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Comparative effectiveness and safety of probiotics with psychotropic potential in mental health benefits in irritable bowel syndrome: a systematic review and network meta-analysis.

  • 2025-08-25
  • European journal of gastroenterology & hepatology 38(1)
    • Theodore Rokkas
    • Konstantinos Ekmektzoglou
    • Evangelia Tsanou
    • Ludovica Bricca
    • Alexandra-Eleftheria Menni
    • Paraskevas Golfakis
    • Katerina Kotzampassi

Study Design

Type
Systematic Review
Sample size
n = 3,154
Population
3154 participants assigned to nine different treatments: Bifidobacterium longum, Saccharomyces, Clostridium butyricum, Bifidobacterium lactis, Lactobacillus acidophilus, Lactobacillus casei strain Shirota, Lactobacillus plantarum, probiotic combinations, and placebo
Methods
Relevant randomized controlled trials (RCTs) were analyzed, using a Bayesian NWM, to compare the performance of probiotics with mental health benefits in IBS treatment

Background

The use of probiotics as a treatment for irritable bowel syndrome (IBS) is gaining attention, with recent studies indicating that certain probiotics or combinations may have mental health benefits for patients with IBS.

Aims

To systematically review and meta-analyze, using network meta-analysis (NWM), the comparative effectiveness and safety of probiotics with psychotropic potential on quality of life, depression, and anxiety in patients with IBS.

Methods

Relevant randomized controlled trials (RCTs) were analyzed, using a Bayesian NWM, to compare the performance of probiotics with mental health benefits in IBS treatment. Treatment effectiveness was assessed using surfaces under cumulative ranking (SUCRA) values.

Results

The analysis included 3154 participants assigned to nine different treatments: Bifidobacterium longum, Saccharomyces, Clostridium butyricum, Bifidobacterium lactis, Lactobacillus acidophilus, Lactobacillus casei strain Shirota, Lactobacillus plantarum, probiotic combinations, and placebo. B. longum and probiotic combinations were found to be significantly more effective than placebo. In terms of improving quality of life (QoL), B. longum was the most effective (SUCRA = 89.7%), while L. plantarum was the least effective (SUCRA = 14.9%). For alleviating depression and anxiety, the combination of probiotics (SUCRA = 95.6%) and L. acidophilus (SUCRA = 74.2%) showed the best results, respectively.

Conclusion

Some probiotics or combinations may offer benefits for patients with IBS in improving QoL, depression, and anxiety; however, as this is a developing field, additional research is necessary to fully understand the effectiveness, underlying mechanisms, and specific strains that may be advantageous. More high-quality RCTs are needed to substantiate these therapeutic possibilities.

Research Insights

Adverse Events Reported

  • bifidobacterium longum→Overall tolerability

    The study reports outcomes for these substances but does not provide specific adverse event data in the abstract.

    Finding
    Reported
  • Lactobacillus acidophilus→Overall tolerability

    The study reports outcomes for these substances but does not provide specific adverse event data in the abstract.

    Finding
    Reported
  • Lactobacillus plantarum→Overall tolerability

    The study reports outcomes for these substances but does not provide specific adverse event data in the abstract.

    Finding
    Reported
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