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Is Bacillus coagulans supplementation plus low FODMAP diet superior to low FODMAP diet in irritable bowel syndrome management?

  • 2019-07-20
  • European journal of nutrition 59(5)
    • Khadijeh Abhari
    • Saeede Saadati
    • Fatemeh Hosseini-Oskouiee
    • Zahra Yari
    • Hedayat Hosseini
    • Golbon Sohrab
    • Ehsan Hejazi
    • Shahram Agah
    • Amir Sadeghi
    • Azita Hekmatdoost

Study Design

Type
Randomized Controlled Trial (RCT)
Population
fifty IBS patients who met Rome IV criteria for IBS
Methods
randomized clinical trial, 8 weeks of low FODMAP diet plus either a probiotic or a placebo capsule
Blinding
Double-blind
Duration
8 weeks
Funding
Unclear
  • Rigorous Journal

Purpose

The aim of this study was to assess the superiority of low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) diet plus Bacillus coagulans supplementation to low FODMAP diet alone in the reduction of irritable bowel syndrome (IBS) symptoms.

Methods

In this randomized clinical trial, fifty IBS patients who met Rome IV criteria for IBS were randomly assigned to receive a low FODMAP diet plus either a probiotic or a placebo capsule for 8 weeks. Probiotic capsules contained 109B. coagulans spores and 400 mg inulin, while placebo capsules consisted of 500 mg rice starch.

Results

Significant improvements were observed in abdominal pain intensity and frequency, abdominal distension, satisfaction with bowel habits, quality of life, defecation consistency, and patient-reported severity score in both groups; however, only improvement in severity score was significantly higher in probiotic group compared with placebo group (P = 0.001). Moreover, the frequency of patients with clinical improvement in IBS-symptom severity scale (IBS-SSS) was significantly more in probiotic group compared to placebo group (P = 0.038).

Conclusion

Our results indicate that the addition of probiotic supplement containing B. coagulans to the low FODMAP diet might be superior to low FODMAP diet in alleviating IBS symptoms.

Research Insights

  • Bacillus coagulans→Improved Bowel Movement Frequency

    Significant improvements were observed in abdominal pain intensity and frequency, abdominal distension, satisfaction with bowel habits, quality of life, defecation consistency, and patient-reported severity score in both groups; however, only improvement in severity score was significantly higher in probiotic group compared with placebo group (P = 0.001).

    Effect
    Neutral
    Effect size
    Small
    Dose
    10^9 spores/day plus 400 mg inulin
  • Bacillus coagulans→Improved Clinical Response Rate

    the frequency of patients with clinical improvement in IBS-symptom severity scale (IBS-SSS) was significantly more in probiotic group compared to placebo group (P = 0.038)

    Effect
    Beneficial
    Effect size
    Moderate
    Dose
    10^9 spores plus 400 mg inulin per capsule
  • Bacillus coagulans→Improved Defecation Consistency

    Significant improvements were observed in abdominal pain intensity and frequency, abdominal distension, satisfaction with bowel habits, quality of life, defecation consistency, and patient-reported severity score in both groups; however, only improvement in severity score was significantly higher in probiotic group compared with placebo group (P = 0.001).

    Effect
    Neutral
    Effect size
    Small
    Dose
    10^9 spores/day plus 400 mg inulin
  • Bacillus coagulans→Improved Quality of Life

    Significant improvements were observed in abdominal pain intensity and frequency, abdominal distension, satisfaction with bowel habits, quality of life, defecation consistency, and patient-reported severity score in both groups; however, only improvement in severity score was significantly higher in probiotic group compared with placebo group (P = 0.001).

    Effect
    Neutral
    Effect size
    Small
    Dose
    10^9 spores/day plus 400 mg inulin
  • Bacillus coagulans→Reduced Abdominal Distension

    Significant improvements were observed in abdominal pain intensity and frequency, abdominal distension, satisfaction with bowel habits, quality of life, defecation consistency, and patient-reported severity score in both groups; however, only improvement in severity score was significantly higher in probiotic group compared with placebo group (P = 0.001).

    Effect
    Neutral
    Effect size
    Small
    Dose
    10^9 spores/day plus 400 mg inulin
  • Bacillus coagulans→Reduced Abdominal Pain

    Significant improvements were observed in abdominal pain intensity and frequency, abdominal distension, satisfaction with bowel habits, quality of life, defecation consistency, and patient-reported severity score in both groups; however, only improvement in severity score was significantly higher in probiotic group compared with placebo group (P = 0.001).

    Effect
    Neutral
    Effect size
    Small
    Dose
    10^9 spores/day plus 400 mg inulin
  • Bacillus coagulans→Reduced Irritable Bowel Syndrome Symptom Severity Score

    only improvement in severity score was significantly higher in probiotic group compared with placebo group (P = 0.001). Moreover, the frequency of patients with clinical improvement in IBS-symptom severity scale (IBS-SSS) was significantly more in probiotic group compared to placebo group (P = 0.038).

    Effect
    Beneficial
    Effect size
    Moderate
    Dose
    10^9 spores/day plus 400 mg inulin
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