Table 1.
Characteristics of RCTs about the efficacy of probiotics in irritable bowel syndrome.
| Study | country | Criteria used | IBS Subtypes | Intervention | Control (PLA) | #Outcome measures used in NMA | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Sample size | *Age | Probiotic used | Dose and duration | Sample size | *Age | Response rate | |||||
| (Abbas et al., 2014) | Pakistan | Rome III criteria | IBS-D | 37 | 37.7 ± 11.6 | S.boulardii | 750mg/day, 6w | 35 | 33.0 ± 12.0 | N.A. | C, D, E, G |
| (Choi et al., 2011) | Korea | Rome II criteria | IBS-D and IBS-M | 45 | 40.2 ± 13.1 | S.boulardii | 4x1011 live cells/day, 4w | 45 | 40.6 ± 12.9 | N.A. | B, C, D, E, F, G |
| (Kabir et al., 2011) | Bangladesh | Rome II criteria | IBS-D | 35 | NA | S.boulardii | 500mg/day, 4w | 35 | NA | N.A. | C, D |
| (Gayathri et al., 2020) | India | Rome III criteria | IBS-C, IBS-D, IBS-M | 52 | 42.25 ± 15.44 | S.cerevisiae CNCMI-3856 | 4×109CFU/day, 8w | 48 | 39.6 ± 12.79 | N.A. | C, G |
| (Pineton et al., 2015) | France | Rome III criteria | IBS-C, IBS-D, IBS-M | 86 | 42.5 ± 12.5 | S.cerevisiae CNCMI-3856 | 4×109 CFU/day, 8w | 93 | 45.4 ± 14 | 47% | A, C, G |
| (Spiller et al., 2016) | France | Rome III criteria | IBS-C | 192 | 45.3 ± 15.7 | S.cerevisiae CNCMI-3856 | 8x109CFU/day, 12w | 187 | 45.4 ± 14.1 | 26.90% | A, G |
| (Enck et al., 2009) | Germany | Kruis scale | N.A. | 148 | 49.8(19–70) | E.coli | (1.5-4.5x107 CFU/mL) 0.75mL drops t.i.d. for 1 week, then 1.5mL t.i.d. for weeks 2 to 8 | 150 | 49.4(18–76) | 4.67% | A |
| (Kruis et al., 2012) | Germany | Rome II criteria | N.A. | 60 | 46.3 ± 12.1 | E.coli Nissle1917 | (2.5-25x109 CFU/capsule) o.d. for 4 days then b.d. for 12 weeks | 60 | 45.1 ± 12.7 | 41.70% | A, G |
| (Andresen et al., 2020) | Germany | Rome III criteria | IBS-C, IBS-D, IBS-M, IBS-U | 221 | 40·1 ± 12·8 | B.bifidum MIMBb75 | 1 × 10⁹ CFU/day, 8w | 222 | 42·6 ± 13·8 | 30% | A, G |
| (Guglielmetti et al., 2011) | Germany | Rome III criteria | IBS-C, IBS-D, IBS-M | 60 | 36.65 ± 12.42 | B.bifidum MIMBb75 | 1x109 CFU/day,4w | 62 | 40.98 ± 12.80 | 21% | A, G |
| (Gupta and Maity, 2021) | India | Rome IV criteria | N.A. | 20 | 36.20 ± 9.81 | B.coagulans LBSC | 6 × 10⁹ CFU/day, 80d | 20 | 34.80 ± 11.06 | N.A. | C, D, E, J, K |
| (Majeed et al., 2016) | India | Rome III criteria | IBS-D | 18 | 36.2 ± 11.07 | B.coagulans MTCC5856 | 2×109 CFU/day, 90d | 18 | 35.4 ± 10.75 | N.A. | C, D, J, K |
| (Madempudi et al., 2019) | India | Rome III criteria | N.A. | 53 | 44.4 | B.coagulans Unique IS2 | 2×109CFU/day, 8w | 55 | 42.3 | 10.91% | A, B, C, D, H, I, J, K |
| (Sudha et al., 2018) | India | Rome III criteria | IBS-C, IBS-D, IBS-M | 72 | 7.86 | B.coagulans Unique IS2 | 2×109CFU/day, 8w | 69 | 7.89 | 21.74% | A, B, C, D, E, H, I, J, K |
| (Lyra et al., 2016) | Finland | Rome III criteria | IBS-C, IBS-D, IBS-M, IBS-U | 131 | 47.2 ± 12.5 | L. acidophilus NCFM | 1 × 1010 CFU/day, 12w | 131 | 49.4 ± 12.9 | 28.40% | A, C, D, F, G |
| 129 | 47.1 ± 13.3 | 1 × 10⁹ CFU/day, 12w | |||||||||
| (Martoni et al., 2020) | India | Rome IV criteria | N.A. | 111 | 39.41 ± 11.80 | L. acidophilus DDS‐1 | 1 × 1010 CFU/day, 6w | 109 | 37.61 ± 10.12 | 15.60% | A |
