Manandhar Anura, Sabir Ghadeer, Abdelhady Hala A, Oumar Abakar Adoum, Gangavarapu Ravindra Reddy, Mahmud Sayed A, Malasevskaia Iana
Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Internal Medicine and Clinical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2024 Oct 22;16(10):e72089. doi: 10.7759/cureus.72089. eCollection 2024 Oct.
Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are prevalent gastrointestinal disorders with significant global prevalence. Conventional treatments often have adverse effects, prompting interest in probiotics as alternative therapies. This systematic review assesses the efficacy of probiotics in managing symptoms and improving outcomes in adult patients with IBS and IBD. A comprehensive search was conducted across databases such as PubMed, Cochrane Library, and Google Scholar and registers ClinicalTrials.gov and International Standard Randomized Controlled Trial Number (ISRCTN). Using targeted keywords, studies on probiotic efficacy in adult IBS and IBD patients were identified. Data screening, extraction, and quality assessment using the Cochrane Risk of Bias 2 (RoB 2) tool for evaluating randomized controlled trials (RCTs) and Newcastle-Ottawa Scale (NOS) for cohort studies were rigorously performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. From the initial 22,037 references, 18 randomized control trials and two observational studies encompassing 2,675 adults, aged 18-76 years, were deemed eligible. The efficacy of probiotics for IBS and IBD is variable. While some IBS trials show symptom improvement, the results are inconsistent, likely due to the diversity of probiotic strains and patient populations studied. In contrast, probiotics demonstrate more consistent benefits for ulcerative colitis (UC) in IBD, particularly with specific formulations like the De Simone combination. However, probiotics' effects on Crohn's disease (CD) remain less clear, highlighting the need for further research to optimize probiotic regimens and understand their differential effects across the spectrum of IBS and IBD.
肠易激综合征（IBS）和炎症性肠病（IBD）是全球普遍流行的胃肠道疾病。传统治疗往往有不良反应，这促使人们对益生菌作为替代疗法产生兴趣。本系统评价评估了益生菌在管理成年IBS和IBD患者症状及改善预后方面的疗效。我们在PubMed、Cochrane图书馆和谷歌学术等数据库以及ClinicalTrials.gov注册库和国际标准随机对照试验编号（ISRCTN）中进行了全面检索。使用目标关键词，确定了关于益生菌对成年IBS和IBD患者疗效的研究。按照系统评价和Meta分析的首选报告项目（PRISMA）2020指南，严格使用Cochrane偏倚风险2（RoB 2）工具评估随机对照试验（RCT），并使用纽卡斯尔-渥太华量表（NOS）评估队列研究，进行数据筛选、提取和质量评估。从最初的22,037篇参考文献中，筛选出18项随机对照试验和2项观察性研究，纳入了2675名年龄在18 - 76岁的成年人。益生菌对IBS和IBD的疗效各不相同。虽然一些IBS试验显示症状有所改善，但结果并不一致，这可能是由于所研究的益生菌菌株和患者群体的多样性。相比之下，益生菌对IBD中的溃疡性结肠炎（UC）显示出更一致的益处，特别是使用德西蒙组合等特定配方时。然而，益生菌对克罗恩病（CD）的影响仍不太明确，这突出表明需要进一步研究以优化益生菌方案，并了解它们在IBS和IBD范围内的不同作用。
