotic , cinahl , medline , quality of life (healthcare) , alternative medicine , physical therapy , meta analysis , intensive care medicine , psychiatry , psychological intervention , pathology , nursing , biology , political science , bacteria , law , genetics
Background Probiotics are often taken by individuals with irritable bowel syndrome ( IBS ). Which products are effective is unclear, despite an increasing research base. This project will systematically review which strain‐ and dose‐ specific probiotics can be recommended to adults with IBS to improve symptoms and quality of life (QoL). It is part of a broader systematic review to update British Dietetic Association guidelines for the dietary management of IBS in adults. Methods CINAHL , Cochrane, Embase, Medline, Scopus and Web of Science were searched for systematic reviews ( SR s) of randomised controlled trial ( RCT )s recruiting adults with IBS comparing probiotic intervention with placebo. AMSTAR , risk of bias and diet bias tools were used to appraise methodological quality. Symptom and QoL data were appraised to develop probiotic‐specific evidence statements on clinically meaningful and marginal outcomes in various settings, graded clinical practice recommendations and practical considerations. Results Nine systematic reviews and 35 RCT s were included (3406 participants) using 29 dose‐specific probiotic formulations. None of the RCT s were at low risk of bias. Twelve out of 29 probiotics (41%) showed no symptom or QoL benefits. Evidence indicated that no strain or dose specific probiotic was consistently effective to improve any IBS symptoms or QoL. Two general clinical practice recommendations were made. Conclusions Symptom outcomes for dose‐specific probiotics were heterogeneous. Specific probiotic recommendations for IBS management in adults were not possible at this time. More data from high‐quality RCT s treating specific symptom profiles are needed to support probiotic therapy in the management of IBS .