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According to Dr. Richard Fedorak, M.D., who presented studies on probiotics at this year's Digestive Disease Week, 'the possibility of using this natural treatment for patients with IBD is a very exciting avenue of investigation.' He went on to explain their significance in IBD. "Bacteria adhere to the lining of the colon like icing on a cake," says he said. "Probiotics are able to negotiate through this layer of bacteria and layer themselves against the epithelial surface. They prevent bacteria from adhering to or crossing the epithelium [lining of the intestine]."
He cited a randomized controlled trial of patients with pouchitis who were treated with a probiotic preparation. Pouchitis is a complication that occurs after surgery to remove the colon. Surgeons create a "pouch" from the lower end of the small intestine so that normal bathroom habits can be retained. The pouch sometimes becomes infected and inflamed. This trial showed that probiotics were able to prevent recurrent episodes of pouchitis in 85% of treated patients (compared to 0% of placebo-treated patients).
"Another important aspect of probiotics is their antimicrobial activity," added Dr. Fedorak. "probiotics produce a number of agents that destroy bacteria."
"It's very likely that there will be a preventative role for probiotics in IBD, and perhaps a role in addition to other therapies," he concluded.
BACKGROUND:
Irritable bowel syndrome (IBS) is a widespread functional disorder of the digestive tract. Its aetiology is unknown and therapeutic options are limited. Recent reports suggest that probiotics may have a role in regulating the motility of the digestive tract.
AIM:
To assess the efficacy of Lactobacillus plantarum 299V (LP299V) in patients with IBS.
PATIENTS AND METHODS:
Forty patients were randomized to receive either Lactobacillus plantarum LP299V in liquid suspension (20 patients) or placebo (20 patients) over a period of 4 weeks. Clinical examination was performed at baseline and at the end of the study. Additionally, patients assessed their symptoms by applying a scoring system.
RESULTS:
All patients treated with Lactobacillus plantarum LP299V reported resolution of their abdominal pain as compared to 11 patients from a placebo group (P = 0.0012). There was also a trend towards normalization of stools frequency in constipated patients in six out of 10 patients treated with LP299V compared with two out of 11 treated with placebo (P = 0.17). With regards to all irritable bowel syndrome IBS symptoms an improvement was noted in 95% of patients in the Lactobacillus plantarum LP299V group vs 15% of patients in the placebo group (P < 0.0001).
CONCLUSIONS:
Lactobacillus plantarum LP299V seems to have a beneficial effect in patients with IBS. Further studies on larger cohorts of patients and with longer duration of therapy are required in order to establish the place of L. plantarum in the treatment of IBS.
PMID: 11711768 [PubMed - indexed for MEDLINE]
Several probiotic formulas contain Lactobacillus plantarum. These include: