Efficacy and safety of probiotics, prebiotics and synbiotics in the treatment of irritable bowel syndrome : a systematic review and meta-analysis

Abstract EN

Treatments that target alterations in gut microbiota may be beneficial for patients with irritable bowel syndrome (IBS).

A systematic review and meta-analysis was conducted of randomised clinical trials (RCTs) evaluating the efficacy and safety of probiotics, prebiotics and synbiotics.

Factors considered in the analysis included global IBS symptoms and/or abdominal pain, secondary symptoms and the frequency of adverse events.

A total of 33 RCTs involving 4,321 patients were identified.

Overall, probiotics significantly improved global IBS symptoms compared to placebos (standardised mean difference = −0.32, 95% confidence interval: −0.48 to −0.15; P <0.001), with significant heterogeneity between studies (I2 = 72%; P <0.001).

This remained apparent in both single- and multi-strain probiotic interventions as well as synbiotic formulations.

However, evidence regarding prebiotics was scarce.

There were no significant inter-group differences in terms of the frequency of adverse events.

Future RCTs should address methodological limitations, including short follow-up periods and patient adherence.