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Probiotics' effects on irritable bowel syndrome.

Probiotics (beneficial gastrointestinal bacteria) have produced mixed results in people with irritable bowel syndrome (IBS), depending upon dosage and form of probiotic. Some forms help some people--which isn't surprising when you consider that IBS has a variety of triggers. An estimated one-quarter of the population in Western societies lives with IBS. Medical science does not know why the intestines become more active, producing diarrhea, constipation, abdominal pain, and bloating; but the condition can be triggered by infection, diet changes, stress, and/or low-grade mucosal inflammation. Many IBS patients have abnormal fecal flora. Probiotics are viewed as an attempt to restore healthy gut flora.

At least four bacterial strains have alleviated IBS symptoms in clinical studies. Lactobacillus acidophilus and L. rhamnosus have reduced abdominal pain in both adults and children, according to an article in the journal WDDTY (What Doctors Don't Tell You). Bifidobacterium animalis lessened bloating and discomfort in 274 IBS sufferers with constipation (Aliment Pharmacol Ther. 2007;26:475-486). This year, a patented strain of Bacillus coagulans (B. coagulans GBI-30, 6086) significantly improved abdominal pain and bloating from baseline in a randomized, double-blind, parallel-group, placebo-controlled clinical trial. This product also reduced the incidence of liquidlike stool in Crohn's patients, according to a small company-sponsored randomized, double-blind, placebo-controlled study in 2005 by N. Grandhi. Four of five patients with Crohn's disease who were taking the probiotic could stop taking antidiarrhea medicine at the end of the 60-day trial, compared with one out of six in the placebo group.

Ganeden Biotech Inc. (Mayfield Heights, Ohio) produces B. coagulans GBI-30, 6086. This bacterium differs from lactobacilli-type probiotics in that it forms spores. These spores are heat-resistant and remain viable for at least five years--a real advantage for mass marketing. They also withstand stomach acid and bile. Upon reaching a more favorable environment in the intestines, the spores germinate. Once active, the bacteria form lactic acid, which affects the pH of the intestinal environment. B. coagulans bacteria also produce coagulin, a heat-stable, protease-sensitive substance that inhibits Gram-positive bacteria. (Not all pathogenic bacteria in the gut are Gram-positive.)

Yogurt--even organic yogurt with live cultures (and no sugar)--can worsen IBS in people who are sensitive or allergic to dairy foods. Dr. Stephen Wangen, chief medical officer at the IBS Treatment Center (Seattle, Washington), warns: "A large number of our patients who experience IBS are actually suffering from a dairy allergy but don't realize it. Yogurt, although it is fermented, is still a dairy product and can be a potent trigger of their digestive problems. For these people, the consumption of yogurt, even brands with high probiotic bacteria content, is inadvisable."

Activa and other yogurt touted as digestive cures may make digestive problems worse. Townsend Lett. June 2008:35.

Hubbard B. IBS: is yoghurt a solution? WDDTY. September 2008; 19(6):10.

Hun L, Bacillus coagulans significantly improved abdominal pain and bloating in patients with IBS. Postgrad Med. March 2009; 121(2). Available at: Accessed July 1, 2009.

Lenard L. Optimizing digestive health. Life Extension. January 2009:49-54.

briefed by Jule Klotter
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Title Annotation:Shorts
Author:Klotter, Jule
Publication:Townsend Letter
Article Type:Report
Geographic Code:1USA
Date:Oct 1, 2009
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