Effect of Lactobacillus plantarum 299v on colonic fermentation and symptoms of irritable bowel syndrome.

2002-11
Digestive diseases and sciences 47(11)
- S Sen
- M M Mullan
- T J Parker
- J T Woolner
- S A Tarry
- J O Hunter

PubMed: 12452404
DOI: 10.1023/a:1020597001460

Study Design

Type: Clinical Trial
Population: 12 previously untreated patients with IBS
Methods: double-blind, placebo-controlled, cross-over, four-week trial of Lactobacillus plantarum 299V
Blinding: Double-blind
Duration: four weeks
Funding: Unclear

Highly Cited
Rigorous Journal

A number of recent clinical trials have promoted the use of probiotic bacteria as a treatment for irritable bowel syndrome (IBS). The recent demonstration of abnormal colonic fermentation in some patients with this condition provides an opportunity for the objective assessment of the therapeutic value of these bacteria. This study was designed to investigate the effects of Lactobacillus plantarum 299V on colonic fermentation. We conducted a double-blind, placebo-controlled, cross-over, four-week trial of Lactobacillus plantarum 299V in 12 previously untreated patients with IBS. Symptoms were assessed daily by a validated composite score and fermentation by 24-hr indirect calorimetry in a 1.4-m3 canopy followed by breath hydrogen determination for 3 hr after 20 ml of lactulose. On placebo, the median symptom score was 8.5 [6.25-11.25 interquartile range (IQR)], the median maximum rate of gas production was 0.55 ml/min (0.4-1.1 IQR), and the median hydrogen production was 189.7 ml/24 hr (118.3-291.1 IQR). On Lactobacillus plantarum 299V the median symptom score was 8 (6.75-13.5 IQR), the median maximum rate of gas production 0.92 ml/min (0.45-1.5 IQR), and the median hydrogen production 208.2 ml/24 hr (146-350.9 IQR). There was no significant difference. Breath hydrogen excretion after lactulose was reduced by the probiotic (median at 120 min, 6 ppm; placebo, 17 ppm; P = 0.019). In conclusion, Lactobacillus plantarum 299V in this study did not appear to alter colonic fermentation or improve symptoms in patients with the irritable bowel syndrome.

Research Insights

Lactobacillus plantarum 299v→Improved IBS Symptom Score
On placebo, the median symptom score was 8.5 [6.25-11.25 interquartile range (IQR)]... On Lactobacillus plantarum 299V the median symptom score was 8 (6.75-13.5 IQR). There was no significant difference.
Effect
Neutral
Effect size
Small
Lactobacillus plantarum 299v→Reduced Faecal pH
Breath hydrogen excretion after lactulose was reduced by the probiotic (median at 120 min, 6 ppm; placebo, 17 ppm; P = 0.019).
Effect
Beneficial
Effect size
Small
Lactobacillus plantarum 299v→Reduced Gas Production
On placebo, the median maximum rate of gas production was 0.55 ml/min (0.4-1.1 IQR). On Lactobacillus plantarum 299V the median maximum rate of gas production 0.92 ml/min (0.45-1.5 IQR). There was no significant difference.
Effect
Neutral
Effect size
Small
Lactobacillus plantarum 299v→Reduced Hydrogen Production
On placebo, the median hydrogen production was 189.7 ml/24 hr (118.3-291.1 IQR). On Lactobacillus plantarum 299V the median hydrogen production 208.2 ml/24 hr (146-350.9 IQR). There was no significant difference.
Effect
Neutral
Effect size
Small