Main idea: The multi-strain synbiotic preparation was associated with a significant improvement in symptoms in IBS-D patients and was well-tolerated. These results suggest that the use of synbiotics offers a benefit for IBS-D patients.
The purpose of the randomized double-blind placebo-controlled trial was to assess the effectiveness of synbiotic preparation containing probiotic Lactobacillus rhamnosus FloraActive™ 19070-2, Lactobacillus acidophilus DSMZ 32418, Bifidobacterium lactis DSMZ 32269, Bifidobacterium longum DSMZ 32946, Bifidobacterium bifidum DSMZ 32403, and fructooligosaccharides in adult patients with diarrhea-dominant IBS (IBS-D). The study included eighty patients with moderate and severe IBS-D who were randomized to receive synbiotics or placebo for eight weeks. Finally, a total of sixty-eight patients finished the study. The primary endpoints included the assessment of the symptoms’ severity with the IBS symptom severity scale (IBS-SSS), an improvement of IBS global symptoms with the Global Improvement Scale (IBS-GIS), and adequate relief of symptoms after four and eight weeks of therapy. Secondary endpoints, which were collected by telephone interviewers three times a week, included the assessment of individual IBS symptoms and adverse events. Synbiotic treatment in comparison to placebo significantly improved IBS-GIS and IBS-SSS score inducing a decrease in the total IBS-SSS and in domain-specific scores related to flatulence and bowel habit after four and eight weeks. Patients treated with synbiotics reported in weekly observations of a significant amelioration in a feeling of incomplete bowel movements, flatulence, pain, stool pressure, and diarrheal stools compared to those receiving placebo. There were no differences in adverse events between both groups.