July 2007: Irritable Bowel Syndrome and Probiotics
The term irritable bowel syndrome (IBS) is used when chronic colon problems occur and a medical cause cannot be determined. Common symptoms include diarrhea, constipation, alternating diarrhea and constipation, excess intestinal gas, intestinal cramping, uncomfortable bowel movements, mucous discharge from the rectum, abdominal discomfort following meals, and excessive awareness of the presence of stool in the colon. Despite all these distressing symptoms, in IBS the intestines appear to be perfectly healthy when they are examined. Thus the condition belongs to a category of diseases that physicians call “functional.” This means that while the function of the bowel seems to have gone awry, no injury or disturbance of its structure can be found. (A similar problem in the stomach is called ]]>dyspepsia]]> , and the two conditions frequently overlap.)
Because the cause of IBS is not understood, conventional medical treatment of IBS is highly inadequate. One drug that had shown promise, Zelnorm, was withdrawn from the market for safety issues. Another, Lotronex, was temporarily withdrawn, and then re-approved, but only under strict limitations. Other medical treatment approaches for IBS include increased dietary fiber, drugs that reduce bowel spasm, and drugs to treat constipation or diarrhea as needed. In addition, various forms of psychotherapy, including hypnosis, have been tried, with some success.
A number of alternative medicine treatments have shown some promise for IBS. The most well known of these is ]]>peppermint oil]]> , thought to reduce bowel spasm. Another approach involves ]]>probiotics]]> , also known as “friendly bacteria.” The most famous probiotic is Lactobacillus acidophilus , used in making yogurt. There are many other probiotics as well. When these health-promoting bacteria take up residence in the digestive tract, they compete with “unfriendly” microorganisms, thereby improving intestinal health.
Based on this, probiotics might be helpful for people with IBS. Numerous studies have indeed shown promise, but all of these were small, and therefore subject to question. In 2007, however, a substantial study was published in France that lends strong credence to the use of probiotics for this condition.
This double-blind placebo-controlled trial involved 274 people with constipation-predominant irritable bowel syndrome. (As the name suggests, this is IBS in which constipation is a more significant symptom than diarrhea). Participants were given either placebo or a probiotic formula containing Bifidobacterium animalis . The results over the six-week study period showed that use of the probiotic led to a significant reduction in colon discomfort compared to placebo. In addition, the probiotic treatment significantly increased stool frequency.
For more information, see the full article on ]]>irritable bowel syndrome]]> .
Guyonnet D, Chassany O, Ducrotte P, et al. Effect of a fermented milk containing Bifidobacterium animalis DN-173 010 on the health-related quality of life and symptoms in irritable bowel syndrome in adults in primary care: a multicentre, randomized, double-blind, controlled trial. Aliment Pharmacol Ther . 2007;26:475-86.
Last reviewed July 2007 by ]]>Steven Bratman, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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