Long-term probiotic administration for irritable bowel syndrome: a legal need

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Abstract

Background. Irritable bowel syndrome (IBS) is one of the most common functional diseases of the gastrointestinal tract. Violations in the intestinal microbiocenosis play a significant role in the pathogenesis of this suffering. The probiotic strain Bifidobacterium longum 35624® has a strong evidence base for use in the management of patients with IBS. The duration of probiotic therapy and the need for repeated courses of probiotics require further study, which determined the need for this observational study.

Aim. To compare the results of prolonged (12 weeks) and usual duration of courses of probiotic Bifidobacterium longum 35624® in patients with IBS.

Materials and methods. 42 patients with a verified diagnosis of IBS of moderate and severe severity who met the inclusion criteria were recruited into the study. Patients were prescribed probiotic Bifidobacterium longum 35624® at a dose of 1 capsule (1×109 CFU), 1 time per day for 12 weeks. The course of the disease was assessed using the visual analogue scale, visceral sensitivity index (VSI), IBS symptom severity scale (IBS-SSS), quality of life indicators were assessed using the IBS-QoL questionnaire scales. Evaluation of indicators was carried out at the inclusion visit, on days 14, 28, 56, 84 of probiotic intake and on day 112 (28 days after the last dose of Bifidobacterium longum 35624®).

Results. The results obtained confirmed the ability of the probiotic Bifidobacterium longum 35624® to positively influence the course of IBS. The addition of the main therapy with a probiotic made it possible to achieve a significant decrease in the severity of abdominal pain, bloating, and stool disorders. The severity of IBS significantly decreased according to the results of IBS-SSS. Reliable positive dynamics of indicators on the scales IBS-QoL, VSI is shown. The most pronounced changes were observed by the end of the third month of taking Bifidobacterium longum 35624®. Thus, according to the IBS-SSS indicators, only by the end of the third month of observation, some patients achieved remission of the disease. All described changes were persistent and persisted one month after the end of the probiotic intake.

Conclusion. The addition of a prolonged course of the probiotic Bifidobacterium longum 35624® to the basic therapy in patients with IBS allows a more pronounced and lasting effect to be achieved. A “post-probiotic” effect was shown – a decrease in VSI after the end of the intake of the probiotic strain. Given the chronic relapsing course of IBS, the use of repeated probiotic courses was proposed to prevent exacerbation of the disease.

About the authors

Olga I. Solovyeva

Mechnikov North-Western State Medical University

Author for correspondence.
Email: o_solovjova@inbox.ru
ORCID iD: 0000-0003-0037-7855

канд. мед. наук, доц., доц. каф. внутренних болезней, клинической фармакологии и нефрологии

Russian Federation, Saint Petersburg

Anna S. Nekrasova

Mechnikov North-Western State Medical University

Email: o_solovjova@inbox.ru
ORCID iD: 0000-0001-5198-9902

канд. мед. наук, доц., доц. каф. внутренних болезней, клинической фармакологии и нефрологии

Russian Federation, Saint Petersburg

Iulia G. Topalova

Mechnikov North-Western State Medical University

Email: o_solovjova@inbox.ru
ORCID iD: 0000-0003-3999-6848

аспирант каф. внутренних болезней, клинической фармакологии и нефрологии

Russian Federation, Saint Petersburg

Viktoriia A. Ponomarenko

Mechnikov North-Western State Medical University

Email: o_solovjova@inbox.ru
ORCID iD: 0000-0002-0377-6635

аспирант каф. внутренних болезней, клинической фармакологии и нефрологии

Russian Federation, Saint Petersburg

Daredzhan B. Tsurtsumiia

Mechnikov North-Western State Medical University

Email: o_solovjova@inbox.ru
ORCID iD: 0000-0001-7806-9364

канд. мед. наук, доц., доц. каф. внутренних болезней, клинической фармакологии и нефрологии

Russian Federation, Saint Petersburg

Inna G. Ilyashevich

Mechnikov North-Western State Medical University

Email: o_solovjova@inbox.ru
ORCID iD: 0000-0002-5784-2634

канд. мед. наук, доц., доц. каф. внутренних болезней, клинической фармакологии и нефрологии

Russian Federation, Saint Petersburg

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Supplementary files

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2. Fig. 1. Dynamics of the main clinical manifestations of irritable bowel syndrome (BS).

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3. Fig. 2. Dynamics VSI (p<0.0001 compared to the visit 1).

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4. Fig. 3. Dynamics of the average score of the IBS-SSS questionnaire.

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5. Fig. 4. Distribution of patients by severity of IBS during observation.

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6. Fig. 5. Symbiosys Alflorex (3×3) flow regimen (Bifidobacterium longum 35624® Strain) in patients with IBS.

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