Lactobacillus plantarum 299v and Reduced Flatulence

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

Across 3 studies, 2 reported beneficial effects on flatulence reduction, with effect sizes ranging from small to large. One large randomized controlled trial found no significant benefit. The most studied population is irritable bowel syndrome (IBS) patients, with doses around 1–2×10^10 CFU/day.

Effective dose range: 1×10^10 to 2×10^10 CFU/day
Studied populations: Irritable bowel syndrome (IBS) patients; cancer patients receiving home enteral nutrition

Caveats: Evidence base is small (only 3 studies) — conclusions should be considered preliminary. One large RCT (n=190) found no significant difference, while a smaller RCT (n=21) and an observational study (n=221) reported benefit. The observational study is subject to bias, and the beneficial RCT had a small sample size. Results are conflicting, and the effect size varies widely.

Generated Jul 12, 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.