The purpose of this paper is to evaluate if probiotics really provide health benefits to patients who suffer from irritable bowel syndrome (IBS). The issue of prescribing or recommending probiotic use is of concern because to date, probiotics are not tested nor regulated by the Food and Drug Administration (FDA) (Bixquert, 2013). Besides, there is increasing interest in the possible beneficial effects of probiotics in a variety of intestinal diseases, including IBS (Fedorak, 2008). Whether supplements containing the “healthy” bacteria are of any benefit is still unproven (Bixquert, 2013).
As stated, probiotics are not currently regulated by the FDA. And, according to Bixquert, ...view middle of the document...
The provider should involve the patient in the decision making while establishing realistic expectations. The importance of the therapeutic relationship in IBS was emphasized in a study that investigated the components of the placebo effect and patient-provider interaction in 262 patients with IBS (Ortiz-Lucas, Tobias, Saz & Sebastian, 2013).
While there are a number of studies addressing probiotic use in the treatment of IBS, for the sake of brevity, I have appraised 2 brief articles and 4 very compelling research studies relating to the use of probiotics in the treatment of IBS.
Analysis and synthesis of research studies
Probiotics and irritable bowel syndrome provided a review of the existing data on the effects of probiotics in the treatment of IBS. After reviewing their research, Korpela and Niittynen concluded that although the “evidence is very promising, no general recommendations on the use of probiotics in IBS can be given yet” (Korpela & Niittynen, 2012).
Like Korpela and Niittynen, Bixquert also demonstrates hesitation in the use of probiotics to treat IBS. Bixquert like many researchers states that “the differential diagnosis of IBS can be difficult” (Bixquert, 2013). Once diagnosed with IBS, Bixquert believes that probiotics can be used to stabilize the normal gut flora (2013). He goes on to say that using probiotics decreases the chances of developing IBS following gastroenteritis (Bixquert, 2013). Five (5) additional proposed actions of probiotics discussed by Bixquert include: correcting lactose intolerance; relieving bloating, flatulence and distention; modulating gut tissue and cytokines; preserving functionality of deconjugate bile salts; and reducing the tumor necrosis factor thereby suppressing the local inflammatory response (Bixquert, 2013). While Bixquert defined 7 different expected actions of probiotics use, he acknowledges that the benefits of using probiotics is unclear and does not warrant a general recommendation of usage with IBS (Bixquert, 2013). He does, however, believe that although probiotic use does not improve bowel function, that it may improve patient symptoms (Bixquert, 2013). While the articles reviewed seem to agree on the lack of information supporting probiotic use in the treatment of IBS, we will now look more closely at the current research findings.
In, Effect of probiotics species on irritable bowel syndrome symptoms: A bring up to date meta-analysis, Ortiz-Lucas, Tobias, Saz, and Sebastian (2013) conducted a meta-analysis to assess the effectiveness of each specific probiotic species in relieving characteristics of IBS. The sample size consisted of 10 of the 24 randomized controlled trials (RCTs) identified studies. Further, the study employed a research methodology of continuous data summarized using standardized mean differences (SMDs). From evaluating the measurement tools, there appeared to be variety, including: pain scores, distention scores and flatulence scores. Specifically,...