| 110 | 41.60 ± 11.11 | B.lactis UABla‐12 | 1 × 1010 CFU/day, 6w | ||||||||
| (Sadrin et al., 2020) | France | Rome III criteria | N.A. | 40 | 48.9 ± 8.4 | L.acidophilus NCFM and L.acidophilus subs p.helveticus LAFTIL10 | 1×1010 CFU/day, 8w | 40 | 48.9 ± 8.0 | N.A. | B, C, D, G |
| (Sinn et al., 2008) | Korea | Rome III criteria | IBS-C, IBS-D, IBS-M | 20 | 41.9 ± 14.4 | L.acidophilus-SDC2012,2013 | 4×109 CFU/day, 4w | 20 | 47.5 ± 11.0 | 35% | A |
| (Bauserman and Michail, 2005) | USA | Rome II criteria | N.A. | 25 | 11.6 ± 3.2 | L.GG | 2×1010 CFU/day, 6w | 25 | 12.4 ± 2.9 | 40% | A |
| (O’Mahony et al., 2005) | Eire | Rome II criteria | IBS-C, IBS-D, IBS-M | 26 | NA | L.salivarius UCC4331 | 1 × 1010 CFU/day, 8w | 25 | NA | N.A. | B, C, D |
| 24 | NA | B.infantis 35624 | 1 × 1010 CFU/day, 8w | ||||||||
| (Ligaarden et al., 2010) | Norway | Rome II criteria | N.A. | 19 | 50 ± 11 | L.plantarum MF1298 | 1x1010 CFU/day, 3w | 19 | 50 ± 11 | N.A. | B, C, D, E |
| (Ducrotté et al., 2012) | India | Rome III criteria | IBS-D (63.89%) and other types | 108 | 36.53 ± 12.08 | L.plantarum 299v(DSM 9843) | 1×1010 CFU/day, 4w | 106 | 38.40 ± 13.13 | 8.10% | A, C |
| (Stevenson et al., 2014) | South Africa | Rome II criteria | IBS-C, IBS-D | 54 | 48.15 ± 13.48 | L.plantarum 299v(DSM 9843) | 1×1010 CFU/day, 8w | 27 | 47.27 ± 12.15 | N.A. | B, F |
| (Niedzielin et al., 2001) | Poland | Clinical diagnosis | N.A. | 20 | 48 ± 18 | L.plantarum 299v(DSM 9843) | 2× 1010 CFU/day, 4w | 20 | 42 ± 15 | 15% | A |
| (Pinto-Sanchez et al., 2017) | Canada | Rome III criteria | IBS-D, IBS-M | 22 | 46.5 (30-58) | B.longum NCC3001 | 1x1010 CFU/day, 6w | 22 | 40.0 (26-57) | 35% | A, B, G |
| (Dapoigny et al., 2012) | France | Rome III criteria | IBS-C, IBS-D, IBS-M, IBS-U | 25 | 48.0 ± 10.8 | Lactobacillus casei rhamnosus LCR35 | 6x108 CFU/day, 4w | 25 | 48.0 ± 10.8 | 40% | A |
| (Thijssen et al., 2016) | Netherlands | Rome II criteria | IBS-C, IBS-D, IBS-M, IBS-U | 39 | 41.1 ± 14.8 | L.casei iShirota | 1.3×1010 CFU/day, 8w | 41 | 42.4 ± 13.5 | 29% | A |
| (Whorwell et al., 2006) | UK | Rome II criteria | IBS-C, IBS-D, IBS-M, IBS-U | 90 | 40.8 ± 10.44 | B.infantis35624 | 1×106 CFU/day, 4w | 92 | 42.4 ± 10.45 | About 40% | A, B, C, D, E |
| 90 | 42.7 ± 10.44 | 1×108 CFU/day, 4w | |||||||||
| 90 | 41.8 ± 10.44 | 1×1010 CFU/day, 4w | |||||||||
| (Sun et al., 2018) | China | Rome III criteria | IBS-D | 105 | 43.00 ± 12.45 | C.butyricum | 5.67× 107 CFU/day, 4w | 95 | 44.91 ± 13.01 | 35% | A, B, C, D, F, G |
| (Niv et al., 2005) | Israel | Rome II criteria | IBS-C, IBS-D, IBS-M | 27 | 45.7 ± 14.2 | L.reuteri ATCC55730 | 2×108 CFU/day, 6m | 27 | 45.6 ± 16.1 | N.A. | B, G |
| (Agrawal et al., 2009) | UK | Rome III criteria | IBS-C | 17 | 42(24,69) | B. lacti DN-173010, S.thermophilus, and L. bulgaricus | 7.35×1010 CFU/day, 4w | 17 | 37(20,59) | N.A. | J, K |
| (Begtrup et al., 2013) | Denmark | Rome III criteria | IBS-C, IBS-D, IBS-M, IBS-U | 67 | 31.63 ± 10.05 | L. paracasei ssp paracasei F19, L. acidophilus La5, and B. lactis Bb12 | 5.2x1010 CFU/day, 6m | 64 | 29.38 ± 8.64 | 29% | H, I, J, K |
