Lactobacillus plantarum 299v and Reduced Flatulence

Research synthesisLow evidenceMixed effect size3 studies · 2 beneficial · 1 neutral · 0 harmful

Across 3 studies on Lactobacillus plantarum 299v for reduced flatulence, 2 reported beneficial effects (one large, one small) and 1 found no significant difference (neutral, small effect). The beneficial effects were observed in IBS patients and cancer patients on enteral nutrition, with doses around 1–2×10^10 CFU/day. Evidence is based on a small number of studies, making conclusions preliminary.

Effective dose range: 1×10^10 to 2×10^10 CFU/day
Studied populations: irritable bowel syndrome patients, cancer patients receiving home enteral nutrition

Caveats: Evidence base is small (only 3 studies) — conclusions should be considered preliminary. The only neutral study was a larger RCT (n=190) with higher evidence quality (score 5), which did not find a significant benefit for flatulence in IBS patients, contrasting with the positive observational study in IBS (n=221) and the small RCT in cancer patients (n=21). This inconsistency suggests the effect may be population-specific or confounded by study design.

Generated May 13, 2026

Doses used in studies

CFU/day: 10 billion–20 billion (median 15 billion, IQR 12.5 billion–17.5 billion) — 2 studies

Safety in these studies

flatulenceNo significant differencefrequency of flatulence ... significantly reduced at week 4 compared to baseline in the Lp299v group (p=0.0117)
Moreover, the changes in the frequency of vomiting and flatulence were significantly reduced at week 4 compared to baseline in the Lp299v group (p=0.0117).
from: Effects of 4 weeks of Lactobacillus plantarum 299v supplementation on nutritional status,
vomitingNo significant differencefrequency of vomiting ... significantly reduced at week 4 compared to baseline in the Lp299v group (p=0.0117)
Moreover, the changes in the frequency of vomiting and flatulence were significantly reduced at week 4 compared to baseline in the Lp299v group (p=0.0117).
from: Effects of 4 weeks of Lactobacillus plantarum 299v supplementation on nutritional status,
Overall tolerabilityReported
Self-assessment identified that long-term treatment with LP299V was tolerated well by 94 % of patients.
from: [Treatment of IBS with Lactobacillus plantarum 299v: Therapeutic success increases with le
Overall tolerabilityReported
Lp299v may reduce the gastrointestinal symptoms related to enteral nutrition; notwithstanding, the improvement of quality of life may be the result of enteral nutrition rather than the effect of administration of Lp299v.
from: Effects of 4 weeks of Lactobacillus plantarum 299v supplementation on nutritional status,

3 of 3 papers

Role of Lactobacillus plantarum 299v versus Placebo in symptomatic improvement of irritable bowel syndrome patients.
- 2022-02-03
- RCT · n = 190
- JPMA. The Journal of the Pakistan Medical Association 72(3)
- - Ahmad Nawaz Babar
  - Muhammad Kamran Hassan
  - Fazl Ullah
  - Anwar Ullah
- PubMed: 35320214
- DOI: 10.47391/jpma.0758
7 Insights on
- Reduced Flatulence
- High evidence
- Large Human Trial
There was no significant difference in terms of relieving abdominal pain, bloating and rectal emptying between the groups (p>0.05).
Effect
Neutral
Effect size
Small
Significant
No
[Treatment of IBS with Lactobacillus plantarum 299v: Therapeutic success increases with length of treatment - real-life data of a non-interventional study in Germany].
- 2021-02
- Observational · n = 221
- Zeitschrift fur Gastroenterologie 59(02)
- - Heiner Krammer
  - Martin Storr
  - Ahmed Madisch
  - Julia Riffel
- PubMed: 33556972
- DOI: 10.1055/a-1340-0204
20 Insights on
- Reduced Flatulence
- High evidence
flatulence (H: -63%)
Effect
Beneficial
Effect size
Large
Significant
Yes
Dose
1 capsule/day; 1×10^10 CFU
Effects of 4 weeks of Lactobacillus plantarum 299v supplementation on nutritional status, enteral nutrition tolerance, and quality of life in cancer patients receiving home enteral nutrition - a double-blind, randomized, and placebo-controlled trial.
- 2020-09-01
- RCT · n = 21
- European review for medical and pharmacological sciences 24(18)
- - K Kaźmierczak-Siedlecka
  - M Folwarski
  - J Ruszkowski
  - K Skonieczna-Żydecka
  - W Szafrański
  - W Makarewicz
- PubMed: 33015813
- DOI: 10.26355/eurrev_202009_23059
6 Insights on
- Reduced Flatulence
- High evidence
The changes in the frequency of vomiting and flatulence were significantly reduced at week 4 compared to baseline in the Lp299v group (p=0.0117).
Effect
Beneficial
Effect size
Small
Significant
Yes
Dose
2 x 10^10 CFU

Lactobacillus plantarum 299v and Reduced Flatulence

Role of Lactobacillus plantarum 299v versus Placebo in symptomatic improvement of irritable bowel syndrome patients.

[Treatment of IBS with Lactobacillus plantarum 299v: Therapeutic success increases with length of treatment - real-life data of a non-interventional study in Germany].

Effects of 4 weeks of Lactobacillus plantarum 299v supplementation on nutritional status, enteral nutrition tolerance, and quality of life in cancer patients receiving home enteral nutrition - a double-blind, randomized, and placebo-controlled trial.