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Probiotics and prebiotics in the management of irritable bowel syndrome: a review of recent clinical trials and systematic reviews

Whelan, Kevin

Current Opinion in Clinical Nutrition and Metabolic Care: November 2011 - Volume 14 - Issue 6 - p 581–587
doi: 10.1097/MCO.0b013e32834b8082
Functional foods: Edited by Nathalie M. Delzenne and Peter Stehle
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Purpose of review Irritable bowel syndrome (IBS) is a common disorder of the gastrointestinal tract, about which there has been considerable recent research. The aim of this article is to briefly review the aspects of IBS pathogenesis that involve the gastrointestinal microbiota, and then to critically appraise the recent and emerging evidence for the use of probiotics and prebiotics in its management.

Recent findings The increased risk of developing IBS following gastroenteritis and the co-existence of dysbiosis, elevated luminal gas production and immune activation, indicate that the gastrointestinal microbiota may be a therapeutic target in IBS. Most systematic reviews indicate that probiotics have a beneficial impact on global IBS symptoms, abdominal pain and flatulence. However, recent trials indicate that different probiotics can improve, have no effect, or even worsen symptoms, confirming that benefits are likely to be strain and symptom-specific. There are no recent clinical trials of prebiotics in IBS, although previous studies indicate potential benefit at lower doses.

Summary Clearly, some probiotics have considerable potential in the management of IBS; however, the benefits are likely to be strain-specific. Preliminary studies suggest low doses of prebiotics may improve symptoms of IBS, although further robust clinical trials are required.

King's College London, School of Medicine, Diabetes and Nutritional Sciences Division, London, UK

Correspondence to Dr Kevin Whelan, King's College London, Diabetes and Nutritional Sciences Division, 150 Stamford Street, London SE1 9NH, UK E-mail: kevin.whelan@kcl.ac.uk

© 2011 Lippincott Williams & Wilkins, Inc.