| (Søndergaard et al., 2011) | Denmark and Sweden | Rome II criteria | N.A. | 27 | 53.9(29–67) | L.paracasei ssp paracasei F19, L.acidophilus La5, and B.lactis Bb12 | 2.5x1010 CFU/day, 8w | 25 | 48.5(29–67) | About 25% | H, K |
| Guyonnet 2007 (Guyonnet et al., 2007) | France | Rome II criteria | N.A. | 135 | 49.4 ± 11.4 | B.animalis DN173 010, S.thermophilus, and L.bulgaricus | 2.98× 1010 CFU/day,6w | 132 | 49.2 ± 11.4 | 56.80% | H, I, J, K |
| (Drouault-Holowacz et al., 2008) | France | Rome II criteria | IBS-C, IBS-D, IBS-M | 48 | 47 ± 14 | B. longum LA 101, L. acidophilus LA 102, L. lactis LA 103, and S. thermophilus LA 104 | 1×1010 CFU/day, 4w | 52 | 44 ± 14 | 42.30% | H, J |
| (Jafari et al., 2014) | Iran | Rome III criteria | N.A. | 54 | 36.6 ± 12.1 | B.animalis subsp. lactis BB-12® , L.acidophilus LA-5®, L.delbrueckii subsp. bulgaricus LBY-27, S.thermophilus STY-31 | 8× 10⁹ CFU CFU/day, 4w | 54 | 36.6 ± 12.1 | 47% | H |
| (Kim et al., 2003) | USA | Rome II criteria | IBS-D | 12 | 48 ± 5.7 | VSL#3: (Threes trains of Bifidobacterium (B.longum, B.infantis and B.breve); four strains of Lactobacillus (L.acidophilus, L.casei, L.bulgaricus and L.plantarum); and one strain of Streptococcus (S.salivarius subspecies thermophilus) | 4.5×1011 bacteria/day, 8w | 13 | 38 ± 3.4 | 38% | H, I, J, K |
| (Zeng et al., 2008) | China | Rome II criteria | IBS-D | 14 | 44.6 ± 12.4 | S.thermophilus, L.bulgaricus, L.acidophilus, and B.longum | 2.6×1010 CFU/day, 4w | 15 | 45.8 ± 9.2 | N.A. | I, J, K |
| (Kajander et al., 2005) | Finland | Rome I and II criteria | IBS-C, IBS-D, IBS-M | 52 | 46(23–65) | L.rhamnosus GG, L.rhamnosus Lc705, P.freudenreichii, and B.breve Bb99 | 8–9×109/CFU/day, 6m | 51 | 45(21–65) | 33.33% | H, J, K |
| (Kajander et al., 2008) | Finland | Rome II criteria | IBS-C, IBS-D, IBS-M | 43 | 50 ± 13 | L.rhamnosus GG, L.rhamnosus Lc705 DSM 7061, P.freudenreichii, and B.animalis | 4.8×109 CFU/day, 20w | 43 | 46 ± 13 | N.A. | I |
| (Kim et al., 2005) | USA | Rome II criteria | N.A. | 24 | 40 ± 14.70 | VSL#3: Threes trains of Bifidobacterium (B.longum, B.infantis and B.breve); four strains of Lactobacillus (L.acidophilus, L.casei, L.bulgaricus and L.plantarum); and one strain of Streptococcus (S.salivarius subspecies thermophilus) | 9×1011 CFU/day; 8w | 24 | 46 ± 14.70 | 33% | H, J, K |
| (Roberts et al., 2013) | England | Rome III criteria | IBS-C, IBS-M | 88 | 44.66 ± 11.98 | B.lactis I-2494, S.thermophilus, and L.bulgaricus | 2.98×1010 CFU/day, 12w | 91 | 43.71 ± 12.76 | 68.30% | H |
| (Wong et al., 2015) | Singapore | Rome III criteria | N.A. | 20 | 53.35 ± 18.56 | VSL#3: Threes trains of Bifidobacterium (B.longum, B.infantis and B.breve); four strains of Lactobacillus (L.acidophilus, L.casei, L.bulgaricus and L.plantarum); and one strain of Streptococcus (S.salivarius subspecies thermophilus) | 9× 1011 CFU/day, 6w | 22 | 40.86 ± 16.46 | N.A. | J, K |
*Mean ± sd or mean (range).
A: Symptom relief rate; B: global symptom scores; C: abdominal pain scores; D: bloating scores; E: straining scores; F: QOL; G: AEs; and H-K refers to the outcome relevant to the comparisons of B. coagulans with different probiotic combinations: H: Symptom relief rate; I: global symptom scores; J:abdominal pain scores; K: bloating scores.
N.A., Not reported or not available.